Beginning of life ethics Flashcards
What is infertility?
A woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse [in the absence of any known cause of infertility, should be offered further clinical assessment and investigation along with her partner]
Couples who’ve been trying to conceive for more than 3 years the likelihood of getting pregnant naturally within the next year is 25% or less. True or false?
True
List 3 factors affect a woman’s fertility?
Abnormal ovulation (e.g. polycystic ovary syndrome, early menopause)
Damage to Fallopian tubes (e.g. surgery, PID)
Endometriosis
List 2 factors that affect a man’s fertility?
Low sperm count/quality
Damage to testicles and/or failure to ejaculate
List 5 Assisted Reproductive Technology based methods to treat infertility
Intrauterine insemination (IUI)
In vitro fertilisation (IVF)
IVF with intracytoplasmic sperm injection (ICSI)
Use of donor sperm/eggs
Surrogacy
define Ovarian hyperstimulation syndrome
Occurs when a woman’s ovaries swell and leak fluid into the body. This condition is a complication that can occur in women who receive fertility treatments that stimulate the ovaries to produce more eggs than usual.
There are rare cases of OHSS occurring spontaneously.
name 2 risks associated with IVF
Transferral of several embryos – multiple births - Recommendation is for single embryo transfer
Welfare of the child -> 1990: the need for a father. ->2008: the need for supportive parenting
How does supportive parenting impact the treatment a women can receive?
A woman shall not be provided with treatment services unless account has been taken of the welfare of any child who may be born as a result of the treatment (including the need for supportive parenting), and of any other child who may be affected by the birth.
What are the Guidelines for IVF in Scotland (updated 2017, from 2013) for 40-42 yr olds?
what’s the max number of cycles they are given?
no IVF before
no evidence of low ovarian reserve
also discuss the implications of IVF and pregnancy at this age
only given 1 cycle of IVF if they’ve had;
women aged 40+ how many cycles of IVF are they given?
only given 1 cycle of IVF
how many cycles of IVF are women given if they are aged less than 40?
3 cycles of IVF
What are the Guidelines for IVF in Scotland (updated 2017, from 2013) for less and 40yr olds?
infertility with an appropriate cause of any duration or unexplained
unexplained infertility of two years - heterosexual couple
unexplained infertility following 6 to 8 cycles of donor insemination - same sex couples
Describe some of the risks associated with IVF for the mother?
ectopic pregnancy - 3% of IVF pregnancies result in this
ovarian hyperstimulation syndrome
multiple pregnancies miscarriage pregnancy-related high blood pressure and pre-eclampsia gestational diabetes anaemia and heavy bleeding needing a caesarean section
Describe some of the risks associated with IVF for the child?
low birth weight
premature birth
congenital birth defects.
explain why children born via IVF are more likely to have birth defects
Patients undergoing IVF are older than the general fertile population and increased female age increases the risk for a genetic abnormality
