Ethical issues and regulation of assisted reproduction

Question 1

Define infertility

Answer 1

Inability to concieve after 1 year of regular unprotected intercourse

Question 2

What are the causes of infertility?

Answer 2

1. No ovulation
2. Tubal factors
3. Endometriosis
4. Male factors
5. Unexplained cause

Question 3

What are forms of assisted reproduction?

Answer 3

1. Artificial insemination with husband semen (AIH)
2. In vitro fertilization (IVF)
3. Freezing of gametes/ embyros/ovarian tissue
4. Sex selection
5. Surrogacy
6. Preimplantation genetic testing (PGT): designer babies
7. Gene editing

Question 4

What is done for ovarian stimulation and artificial insemination with husband semen (AIH)?

Answer 4

Stimulation of ovaries
* Clomid or gonadotrophin
* Increase in number of follicles

Intrauterine insemination
* Sperm preparation and selection
* Timing with hCG
* Close to the site of fertilization

Question 5

What is the IVF procedure?

Answer 5

Ovarian stimulation
Egg collection
Fertilization
Embyro transfer

Question 6

What are the 4 possible side effects of IVF?

Answer 6

• Multiple pregnancies
• Ovarian hyperstimulation syndrome (OHSS): around 4% with abd distension, vomiting, ovarian cysts, fluid inthe abdomen and lung
• Ectopic pregnancies
• Bleeding from the ovaries and pelvic infection

Question 7

What are advantages of IVF?

Answer 7

• Continuation of bloodline
• Successor
• Fulfill other peoples expectations
• A complete happy family

Question 8

Define artificial insemination

Answer 8

To cause conception by delivering sperm to female reproductive tract without sexual intercourse
The naturalness argument

Question 9

What is the objections against homologous and heterologous artificial insemination?

Answer 9

Homologous: masturatbion and nature of the unitive, procreative link as inseperable
Heterlogous:
* 3rd party
* Identity of the donor
* Identity crisis of the future child
* Ethics of anonymity

Question 10

What are the ethical issues surrounding embyros created by IVF?

Answer 10

• Stem cell research requires surplus embyros from IVF
• Many feel uneasy about the creation and manipulation of human embyros in the IVF program
• Creation of embyros require a large number of human eggs: is there coercion or exploitation?
• Commodification of human eggs and the status of women in society

Question 11

What are the issues surrouding surrogacy?

Answer 11

• Who the surrogate mom is matters
• Economic exploitation of the surrogate mother
• Emotional trauma to the surrogate mother
• Emotional trauma to the child born: bonding, separation, identidy

Question 12

What is the argument that surrogacy is wrong?

Answer 12

Economic exploitation of the surrogate mother
Degrages ones human dignity
Encourage a way of thinking of ones body as standing somehow apart from ones self: a false and dangerous conception of personhood

Question 13

What are the 3 important documents for human reproductive technology in HK?

Answer 13

1. The HRT ordinance
2. Licensing manual for HRT centers
3. Code of practise on HRT and embyro research

Question 14

What is the prohibitions for human reproductive technology under the HRT ordinance?

Answer 14

1. Provision of HRT to unmarried persons
2. Sex selection for social reasons
3. Using donated gametes in surrogacy
   arrangement
4. Commercial dealings in gametes or embryos

Question 15

What is the use of the HRT (human reproductive technology) ordinance?

Answer 15

1. To regulate HRT, and use of embryos and gametes for research and other purposes;
2. To confine the provision of HRT procedures to infertile couples;
3. To regulate surrogacy arrangements;
4. To establish a HRT Council; and to provide
   for matters incidental thereto or connected therewith.