Ethics of Assisted Reproduction Flashcards
When is pre-implantation tissue typing allowed?
For the treatment of an existing child who is affected by a serious or life threatening condition
What are the UK rules with regards to sex selection?
Illegal, unless there is a risk of a serious medical disorder linked to gender i.e. X linked haemophilia or muscular dystrophy
How is sex selection done?
Pre-implantation genetic diagnosis
When is creating an embryo with two genetic mothers allowed?
To treat serious mitochondrial disease
What are the situations in which it is acceptable to refuse fertility treatment?
Issues for the welfare of the child, reduced chance of success, increased risk of harm, when it is illegal (i.e. for sex selection)
What may be some reasons to refuse fertility treatment with regards to welfare issues for the child?
Drug addiction, history of domestic abuse, homelessness
What is the main reason that fertility treatment would be declined for reduced chance of success?
Older age of the mother
What are some reasons that fertility treatment may be refused on the NHS for increased risk of harm? These patients can be treated how?
Obesity/smoking - may be treated if they go private
If a female has a BMI higher than what, fertility treatment will be declined ever if they go private?
> 35
What are the NHS criteria for fertility treatment with regards to the age of the female?
< 40 at time of treatment, < 41 at frozen embryo transfer
What are the NHS criteria for fertility treatment with regards to the duration of infertility?
> 2 years
What are the NHS criteria for fertility treatment with regards to the duration of a stable relationship?
At least 2 years
What are the NHS criteria for fertility treatment with regards to the BMI of the female?
> 18.5, < 30
What are the NHS criteria for fertility treatment with regards to sterilisation?
Neither partner can be sterilised
What are the NHS criteria for fertility treatment with regards to smoking?
Both partners need to be non-smoking for at least 3 months pre-treatment and during treatment (including any form of replacement therapy)
What are the NHS criteria for fertility treatment with regards to illegal and abusive substances?
Both partners must abstain
What are the NHS criteria for fertility treatment with regards to methadone?
Both partners must be methadone free at least 1 year pre-treatment
What are the NHS criteria for fertility treatment with regards to alcohol?
Neither partner should drink alcohol prior to or during treatment
What are the NHS criteria for fertility treatment with regards to previous children?
Eligible if one partner has no biological children
How many cycles of ART will a female aged < 40 get on the NHS?
3
How many cycles of ART will a female aged 40-42 get on the NHS? What are the rules for this?
1 - the female must never have had fertility treatment before, no evidence of poor ovarian reserve, in the patient’s best interests
Does an embryo/foetus have rights?
No, not until it is born
Embryonic research is permitted until when? Why is this?
14 weeks - when the primitive streak appears
Abortion for social reasons is permitted until when?
24 weeks
When can abortion be performed later than 24 weeks?
If the baby is severely handicapped or there is a significant risk to maternal life
Do sperm/egg donors get paid?
Not paid, but they do receive compensation (this is higher for the female since they undergo invasive procedures with more risks)
Are sperm/egg donors kept anonymous?
No, the child has the right to their information once they are 18
What happens if not enough people in a unit are supportive of fertility treatment for a couple?
They cannot have treatment there, but they can try somewhere else
After a major life change during fertility treatment e.g. death of one partner or a break up, what should be done?
Things should be left for at least a year to see what happens and if the person changes their mind
