Ethics of Assisted Reproduction

Question 1

When is pre-implantation tissue typing allowed?

Answer 1

For the treatment of an existing child who is affected by a serious or life threatening condition

Question 2

What are the UK rules with regards to sex selection?

Answer 2

Illegal, unless there is a risk of a serious medical disorder linked to gender i.e. X linked haemophilia or muscular dystrophy

Question 3

How is sex selection done?

Answer 3

Pre-implantation genetic diagnosis

Question 4

When is creating an embryo with two genetic mothers allowed?

Answer 4

To treat serious mitochondrial disease

Question 5

What are the situations in which it is acceptable to refuse fertility treatment?

Answer 5

Issues for the welfare of the child, reduced chance of success, increased risk of harm, when it is illegal (i.e. for sex selection)

Question 6

What may be some reasons to refuse fertility treatment with regards to welfare issues for the child?

Answer 6

Drug addiction, history of domestic abuse, homelessness

Question 7

What is the main reason that fertility treatment would be declined for reduced chance of success?

Answer 7

Older age of the mother

Question 8

What are some reasons that fertility treatment may be refused on the NHS for increased risk of harm? These patients can be treated how?

Answer 8

Obesity/smoking - may be treated if they go private

Question 9

If a female has a BMI higher than what, fertility treatment will be declined ever if they go private?

Answer 9

> 35

Question 10

What are the NHS criteria for fertility treatment with regards to the age of the female?

Answer 10

< 40 at time of treatment, < 41 at frozen embryo transfer

Question 11

What are the NHS criteria for fertility treatment with regards to the duration of infertility?

Answer 11

> 2 years

Question 12

What are the NHS criteria for fertility treatment with regards to the duration of a stable relationship?

Answer 12

At least 2 years

Question 13

What are the NHS criteria for fertility treatment with regards to the BMI of the female?

Answer 13

> 18.5, < 30

Question 14

What are the NHS criteria for fertility treatment with regards to sterilisation?

Answer 14

Neither partner can be sterilised

Question 15

What are the NHS criteria for fertility treatment with regards to smoking?

Answer 15

Both partners need to be non-smoking for at least 3 months pre-treatment and during treatment (including any form of replacement therapy)

Question 16

What are the NHS criteria for fertility treatment with regards to illegal and abusive substances?

Answer 16

Both partners must abstain

Question 17

What are the NHS criteria for fertility treatment with regards to methadone?

Answer 17

Both partners must be methadone free at least 1 year pre-treatment

Question 18

What are the NHS criteria for fertility treatment with regards to alcohol?

Answer 18

Neither partner should drink alcohol prior to or during treatment

Question 19

What are the NHS criteria for fertility treatment with regards to previous children?

Answer 19

Eligible if one partner has no biological children

Question 20

How many cycles of ART will a female aged < 40 get on the NHS?

Answer 20

3

Question 21

How many cycles of ART will a female aged 40-42 get on the NHS? What are the rules for this?

Answer 21

1 - the female must never have had fertility treatment before, no evidence of poor ovarian reserve, in the patient’s best interests

Question 22

Does an embryo/foetus have rights?

Answer 22

No, not until it is born

Question 23

Embryonic research is permitted until when? Why is this?

Answer 23

14 weeks - when the primitive streak appears

Question 24

Abortion for social reasons is permitted until when?

Answer 24

24 weeks

Question 25

When can abortion be performed later than 24 weeks?

Answer 25

If the baby is severely handicapped or there is a significant risk to maternal life

Question 26

Do sperm/egg donors get paid?

Answer 26

Not paid, but they do receive compensation (this is higher for the female since they undergo invasive procedures with more risks)

Question 27

Are sperm/egg donors kept anonymous?

Answer 27

No, the child has the right to their information once they are 18

Question 28

What happens if not enough people in a unit are supportive of fertility treatment for a couple?

Answer 28

They cannot have treatment there, but they can try somewhere else

Question 29

After a major life change during fertility treatment e.g. death of one partner or a break up, what should be done?

Answer 29

Things should be left for at least a year to see what happens and if the person changes their mind