Malindi Maughan - British
IVG is the technology dreamed about in Sci-Fi novels, which predicts that the science will be
created in an alternate universe, or a world so far into the future that it no longer looks like ours.
However, the technology is much closer than you think, and it has the possibility of impacting the lives of this generation. IVG is another form of artificial reproductive technology (ART), a way of taking cells and then making a child from them. This process has been commonly accepted within in vitro fertilisation (IVF), as the cells taken are gamete cells that were originally from the parents. However, in IVG, the difference is that instead of gametes being taken for fertilisation, normal cells would be taken, turned into pluripotent calls, and then made into gametes. In this essay, I wish to look at the ethical implications of IVG within six areas: straight couples, homosexual couples, post-menopausal mothers, genetic testing, the ability to provide the countries citizens with the best care and the possible change in society’s perception of families.
IVF has been the go-to for heterosexual couples since the 1970s (Eskew, Ashley M, and Emily S Jungheim), however, it has often been cited as a painful process, thus IVG could be a revolutionary extension of IVF. For heterosexual couples IVG could be used where other ARTs have failed, providing eggs or sperm (that are genetically related to the couple) where the couple is unable to provide. IVF is very gruelling and painful, due to the hormones and procedures that are required to obtain the egg. This is believed to also affect the chance of successful implantation in the short term (Bourne, Hannah et al.). IVG would be able to significantly decrease the suffering that the mother feels, as there would be no need to do any procedures, except the retrieval of cells and the implantation. This is an amazing opportunity for heterosexual couples and could result in significantly decreased physical suffering that the mother would have to go through.
IVG could also be utilised by homosexual couples, who are situationally infertile. The current technology relies on a gamete provider, for example, in lesbian couples where one parent
provides an egg, and there is a sperm donor who is the genetic father, meaning that only one parent is genetically related to the child. IVG can provide a solution to this, through providing a way for both parents to be genetically related to their child. However, there is an argument that, by providing homosexual couples with the opportunity for IVG, the overall emotional suffering for homosexuals would increase. Kamboj, Navjot et al. looked at the mental disorders related to women’s infertility. In their study they showed that infertile women are more prone to mental disorders, such as anxiety, depression, and stress. Through IVG, homosexual couples could have genetically related children.
However, not all homosexuals would be able to have genetic children despite IVG (due to either the price or failed implantation); therefore, negative feelings around fertility could be propagated, possibly leading to the mental disorders that are referenced above. However, if IVG was to be provided to heterosexual couples and not homosexual couples, due to the belief that it would increase their emotional suffering, it would impact homosexuals couples’ autonomy to choose if they want to be involved with IVG or not.
Furthermore, the possible joy that new-found parents would feel would outweigh the possible
negative emotions felt by couples that could not benefit from IVG. Overall, IVG would be revolutionary addition to the ARTs that are available to homosexual couples and could greatly
add to homosexual couples’ lives.
IVF is not a guarantee, as only 46% of first implantations work, with the number then decreasing after the initial implantation (Wang, Yangyang et al.). There are many reasons as to why there are fewer implantations, but a significant reason is due to the age of the eggs; where the eggs are older, they have a decreased likelihood of working. IVG would remove this factor and allow
older parents to not worry about the effects of their older eggs. IVG could also provide an amazing opportunity for women who want to have children after they have gone through menopause. IVG would remove the time constraints on having children, as it removes the need for eggs. It would stop the pressure around women's age and allow women to pursue a career. This provides women with greater autonomy over their lives, allowing them, not their bodies, to dictate when they have children. There are many benefits to removing the time pressure for reproducing for women; however, there could be an inadvertent impact on the children of these older parents. People could have parents that die much earlier in their lives, due to the parents being much older when they are born. This could have a negative impact on the child’s mental health and mean that many important milestones in the child’s life will be missed. If IVG were to be implemented, there would have to be regulations regarding the age of the parents. There are currently some proposed suggestions that would reduce the impact of the parents’ age on the child’s life, such as the parents having a combined age of 100, or having the parents’ mean age of 55. These precautions would reduce the inadvertent negative impact on a child’s life that could occur from having parents that are much older. Even though this would add to the time pressure on the parents, it would still substantially increase the reproductive age by at least 5 years. Overall, IVG can provide women who want children later with an option to have genetic children. However, if it were to be implemented, there would have to be regulations as to the upper age limit.
IVG could increase genetic selection. This could allow for parents, who have a tendency towards certain genetic disorders to produce children without genetic disorders. An example is cystic fibrosis, which is associated with a shorter lifespan yet is genetically recessive. People could use IVG without the fear that their children would inherit a disease, like cystic fibrosis. This is because IVG allows for the creation of many more embryos, which then increases the likelihood that an embryo with a certain characteristic would be selected (Bourne, Hannah et al.)
However, there are fears that this would cross the line of harm prevention and stray into eugenics. If IVG were to be implemented, there would have to be strict regulations around genetic testing, just as there are currently very strict regulations around genetic modification. Currently, genetic testing is regulated to varying degrees around the world, implementing either soft or hard approaches (Ginoza, Margaret E C, and Rosario Isasi). If IVG is implemented, there would have to be very stringent global measures regarding the levels of genetic testing allowed.
Globally, IVG could cause a significant change. IVG could be used by other countries to increase tourism in the form of fertility-tourism. The regulations implemented regarding the treatment would vary globally, and as a result, the quality of IVG would also vary. This is seen through case study of Greece in the context of IVF, which nurtured fertility tourism, due to the need for a form of international income to assist the country financially. People were then able to travel to get treatment in Greece, whereas they might not have had the same treatment in their own country. (Paraskou, Anastasia, and Babu P George). This consequence of denying IVG to certain populations is dangerous, as it could lead people to seek IVG where it is practiced, possibly leading to them being subjected to unsafe procedures. This could mean that practicing IVG would overall protect the citizens. Furthermore, IVG has the possibility of being abused: people could become parents without their knowledge; there could be children with one genetic parent, leading to an increased probability of genetic diseases for the child; people could become parents while they are still children, or after they have died. With all new technology there is a possibility of abuse, and IVG is no different. The abuse of IVG has the possibility of enacting substantial harm to the people involved. For these scenarios to be stopped or reduced,there would have to be significant regulations in place. The clinics that would provide IVG would have to be regulated and monitored.
Furthermore, to prevent people from becoming parents without their knowledge or consent, both parents would have to be present for the procedures, amongst other controls. Overall, IVG could be abused, creating many undesirable consequences. However, if the right regulations were implemented, then IVG could provide more benefits than harm.
Throughout society, we have generally heralded the nuclear family as the gold standard; however, IVG can provide a new chance for many different forms of family to have genetic children. This is hoped to reduce the stigma around different family types, and lead to a more accepting society in all. IVG can lead to more than two genetic parents. If there were to be four parents, the cells for the four parents could be combined to create one embryo. This would mean that each parent would be related to the child by 25% (there are other modified uses of IVG that would change the proportion of genetic inheritance) (Notini, Lauren et al.). There are many families that would be able to be genetic parents for the first time due to IVG: multiple parents, older parents, and homosexual parents. This change in the type of genetic parents could change societies’ perceptions on previously ostracised groups. This would further reduce overall stigma, and hopefully lead society to be more accepting and accommodating generally. However, IVG could propagate the belief that having genetically related children is the gold standard. This is a dangerous belief, as it could decrease the number of adoptions and foster parents. However, over the last 30 years, the stigma around adoption has decreased (Walkner, Amy J, and Martha A Rueter). With the resultant increase in different families due to IVG, there could be greater social acceptance of all different types of families, not exclusively genetically related families. Ultimately,this will lead society to become more accepting of different families.
In conclusion, I believe that we should move forward with IVG. IVG can provide many people
with substantial benefits, giving many different families the possibility of having children, where
previously they had no chance. IVG, however, could cause inadvertent negative impacts, such
as parents being much older when they have children, or the chances for abuse. However, strict
regulations could be implemented, such as having an upper age limit or regulating the amount of genetic testing. This would reduce the risks associated with the use of IVG, and so the benefits of IVG would outweigh the potential risks. Providing people with the chance to have their own genetically related children is a privilege that should not be stopped due to the fears of
abuse.
Bibliography:
Kamboj, Navjot et al. “Women infertility and common mental disorders: A cross-sectional study
from North India.” PloS one vol. 18,1 e0280054. 5 Jan. 2023, doi:10.1371/journal.pone.0280054
Ginoza, Margaret E C, and Rosario Isasi. “Regulating Preimplantation Genetic Testing across
the World: A Comparison of International Policy and Ethical Perspectives.” Cold Spring Harbor
perspectives in medicine vol. 10,5 a036681. 1 May. 2020, doi:10.1101/cshperspect.a036681
Paraskou, Anastasia, and Babu P George. “The market for reproductive tourism: an analysis
with special reference to Greece.” Global health research and policy vol. 2 16. 12 Jun. 2017,
doi:10.1186/s41256-017-0037-8
Notini, Lauren; Gyngell, Christopher; Savulescu, Julian. "Drawing the line on in vitro
gametogenesis" Bioethics. 2020 Jan; 34(1): 123–134. Published online 2019 Oct 15, doi:
10.1111/bioe.12679
Wesevich, Victoria G et al. “In Vitro Gametogenesis in Oncofertility: A Review of Its Potential
Use and Present-Day Challenges in Moving toward Fertility Preservation and Restoration.”
Journal of clinical medicine vol. 12,9 3305. 6 May. 2023, doi:10.3390/jcm12093305
Suter, Sonia M. “In vitro gametogenesis: just another way to have a baby?.” Journal of law and
the biosciences vol. 3,1 87-119. 17 Dec. 2015, doi:10.1093/jlb/lsv057
Walkner, Amy J, and Martha A Rueter. “Adoption status and family relationships during the
transition to young adulthood.” Journal of family psychology : JFP : journal of the Division of
Family Psychology of the American Psychological Association (Division 43) vol. 28,6 (2014):
877-86. doi:10.1037/fam0000020
Wang, Yangyang et al. “The number of previous failed embryo transfer cycles is an independent
factor affecting implantation rate in women undergoing IVF/ICSI treatment: A retrospective
cohort study.” Medicine vol. 100,9 (2021): e25034. doi:10.1097/MD.0000000000025034
Bourne, Hannah et al. “Procreative beneficence and in vitro gametogenesis.” Monash bioethics
review vol. 30,2 (2012): 29-48. doi:10.1007/BF03351338
Eskew, Ashley M, and Emily S Jungheim. “A History of Developments to Improve in vitro
Fertilization.” Missouri medicine vol. 114,3 (2017): 156-159.
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