Bioethics in Faith and Practice, Volume 4, Number 1

9 Bioethics in Faith and Practice ⦁ 2019 ⦁ Volume 4 ⦁ Number 1 Bioethics in Faith and Practice vol. 4 no. 1, pp. 9-26. ISSN 2374-1597 © 2019, Breanna Beers, licensed under CC BY-NC-ND ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ) Direction Determines Destination: The Ethics of IVF Breanna Beers Cedarville University Introduction Since the birth of Louise Brown in 1978, 1 in vitro fertilization (IVF) has become a widely accepted infertility treatment option. It’s an expensive and involved procedure, typically only sought out when other fertility therapies fail. By allowing fertilization to take place in a highly controlled environment using only healthy gametes, IVF gave hope to many couples who previously had no further recourse for treatment. The IVF procedure takes place over several weeks, timed according to the would-be mother’s menstrual cycle. Couples undergo a number of pre-cycle tests to identify any relevant factors that may influence treatment. 2 Treatment protocol often varies among individuals, but women wishing to conceive typically take birth control pills for several days or weeks before beginning a cycle in order to control cycle timing, follicle development, or other factors. Once it is time for the treatment cycle to begin, ovulation is stimulated using gonadotropins and a gonadotropin-releasing hormone (GnRH) agonist or antagonist. 3 Gonadotropins are hormones that play a role in stimulating egg production in women; the GnRH agonist or antagonist prevents the dominant oocyte follicle(s) from being ovulated before the others have time to fully develop. This combination allows as many mature eggs as possible to be obtained. 4 Next, the eggs must be retrieved from the ovaries. About 36 hours before the procedure, ovulation is induced by taking human chorionic gonadotropin. A needle is inserted up the vagina and through the vaginal wall to puncture the ovary. The follicular fluid is then extracted and taken to the laboratory to isolate the eggs. Usually, the patient is under anesthesia during this procedure. 5 Once the eggs have been isolated, they are fertilized in vitro by either conventional fertilization or by intracytoplasmic sperm injection (ICSI). Under the conventional method, healthy sperm are isolated from the provided sample and simply exposed to the eggs for natural fertilization. ICSI involves manually injecting sperm into the egg, which may increase fertility rates, especially in cases of male-factor infertility. 6 ICSI is becoming an increasingly popular technique in many clinics; in 2012, more than three-quarters of 1 Craig Niederberger et al., "Forty Years of IVF," Fertility and Sterility 110 (2018), 185-324. 2 Craig Niederberger et al., "Forty Years of IVF," Fertility and Sterility 110 (2018), 185-324. 3 Artur Wdowiak, Edyta Wdowiak and Iwona Bojar, "Improving the Safety of the Embryo and the Patient during in Vitro Fertilization Procedures," Wideochir Inne Tech Maloinwazyjne 11 (2016), 137-143. 4 Qiaohong Lai et al., "Comparison of the GnRH Agonist and Antagonist Protocol on the Same Patients in Assisted Reproduction during Controlled Ovarian Stimulation Cycles," International Journal of Clinical and Experimental Pathology 6 (2013), 1903-1910. 5 Wdowiak, "Improving the Safety of the Embryo and the Patient during in Vitro Fertilization Procedures," , 137- 143 6 Craig Niederberger et al., "Forty Years of IVF," Fertility and Sterility 110 (2018), 185-324).