Advances in Fertilization

Advances in Fertilization Many options exist for couples who want to have children but cannot conceive on their own There are different forms of assisted reproductive technology (special medical techniques) that are used to help a woman become pregnant

In-Vitro Fertilization In-vitro fertilization is the joining of a woman’s egg and a man’s sperm in a laboratory dish Fertility drugs are used to stimulate the release of eggs which are removed from the body and inseminated or mixed with the sperm The eggs and sperm are stored in an environmentally controlled chamber The sperm enter the eggs within a few hours of insemination When the eggs divide it becomes an embryo Embryos are monitored form normal growth and implanted into the uterus 3-5 days after fertilization

IVF today First “test tube” baby has own baby http://london.ctvnews.ca/first-test-tube-baby-born-in-canada-becomes-a- dad-1.1670598

Why use in-vitro? Women who have difficulty getting pregnant Blocked or damaged fallopian tubes Women with ovulation disorders Women who have had their fallopian tubes removed Male factor infertility Decreased sperm count or sperm motility Unexplained infertility Genetic disorder

Things to consider High costs Doesn't guarantee pregnancy $10,000 round Doesn't guarantee pregnancy Possibility of multiple births http://www.cbc.ca/player/play/1822181531

Surrogacy A surrogacy arrangement is the carrying of a pregnancy for intended parents There are 2 main types of surrogacy Gestational surrogacy Pregnancy results from embryo created by in-vitro fertilization with the mother’s egg and farther sperm Resulting child is genetically unrelated to the surrogate Genetic surrogacy The surrogate is artificially inseminated with the father’s sperm so the resulting child is genetically related to the surrogate Surrogacy is legal in Canada, however, compensation for surrogacy is prohibited

Surrogacy Under the assisted human reproduction act (2004), a surrogate mother may only be reimbursed for out of pocket expenses (ie they can’t pay you for carrying the baby, but can pay for medical expenses, food etc…) Surrogacy arrangements in Canada are typically accompanied by legal contracts Issues regarding the custody of the child after birth and what would happen if an abnormal or health issue is noticed before the birth would be addressed in the contract

Surrogacy http://globalnews.ca/news/2879259/surrogacy-in-canada-what-you-need- to-know/ International Surrogacy https://www.youtube.com/watch?v=L6ahtCd6OGo

Artificial Insemination Technique that can help treat certain kinds of infertility in both men and women Sperm are inserted directly into the cervix, fallopian tubes, or uterus, making the trip to the egg shorter for the sperm and bypassing any possible obstructions Most common form of artificial insemination is intrauterine insemination in which the sperm is placed in the uterus

Sperm & Egg Donation Why do people need sperm or eggs? They can’t get pregnant using their own sperm or eggs, because of infertility or some other health problem. They need donor sperm, eggs, or embryos to build their family (like in the case of a same sex couple or a single mother). They have a genetically inherited condition that they want to avoid passing on to their children.

Egg Donation When the ovaries may no longer be producing normal eggs, eggs (ovum) can be donated by another person Donor eggs are typically obtained from an anonymous or known donor. The donors undergo infectious disease screening, psychological counseling, and medical screening. A donor egg cycle is very similar IVF cycle, with the exception that the donor receives the stimulation medications and undergoes the egg retrieval procedure The embryos that develop from the donor eggs and the male partner’s sperm are then transferred into the recipient (female partner). child will only be genetically related to the male partner both partners are the parents, and the female partner carries the pregnancy.

Sperm Donation Donors are required to undergo a rigorous screening process involving physical examination, in-depth family history and tests for transmittable bacterial, viral and genetic abnormalities You can remain anonymous If you initially donated on an anonymous basis, you can later ask that your records be changed to show that you now consent to having your identity revealed to a person born as a result of your donation. If you agree to release your identity, whether you are ever contacted will depend on the individual(s) who received your donation http://heartlandfertility.mb.ca/en/your-team/medical-team/

Legal Issues Legal issues Canadian law says that you must: be at least 18 to be a donor give written consent to use your eggs, sperm, or embryos before they can be used by a clinic or doctor in a medical procedure agree in writing to certain legal rules relating to your donation In Canada, compensation to the donor for egg/sperm donation is not allowed. Donation in Canada is performed for altruistic reasons.

Sperm & Egg Donation Why do people donate? feel empathy for someone who has gone through the pain of infertility know someone who is/was a donor are approached to donate by someone you know want to help a close friend or family member to become a parent want to help a complete stranger to experience the joy of having a child consider this another way to selflessly help others

Why so many fertility issues? http://globalnews.ca/news/3070201/reality-check-are-fertility-problems-on- the-rise/

Journal Entry If you were unable to conceive a child naturally, what method do you think you might pick? Explain why you would pick this option. How do you feel about international surrogacy (ie - paying someone to carry your baby – other than “out of pocket” expenses) Do you think this is a good thing, or is it exploiting women in poor countries or those coming from lower socioeconomic status.