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In-Vitro - Bio 490 - Med. Eth. in Repr. Tech.

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by

Jacob Lauer

on 6 November 2013

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Transcript of In-Vitro - Bio 490 - Med. Eth. in Repr. Tech.

Background of In-Vitro Fertilization and Ethical Implications
Outcomes
Advantages/Disadvantages:
Infertile or homosexual couples
Success Rate
Cost
Multiple births
Regulations and coverage

To externally fertilize an egg with sperm to produce a viable embryo to develop in-vivo and produce offspring.
Purpose
http://www.foxnews.com/health/2012/10/22/in-vitro-fertilization-may-increase-risk-birth-defects/
Agenda:
Purpose
Techniques and Connections
Historical Aspect
Outcomes
Implications: Ethical, Monetary, Medical, Familial

Background - What is IVF?
http://health.india.com/sexual-health/louise-brown-the-worlds-first-test-tube-baby-celebrates-34th-birthday/
Steps:
Eligibility
Super-stimulation with FSH
Monitor egg health, prime oocytes retrieved
Transfer to medium
Fertilization with sperm
Maintain environment for growth
Transfer of embryo into uterus.
Techniques
Medical Aspects:
Short and long-term health (mental and physical) on child and mother
Birth defects
Variables and exposure of in-vitro environment

Socioeconomic bias
Insurance
Embryo "left-overs"
Emotions/Feeling/Claim over child
Further Implications
http://ambassadors.net/archives/issue25/features2.htm
http://www.paradigmhealthcare.in/IVF.html
http://fertilitysuccessrates.com/ivfclinics/West-Allis/Aurora-Fertility-Services-West-Allis-Memorial-Hospital/report403.html
First "test-tube" baby: Louise Joy Brown - July 25,1978
Since: 5 million IVF babies according to NBC news (Oct. 14, 2013) and ICMART
IVF Timeline

Historical
www.telegraph.co.uk
Socioeconomic bias
Insurance Coverage
Maeve (Infertile Couple)
May or may not be covered depending on location
Insurance provider view: is it a disease?
Waste/Embryo Leftovers
Jake (Recipients)
Feelings and Ethics of disposal/Waste
Paying for waste/preservation
Preserve for possible future births
Feelings of Donation
Parental/Child Emotions and Claims
Discussion Questions
What are your thoughts on how to deal with excess embryos preserved after IVF?

Do you have any additional comments on the human/personhood status of fertilized embryos? What characteristics would you use to define personhood or human status of the embryo? What perspectives have you read or heard that you agree or disagree with?

What sort of economic or social implications would result from legally binding surrogates to ensure that parties involved remain loyal to the obligations of IVF initially agreed upon?

Does it seem ethical to be a paid donor of embryos?

Considering that the divide between low and high income earners is increasing, how might that affect IVF use/access?
Maeve (Lower Income)
Unequal access
Programs for equal access
Income/Raising correlation
Jake (Higher Income)
More accessible
Ability to cover the costs
Ability to raise child well due to socioeconomic standing
Insurance coverage
Jake (Fertile/Government)
Mandated WI coverage
ACA coverage after 2014
States choose EHBs
Pay for coverage not using
http://www.resolve.org/get-involved/legislative-issues/blog/what-the-affordable-care-act-does-wrong.html
http://www.insurancequotes.com/health/infertility-treatment
Maeve (Medical)
Research
Embryonic Stem Cells
Jake (Children)
Stigma
Privilege/Favored
Belongingness
Maeve (Parents/Donor)
Emotional toll vs. gain
Who's child?
Connections
PGD/GCT
Surrogacy
Cryopreservation
Gamete Donation
Reproductive Toxicology
IVF Timeline
1968 - Robert Edwards and Patrick Steptoe perform first successful IVF.
1969 - Results published in journal Nature.
1975 - Edwards and Steptoe have first successful implantation. The implantation occurs in the fallopian tube of the patient and the pregnancy is unsuccessful.
1977 - First successful egg removal, external fertilization, and implantation of embryo.
1978 - Louise Brown arrives by C-section.
1979 - The U.S. E.A.B. board approves Federal funding of IVF research. (60%, 1/2 would try).
1980 - First IVF clinic, Vatican opposes, public opinion shifted to support.
2004 - Natalie Brown, 450 IVF clinics in U.S., 1/2M IVF babies.

Sample IVF Cost Calculations
-Example #1: $12,850
35 year old patient using own eggs. Preserve remaining embryos. 51% clinic live birth rate.
-Example #2: $33,710
36 year old patient using own eggs. Assisted hatching, ICSI, 40% clinic live birth rate.
-Example #3: $83,540
38 year old patient using own eggs with surrogate. Blastocyst transfer, ICSI, PGD. 63% clinic live birth rate.

Sources
Questions???
http://www.indiwall.com/wallpaper/jim-carrey-as-the-riddler-wallpaper/
Discussion Questions
Knowing the trend of decreased fertility, what does this mean for the future of IVF?

How could or should IVF be better regulated at any level?

What are some potential concerns that may arise from egg sharing?

What are some dangers and benefits that could be associated with multiple pregnancies in IVF?
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