Assisted Conception and Related Issues

Issues and Cross References

textual corrections made 8th March 2005

Paths to viable zygotes

Because of the developments in cell handling and manipulation technology there are a range of paths to viable zygotes.

Only the traditional IVF process has been thoroughly tested for use on humans.

Some of the others, tested and used on animals still have a number of problems aside from the ethical issues which are raised.  The main problem being that although a zygote is produced there are a large number in which the genetic material is badly damaged. Often this is not seen until the foetus is delivered.

Once the technical problems are thoroughly researched and genetic damage eliminated some of these may eventually offer paths to viable human zygotes and blastula for implantation. For a discussion on the issues involved in the paths follow the appropriate link.

 

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Aged Mothers.

21st June 2001

Announced in the press and on television.

A French man, Robert Salomone, 52, has fathered two babies by IVF. The eggs were supplied by an American woman, who also was the surrogate mother for one of the infants. The other was carried by his sister, Jeanine Salomone, who is 62. The babies are called, Benoit-David who was carried by Miss Salomone, and Marie-Cecile who was carried by the American woman (unnamed).

Relationships:

Much has been made in the press over the fact that Benoit-David is his father's nephew, because his aunt is his birth mother. It emphasises the potential for confusion which may be exploited particularly if someone wants to make a story or deliberately cause trouble. However distinctions need to be carefully kept.

The genetic relationships are simple. Robert Salomone is the genetic father of both infants, as is the American woman.

The American woman is also the birth mother of Marie-Cecile. This woman must have given prior consent for the adoption of her daughter by Robert and Jeanine.

Jeanine Salomone is the genetic aunt of both infants, and the surrogate mother to Benoit-David.

(Check these details:

  1. Is the American woman both the donor and surrogate for Marie-Cecile? - Yes
  2. Was Jeanine Salomone directly genetically involved in either infant? - No

Both of these pieces of information is checked as correct. on BioNews on the 25th. June 2001)

What was the foundation for the accusation of incest.

It appears to be the fact that a sister carried her brothers baby, even though there was no intercourse. Surrogacy is not incest. The motivation in incest is about the sexual attraction between brother and sister. However Jeanine's motivation would seem to be that she wanted to be involved in the process of providing an heir to her mothers fortune.

Issues:

For the babies and the parents

Through IVF two infants are being brought up by two aged parents.
When the children become old enough to go to school and start taking their place in society the disadvantage for them is that their nominal mother, and their father will both look and be old enough to be grandparents or great-grandparents.

Irrespective of the outrage that some may feel - the future of the two infants must be considered.
Emotional knee-jerk reactions may cause long term problems for the infants. Strong emotional reactions generated in the local community may cause later social exclusion problems both for the family, and the infants. Although newspaper and television interviews with neighbours suggest that this family are already socially isolated.
Headlines about incest, and other such problems only cloud the attempt to find genuine paths, not just for the infants, but also for the whole of the IVF process and subsequently the cloning process.

Are potential emotional problems for the children one of origins or one caused by the attitudes of the community or the professionals involved? Asked to go an meet a family to arrange a baptism, or a wedding it doesn't ease the process if you ask the babies mother if she is the grandmother, or if you ask the bride's intended if he is her father. This gets the relationship of to a bad start. It's embarrassing both for the family and for the minister (or other professional). While it is possible to learn ways around this. It highlights the problem for all social relationships.
Expectations of who is who are generated on averages of what we have previously encountered. Most mothers with babies are under 35, most fathers with young families are under 40. In order to smooth social interaction people make assumptions and do so in order to speed up relationship building. We don't want to have to think in extensive detail about who is who every time we meet someone new. Life is too short for that.

Motives are also a problem.
The apparent intention was to produce heirs for a family fortune.  (Will the relationship remain caring or become jealous)
If there really is a lot of money around, then nannies will not be a problem when the burden of child rearing becomes too much for the elderly father and his sister. It gives a new edge to "born with a silver spoon in his mouth".

Dangers for IVF and human cloning

IVF has helped many otherwise childless couples have families. This is both within the normal band for parenthood, and within the normal idea of a family being a man and a woman committed to each other for the purpose of raising children. Are these guidelines transparent and open to public discussion.

This case is outside these parameters, and was only achieved by deliberate deception on the part of Salomones. It therefore raises questions about verification of identity, and concerns about ensuring adequate nurture for the infants so produced. Should there be a more severe test for all than that of simply a man and a woman getting together and deciding to start a family.

Responsibility relationships may become a significant part of the key for defining parenthood. i.e. who caused the babies to be born, or for whom were they given birth.  Inheritance could be through legal relationships founded upon responsibility relationships.

note: BioNews 25/6/2001 reports the reaction of the Pacific Fertility Centre which carried out the Salomones IVF procedures. "Dr Vicken Sahakian, who carried out the treatment and arranged the surrogacy, said 'they had the same name and I wasn't going to ask for their wedding certificate'. He added, 'I would never have undertaken these fertilisations if I had known'".

Deception

A legal issue may arise in the American adoption. The brother and sister presented themselves as a childless married couple. In America irrespective of a surrogacy agreement there may be invalidation of the agreement concerning Marie-Cecile because the relationship was not as presented. Deception within the legal system is a perjury, and punishable.

The donor mother may also feel that there is a problem. Her eggs were donated to a false cause, and she too has rights. She is the genetic mother of both infants, and the birth mother of one. Allowing deception to continue unchallenged may make some woman more uncertain about being donors.

Genetic and Nurture parenting

Adoption agencies in the UK cope adequately with the difference between genetic and nurture parenting. There may be lessons to the be learnt from that area, and from the family support given. Adopted children have their own care worker. Who has a different responsibility to the adoptive parents.

When a child should know about its origins should not be left to nurture parents. In the UK each adopted child has a care worker who controls this kind of information. Left too late in life, this knowledge brings crises which are life shattering and unnecessary. Given early enough and in the right framework it is absorbed and handled much more effectively and smoothly. Nurture parents may not tell because of hidden personal motivations.

Forward Considerations:

There are different legal approaches in countries practising IVF.
In America: IVF has no age restrictions, and surrogate motherhood is legal. There are state specific laws as well as federal laws. These are quite varied.
In France: IVF is illegal for post menopausal women, and surrogate motherhood is also illegal.
In the UK: IVF age restrictions (?); surrogate motherhood is not allowed.

International agreed guidelines for the application of IVF

Transparency and public agreement on IVF guidelines.

Identity and relational proofs should be required, to ensure adequate nurture for the infant. Pre & Post natal counselling and support could be a required part of the process.

Individual care workers for all infants produced through IVF (and when it happens human cloning).

On telling Children

There are a range of opinions about the value of telling children about their IVF origins.

Professional's approach

Professionals tend to take the approach that they are only assisting nature. The infant is simply a normal infant. They resist the whole concept of there being anything unusual about  babies enabled by this technology. (This almost sounds like dogma rather than an evaluation of the issues.) Therefore their argument is that there is nothing to tell.

Parent's approach

90% of parents resist the idea of an infant ever knowing that IVF or gamete donation (giving of eggs or sperm) has been used. Within the UK anonymous donation is norm. So that a person created this way would not be able ever to find out who their genetic parent was. In other countries (e.g. New Zealand, USA ) open donation is practised, so that knowledge would be available.

It may be natural for a parent to resist sharing the knowledge of origins. I would guess that for many IVF is a very emotionally exhausting process. Living with uncertainty of hopes being dashed or fulfilled is a real burden. There is also a sense that needing help to do something that their neighbours do in the bedroom implies inadequacy. However hard you work to reassure, intervention speaks of the need for help. Parent's do not find telling children of their inadequacies an easy thing. In fact most human beings work hard to hide their inadequacies even from themselves. So the natural human reaction is once the intervention is over to keep it as private as possible.

It may therefore be right for the parent's self esteem to hide the fact of IVF or gamete donation, but is it in the offspring's best interest.

Children and the right to know

What right does a human being have to know about his or her own origins? Parentage appears important in all societies. Some oriental and other societies have ancestor worship. Judaism still has a strong concern about patriarchal lineage. Inheritance is often linked to parenting. Default inheritance (i.e. in the absence of a will) is founded on kin relationships. In the UK that kin relationship also includes the legal relationship between husband and wife (i.e. a non-genetic relationship). Within society it is therefore important to know who you are and the formal (separate from social)  relationships you have with those around you. Legal issues depend upon this.

Instinctively, then, I would want to say a human being has the inalienable right to know about his parentage and lineage. And that to deny this knowledge would be a breach of natural justice.

What areas of information are there to support or discredit the idea of a right to know? 

Children and the need to know

Uncertainty about origins raises the question in the individual "Who am I?" and the resolution to this question is important. I was brought up in a stable (not perfect)  family and never really had to face this question. In my dark moments the question that really troubled me is "What is life for?", and "Am I a valuable person?"

The "Who am I?" question throws the whole linkage of relationships into question. Not just the formal relationships, but also the social relationships. Forbidden social relationships may become possible because of a change formal relationships. Conversely a desired or started social relationship may become forbidden because of shift in formal relationships. If this is added to the turmoil of adjustments a teenager has to make as they work out how to become a creative member of society it creates fundamental problems. This information given at such a point takes away the whole framework upon which the new relationship with the world is being founded. Recovery may be a long drawn out process.

Only if you know who you are, and nothing is hidden from you can you live a life that is not a lie. Therefore there is a need  is for a person to know who they are.

When dealing with adults involved in genetic testing there is also a right not to know. Tests that may reveal heart problems can also reveal a disposition towards Alzheimer's. You may not want to know, even though as Robert Wachbroit argues their may a  responsibility to know. (Disowning Knowledge: Issues in Genetic Testing, Robert Wachbroit, Maryland School of Public Affairs web site, written summer 1996)

A child may have a right and a need to know, but its almost impossible them to exercise a right not to know. "Do you want to know about your origins?" or "These are not your real parents. Do you want to know more?"  already conveys the information that there is something unusual and significant about their origins.

When should a person know about their origins.

Within the social services and adoption agencies within the UK there is a body of experience and knowledge on dealing with origin issues at a practical level. It seems that dogma should not override the genuine lessons of experience. Certainly the little contact I have with those who have been adopted shows that early telling allows the information to be dealt with and processed within a secure environment. The information is handled without threat to the important support relationships that exist.  Life goes on, built on truth, and is secure.

Issues:

What is best for the growing child, whether produced by IVF, Gamete donation, cell fusion. Not should they know, but when should they know?

Technology used to assist reproduction raises origin questions for individuals. Adoption agencies have experience in these areas, what are their recommendations and their justifications for their actions?

More on Children

See also the Diagnosis Section - children

Chemical triggering of Parthenogenesis 31.10.2001

Source B i o N e w s 131 - Week 22/10/2001 - 28/10/2001

* NO SPERM REQUIRED:

Scientists from the Institute for Reproductive Medicine and Genetics in Los Angeles, US are seeking a way to fertilise human eggs without the need for sperm. The research involves the use of a chemical cocktail which acts as 'artificial sperm', tricking an egg to form an embryo. The embryos would currently be incapable of developing into children, as the cells would be likely to divide for a short time before dying. But it is hoped that the early embryo could be used as a source of stem cells for use in medical research.
The process of coaxing eggs to develop into embryos without sperm is called parthenogenesis. Occasionally this happens naturally in other animals such as frogs and insects. Whereas in sexual reproduction an egg provides only half of the number of chromosomes needed to form an embryo, in parthenogenesis the egg duplicates its own chromosomes to form the necessary number.
The discovery came about during investigations into new ways of modifying embryos in order to grow brain nerve cells for transplant into patients with Parkinson's disease. Experiments with mouse eggs triggered their development into embryos. Some of these were placed into surrogate mice, but they were not able to grow into fully developed offspring. The scientists realised that using the technique for reproductive purposes would cause ethical problems, especially if the process was developed for human use.
- The Times 23/10/2001 'Stem cell scientists seek 'safe' embryos'
- The Times:
http://www.thetimes.co.uk/article/0,,2-2001365558,00.html
- ABC news 22/10/2001 'New source of stem cells'
- ABC news:
http://more.abcnews.go.com/sections/living/dailynews/newstemcells011022.html
- The Daily Mail 22/10/2001 'We can create babies without the need for men, claim scientists'