New Approaches To Human Reproduction by Linda M. Whiteford

Author:Linda M. Whiteford [Whiteford, Linda M.]
Language: eng
Format: epub
ISBN: 9780367006754
Barnesnoble:
Publisher: Taylor & Francis
Published: 2019-06-17T00:00:00+00:00

The author acknowledges the following citations that were not incorporated info the text: "I am indebted to Prof. Albert R. Jonsen for this idea" on p. 102, line 20, following the word "assent"; Guilleman and Holmstrom (1986) on p. 103, line 21; Bogdan et al. (1982) on p. 104, line 32; Guilleman and Holmstrom (1986) on p. 107, line 10; Guilleman and Holmstrom (1986) on p. 112, line 25.

Part Three

Ethical Implications of Family Formation by Surrogacy

8

The Technology of AID and Surrogacy

Kamran S. Moghissi

Abnormalities of the male reproductive system resulting in inadequate or absent semen and sperm are responsible for 30 to 40 percent of cases of infertility. Unfortunately, the management of male infertility is often ineffective, and the options for couples with this problem who do not respond to the usual therapeutic methods are limited to either adoption or artificial insemination by donor (AID). Artificial insemination, first used for humans by John Hunter, a Scottish physician, at the end of the eighteenth century, is a relatively simple procedure from a medical point of view. Donor sperm, rather than the husband's, was first used in this procedure in 1884. The development of techniques for cryopreservation of semen (the maintenance of semen by storing at very low temperatures) has expanded and simplified the use of AID.

In 1957, Schellen estimated that in the United States 100,000 babies had already been born as a result of AID and concluded, on the basis of this survey, that between 6,000 and 10,000 children are born in the United States annually as a result of AID (Currie-Cohen, Luttrell, and Shapiro 1979). As many as 300,000 U.S. children are currently believed to have been conceived by AID, and the number is growing at the rate of 10,000-20,000 births a year. In 1988, AID is offered by the majority of infertility facilities in university clinics and larger medical centers.

The principal steps in performing AID are (1) screening of the couple; (2) evaluation of the female recipient; (3) selection and management of the donor; and (4) timing and technique of insemination. A history of infertility of at least one year's duration would be sufficient grounds for initiating infertility evaluation by most physicians. Occasionally, known history of azoospermia (the absence of spermatozoa in the semen) or advanced age of the couple may be reason for accelerated infertility investigation leading to AID.

The major medical indications for AID include azoospermia or severe oligospermia (a deficiency of spermatozoa in the semen), known hereditary or genetic disorders (such as Tay-Sachs disease or Huntington's disease, which causes neurological damage), and noncorrectable ejaculatory dysfunction of the husband. Additional indications include Rh or other blood group incompatibility, spinal cord injury, exposure to environmental mutagens, presence of sperm antibodies in the male, and unexplained infertility.

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