Argumentative Essay on Fertility Donation
- Introduction
Assisted reproductive technologies (ART), also referred to as third party reproduction, are a wide range of technologies that are used to help people to get children. The technologies are used in various circumstances that make it impossible for the person to bear a child, for instance where either of the partners is infertile, in gay marriages, where a genetic disorder that may be passed on the offspring has been detected in one of the partners and other circumstances that will be specifically mentioned in this paper. The assisted reproductive technologies, while they have helped people who could not have otherwise have children achieve this satisfying achievement (bringing forth children), has raised a lot of controversy especially on the ethical front. This paper will argue that fertility donation is not the best choice due to the ethical considerations, the side effects and the risks associated with sperm and egg donation on both the donor and the recipient. However, before delving into the arguments against fertility donation, it is important to understand the different aspects of assisted reproductive technologies and why they are used.
2.0 Background information on ART
Egg donation as a process where a donor woman donates 1-10 eggs (ova/oocytes) to another (recipient) and thus enable the recipient to conceive. The donated eggs is then fertilized by a sperm from the recipient’s partner or a donated sperm (especially in cases of homosexual/gay partners) in the lab through a process call in vitro fertilization (IVF). Following successful fertilization, the embryo is implanted in the recipient’s womb or in a surrogate woman. Egg donation is used in several circumstances such as when the female partner is infertile due to congenital or age related reasons, has early menopause, has had several unexplained miscarriages, has a genetic condition that has been detected and acquired absence of the eggs or essential parts of the reproductive system. Certain diseases, certain surgical procedures (such as removal of the ovaries or uterus), autoimmunity, radiotherapy and certain drugs may compromise the reproductive system. The above mentioned factors may result in reduced quality or quantity of oocytes. Usually the donor is given fertility drugs that stimulate the ovaries to produce multiple eggs rather than the usual situation where the ovaries produce one egg every month. The recipient may also be given medications to synchronize her reproductive cycle to that of the donor and to prepare her body to receive the embryo. The mature ova are retrieved from the ovaries through a surgical procedure called transvaginal ultrasound aspiration. The arguments against egg donation will be based on the side effects of the drugs and transvaginal ultrasound aspiration.
Sperm donation (also referred to as donor/artificial insemination) is the second ART. Donor insemination is used in cases of male infertility due to low sperm count, poor sperm quality, radiation/chemical damage to the male reproductive system, impotence, lesbian partners or single women who want a child of their own, impotence and where a male partner has been diagnosed with a genetic disorder. The third fertility donation is embryo donation, which is similar to but different from egg donation. In the case of embryo donation, a woman who has undergone IVF chooses to the excess fertilized eggs that have not been used in her cycle and thus the embryo is transferred to another woman’s uterus. The last aspect of ART is surrogacy in which one woman carries the pregnancy for another. This is often used where the second woman has functional ova but the uterus cannot carry a baby for one reason or another. Surrogacy is also used where a gay (males) couple wants to have a child of their own. Based on the demerits (ethical, emotional, legal and physical), side effects and risks associated with fertility donation, this paper argues that it is not the best choice.
3.0 Arguments against fertility donations
Artificial reproductive technologies, particularly egg and sperm donation, are associated with several risks and have raised several ethical concerns. One of the major concerns that have been raised against fertility donation has to do with the success rate in terms of conception. It has been reported in 71% of recipients of donated ova conception does not occur. The success rate of IVF has also been found to decrease with the age of the recipient. As such, where IVF is chosen to help older women get children the failure rate is higher, and the said women can be financially and emotionally drained by several failures to conceive. In addition, women who conceive through IVF have higher chance of getting pregnancy complications such as gestational hypertension. Another study established that ARTs increases the probability of multiple births which come with a whole range of developmental as well as delivery complication. The same study also found that infants conceived through ARTs are more likely to have certain birth defects such as such as heart diseases, some gastrointestinal defects and cleft lip. The ARTs were directly responsible for increased risk of birth defects and also increased the birth defects because of multiple births.
As earlier mentioned certain drugs are administered to the egg donor and the recipient, like any other drug, these fertility drugs are associated with both short term and long-term side effects and risks. One of the risks associated with the drug administration, which is often through injections, is the risk of infection. In some cases, doctors administer antibiotics in a bid to reduce the risk of infection. In cases where a woman donated eggs severally, the co-administration of antibiotics could lead to the development of resistant bacteria strains. Before stimulation of the donor’s ovaries to produce multiple eggs, leuprolide acetate (lupron) is administered to temporally shut down the ovaries. This drug has been associated with some side effects such as vasodilatation, rashes, itching, tingling, burning sensation, dizziness, joint pains, headaches, nausea, hives, muscular pains, insomnia, edema (mainly in the hands), anxiety and depression. Other adverse effects of Lupron include chest pain and difficulties in breathing, hair loss, low libido, severe weakness, fainting, asthenia gravis, emotional instability, abdominal pains, disrythmia, vertigo, hypertension, amnesia, abnormal liver function and chronic thyroid enlargement. Albeit the drug being approved by the FDA for specific uses such as treatment of fibroid associated anemia and endometriosis, Lupron is not approved for multiple egg extraction and thus is used illegally for this function.
Egg donors are also given drugs to stimulate the ovaries leading to maturing of multiple eggs instead of the normal one egg per month. The stimulation of the ovaries leads to fluid retention in the abdomen, which has several symptoms such as bloating, temporary weight gain, swelling of the ovaries and damage of organs such as the uterus and the bladder. The accumulation of the fluid in the abdomen and in the chest may, in rare instance, result in death due to blood clots, arterial occlusion, liver failure, kidney damage, stroke, loss of a limb and shock. The above mentioned are major symptoms of the potentially fatal ovarian hyperstimulation syndrome (OHSS) which occurs in 0.05-5% of egg donors and is responsible for enlargement of the ovaries and cyst development. The blood clots associated with OHSS are known to damage organs such as the brain, the lungs and the heart. Other symptoms associated with OHSS include swallowing difficulties, intestinal ulcers and polyps, blackouts, diarrhea, vomiting, blurred vision, breast tenderness, mood swings, intestinal and virginal bleeding. Overstimulation of the ovary may become uncontrollable and require the removal of one or both ovaries hence permanent infertility. In the long term, the fertility drugs are also associated with increased risk of ovarian, uterine and breast cancer. However, the data to ascertain these long-term effects of egg dovation is not sufficient. Other adverse effects of egg donation include infertility and ovary loss due to ovary twisting resulting in cutting of its blood supply causing loss of the ovary, accidental pregnancy due to increased ovulation and early menopause.
Both egg and sperm donations involve extensive screening to determine the suitability of the donor. A lapse in the screening process predisposes the recipient to the risk of being infected with diseases, particularly with sexually transmitted diseases. In addition, both sperm and egg donors are likely to experience psychological stress because of the extensive screening process. However, there is no study that has shown any negative effects of sperm donation on a healthy donor. Never the less, there are many legal and ethical issues that surround both egg and sperm donation.
One of the major ethical issues related to fertility donation is conflict of interest between recipients, donors and providers of fertility services. The said conflict of interest has led to the commercialization of sperm and more so egg donations. Donors are given monetary incentives to provide the eggs or sperm which is likely to compromise the concept of informed consent. In this case, the donors end up donating eggs or sperm without fully understanding the risk associated with the donation, which is unethical. This is particularly the case with donors with a financial insufficiency and thus is desperate to earn money out of egg or sperm donation. The commercialization of the fertility donation also tempts the donors to frequently donate eggs and thus put their health at risk. The infertility care provider on the other hand is paid by the recipient and not by the donor. As such, the physician is likely to feel more obliged to take care of the recipient and neglect the donor, hence the best of the donor is easily compromised. As earlier mentioned, the commercialization of egg and sperm donations has compromised the concept of informed consent. The fertility clinics make billions from exploiting the plight and desperation of infertile couples and exploit the poverty of donors. This commercialization of egg and sperm donation has also introduced unethical professionals such as egg brokers who are intermediaries between the donors, fertility clinics and recipients. Where egg donation is illegal, the compensation is higher thus encouraging illegal trade.
There are also ethical issues that are related to personal and religious persuasions. These have to do with the belief that it is morally wrong to manipulate the process of child bearing in the lab. Most religions believe that God is the giver of life and humans should not play God. The issue of IVF and artificial insemination is particularly repulsive to the religious because it is often done outside the confines of marriage. The fact that ARTs often assist gay couples to get children, it is not supported by many with religious persuasions. Due to these religious persuasions couples or single ladies who use ARTs and the children from these technologies be stigmatized or be discriminated against. Like adopted children, children conceived through ARTs may desire to know their biological parent (in cases of single mothers or gay parents). This presents an ethical dilemma to the parent especially where the donor is anonymous. Concerns have been raised with regard to the effect of a child’s inability to know the biological parent. The child is likely to struggle with the desire to know the biological parent leading to an antagonistic relationship with the other parent (recipient). Another ethical issue that has been mentioned in relation to egg donation if the lack of sufficient data on the safety the drugs used on both the donor and the recipients. In addition, there are drugs that are approved for other uses and not ARTs are used in egg donation with is not only illegal but also unethical. In addition, there are legal issues associated with fertility donations and thus the donor and the recipient need to sign a legal agreement that clearly spells out the rights of the two parties and those of the resulting child or children. In most cases, particularly where anonymous donors are involved, the donors sign agreements to relinquish all the rights of the child.
There are also emotional and psychological demerits of fertility donations. One of the most common psychological risk is the fear of the donor’s attachment to their egg or sperm or the potential offspring. There is also the fear that the donor may want a relationship with the offspring resulting from the donated egg/sperm resulting in legal battles.
The naysayers argue that fertility donation gives infertile parents an opportunity to have a child of their own. Regardless of this argument, the risks and side effects associated with fertility donation outweigh the benefits. In addition, the adoption option is safer for infertile couples and less controversial. Clearly, the adverse health effects of sperm donation, but the ethical and legal concerns cut across the fertility donation techniques. In conclusion, given the many side effects, risks and ethical issues associated with fertility donation, fertility donation is not the best choice.
Works cited
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