Notes

AuthorMaureen McTeer
Pages209-242
[  ]
Notes
prologue | The Story Begins
I drafted this story, as a challenge for my law students one year, asking them
to identify the medical-legal and ethical issues it raised.
W Ombelet & J Van Robays, “Articial Insemination History: Hurdles and
Milestones () : Facts Views Vis OBGYN .
chapter one | In vitro Fertilization
Jay W Mark, “Medical Denition of In vitro Fertilization” (last modied
March ), online: MedicineNet medicinenet.com/in_vitro_fertilization/
denition.htm.
For a full catalogue of IVF and the fertility purposes to which it is currently
applied, see “In Vitro Fertilization” ( June ), online: Mayo Clinic
mayoclinic.org/tests-procedures/in-vitro-fertilization/about/pac-.
European Society of Human Reproduction and Embryology, News Release,
“More an  Million Babies Born from IVR Since the World’s First in ”
( July ), online: ScienceDaily sciencedaily.com/releases///
.htm.
IVF use in assisted human reproduction usually covers fourtechnologies:
intracytoplasmic sperm injection (ICSI), gamete intrafallopian transfer (GIFT),
zygote intrafallopian transfer (ZIFT), and frozen embryo transfer (FET).
“Home” (), online: Canadian Fertility & Andrology Society cfas.ca.
For a fuller denition of the terms used in infertility, see “Multiple Den-
itions of Infertility” ( February ), online: World Health Organization
who.int/reproductivehealth/topics/infertility/multiple-denitions/en; “e
International Glossary on Infertility and Fertility Care” (), online:
International Committee for Monitoring Assisted Reproductive Technologies
icmartivf.org/glossary/a-d.
[  ]
FERTILITY: 40 YEARS OF CHANGE
See “Canadian Infertility Awareness Week” (), online: Canadian Fertility &
Andrology Society cfas.ca/Canadian_Infertility_Awareness_Week_.html.
is resource includes the one in six statistic and adds that “all communities
are aected.” e use of the word “community” as opposed to “couples” and
its meaning (or source) has not been dened as of .
Speaking in , Mrs. Brown said she had been so desperate to have a baby
that she was willing to put up with anything to give birth. See “First Test
Tube Baby Mother Lesley Brown Dies” BBC News ( June ), online:
bbc.com/news/uk-england-bristol-.
It would be ve years before Canada welcomed the rst IVF baby conceived
in Canada. Twin boys were born the year before in Oakville after their
mother underwent treatment in the United Kingdom. “Canada’s Very Own
Test Tube Baby” CBC Digital Archives ( February ), online: cbc.ca/
archives/entry/canadas-very-own-test-tube-baby.
 e passing years would actually show a decline in pregnancies. See NGleicher,
VA Kushnir & DH Barad, “Worldwide Decline of IVF Birth Rates and Its
Probable Causes” ( August )  Human Reproduction Open .
 See “ART Fact Sheet” (), online: European Society of Human Reproduc-
tion and Embryology eshre.eu/Press-Room/Resources.
 Alexis Madrigal, “ere Really Are So Many More Twins Nowe Atlantic
( April ), online: theatlantic.com/health/archive///-million-
extra-twins-have-been-born-in-the-last--years/. See also Clare Wil-
son, “e Number of Twins in the World Is the Highest It Has Ever Been”
( March ), online: NewScientist newscientist.com/article/-the-
number-of-twins-in-the-world-is-the-highest-it-has-ever-been.
 UK, Department of Health & Social Security, Report of the Committee of
Inquiry into Human Fertilisation and Embryology, (Report) Dame Mary
Warnock DBR et al (London: Her Majesty’s Stationary Oce, ), online:
www.hfea.gov.uk/media//warnock-report-of-the-committee-of-inquiry-
into-human-fertilisation-and-embryology-.pdf [Warnock Report].
 “Until IVF became a reality, the probability of achieving a pregnancy for
women with tubal problems was not great. IVF may be appropriate perhaps
for  of infertile couples. Recently claims have been made for IVF as a
treatment for other forms of infertility including in use in the treatment of
oligospermia and unexplained infertility” [emphasis added]. Ibid at .
 “We have considered these arguments, but, nevertheless, we believe that as a
general rule it is better for children to be born into a two-parent family, with
both father and mother, although we recognize that it is impossible to predict
with any certainty how lasting such a relationship will be.” Ibid at –.
 Ibid at –:
It is now very dicult to give an estimate of the success of the technique [IVF]
because of diering methods of measuring success and also because rates vary
[  ]
Notes for Chapter One
between centres. However, we have been given permission by Mr. Steptoe and
Dr. Edwards to quote the following gures on the outcome of IVF treatment
carried out at Bourn Hall clinic, as an illustration. During the period October
 (when the clinic opened) to the end of December , , laparoscopies
were carried out on , women of whom  were admitted for treatment on
two or more occasions. ese resulted in a total of  pregnancies, of which 
ended in miscarriage and four in an ectopic pregnancy. Of these  pregnancies,
in  treatment was undertaken because of diseased or absent fallopian tubes
without associated semen problems. e majority of the remainder were under-
taken either because of a combination of semen problems and diseased fallopian
tubes, or because of semen problems alone. In  there were  laparoscopies
performed for  women. In  of these laparoscopies one or more eggs was
recovered, and in  one or more eggs was fertilised. In all these cases, one or
more embryos was transferred to the woman and in  a pregnancy occurred
which ended in birth or a clinically recognisable miscarriage. By May  the
clinic knew of  pregnancies, of which  were ongoing.  children had
been born since it had opened, including sets of twins and one of triplets.
Among these infants there had been no major congenital malformations. It
seems to us that the techniques have now passed the research stage and can be
regarded as an established form of treatment for infertility.
 Ibid at –.
 Ibid at :
e protection of the public, which we see as the principal objective of regu-
lation, demands the existence of an authority independent of Government,
health authorities or research institutions. e authority should be specically
charged with the responsibility to regulate and monitor practice in relation to
those sensitive areas which raise fundamental ethical questions. We therefore
recommend the establishment of a new statutory licensing authority to regulate
both research and those infertility services which we have recommended
should be subject to control.
 Ibid at .
 Ibid at .
 Ibid at .
 Ibid at .
 Ibid. at .
 Ibid. at .
 Ibid. at .
 Ibid. at .
 Ibid. at  and .
 Ibid.
 Ibid.

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