Infertility

Infertility could occur due to many reasons. It can be physical, diseases, congenital, immunological, drugs or even psychological. In many countries, female is often blamed for the inability of the conception of a child, but more often than not, the issue prevails in the male partner. Infertility clinics can help in diagnosis and recommend the right treatment of some of these problems and enable these people to be able to have children. However, in many cases, corrections are not possible. In such a situation, couples can have children through some special techniques, popularly known as assisted reproductive technologies (ART).

In vitro fertilisation (IVF)

  • Fertilisation is done outside the body and artificial body environment is created for the growth of cells.
  • It is often followed by transfer of the embryo, ie. embryo transfer (ET)
  • Test tube baby programme:
    • Ova from wife or donor (female) and sperms from husband or donor (male) are collected and are prompted to form zygote under artificial conditions in the laboratory.
    • The early embryo or zygote which has reached up to the eight blastomeres stage can be transferred to the fallopian tube. It is called the zygote intrafallopian transfer.
    • In case it is more than eight blastomeres, it is directly transferred in the uterus to complete its further growth. It is called intrauterine transfer (IUT).
  • Embryos that are generated by in-vivo fertilisation can also be used for such transfer and is used to help females who cannot conceive.
  • GIFT (Gamete Intra-Fallopian Transfer)
    • It is a method in which ovum is collected from a donor and is transferred to another female who cannot produce ovum but can provide an appropriate environment for fertilisation and development.
  • ICSI (Intracytoplasmic Sperm Injection)
    • It is a procedure in which embryo is formed in the laboratory and the sperm is directly injected into the ovum.

Artificial Insemination

When infertility is either due to the inability of the male partner to inseminate the female or due to the low count of sperms in the ejaculates, then it is corrected by artificial insemination technique.

  • Semen is collected either from a healthy donor or the husband
  • It is then artificially established into the vagina or the uterus of the female.

The social implications of contraception and fertility treatments

  • Accessibility of fertility treatments:
    Fertility treatments have a significant impact on the lives of many infertile or semi-fertile couples. However, high financial costs put a restraint on the adoption of these methods especially in developing countries
  • These can lead to overpopulation in countries where already the demography is quite large and there is already too much fewer resources for the survival of all people. It will lead to social and economical inequality, risk of spread of many diseases that will ultimately put a burden on the financial costs of the country.
  • Fertility options like IVF have many risks that include multiple pregnancies, ovarian hyperstimulation syndrome and ectopic pregnancy.
  • Fertilisation outside the body is viewed as unnatural in society and required extensive lab work.
  • Increased risks like that of multiple pregnancies put the life of both mother and foetus on risk. These methods also involve a higher risk of miscarriage and premature deaths along with some other complications. Therefore, often results in emotional and financial loss.
  • Children born through methods like IVF are more prone to complications like mental retardation, chronic lung problems, cerebral palsy and learning disabilities.
  • Another social issue is the concern of age. There are raised concern for maternal health and ability to survive pregnancy and the ability to remain alive long enough to raise a child.
  • The method of ICSI which is concerned with male infertility raises the issue of passing infertility to the offspring. If there is a gene for infertility, then there are chances that it can be passed to the offspring that will perpetuate the dependence of these techniques for reproduction.
  • The knowledge of infertility, in general, creates discord in marriages many times. However, these fertility treatments also give hope to couples and can actually assist in stable marriages resulting in positive social implications.
  • The use of donors in conception also raises some issues regarding lineage and kinship. Debates over the custodianship, adultery, single parents raise many issues of concern.
  • Couples generally prefer donors who are relatives.
  • Often, oocytes are preferred over sperm to avoid the stigma of
  • Preimplantation genetic diagnosis is the technique that allows couples to know about the serious genetic conditions that can possibly affect the child. But it raises the social implication of sex determination and couples may want babies with certain desirable features. Sex selection which is biased can have negative effects on society.