Assisted reproductive technologies: new opportunities
Abstract
The article attempts to evaluate the potential of assisted reproductive technologies to influence fertility, based on calculations made using the latest available statistical data from the world, Europe and Russia. It examines assisted reproductive technologies in a historical and ethical context, since both influence the readiness of different populations to use them to overcome involuntary childlessness and problems with reproductive health. The analysis, based on existing statistics (which have important quality limitations varying from one country to another and are probably incomplete), allows us to tentatively presuppose that, on a worldwide scale, many indicators of ART efficiency have reached a kind of “plateau” – that is, have stopped increasing and stabilized. In some countries, indicators of the availability of these technologies to the population have stabilized as well. This has happened in those countries where they are close to the maximum, where the share of ART children in the country’s total annual fertility is over 4%. The “old” reproductive technologies – in-vitro fertilisation, ICSI, surrogacy and gamete donation – have already occupied their “niche” in the area of reproductive options, and their growth potential now seems limited. One reason for this is the practiсe of limiting the number of embryos during one transfer to two in order to decrease the number of fetuses in one pregnancy, which leads, on the one hand, to a somewhat lower ART pregnancy rate, but on the other, to improved health of the resulting children. The demographic potential of ART can be increased if the following occur: they become economically and geographically accessible to larger numbers of people; they are used more often by women of a relatively younger reproductive age (younger than 34 or at least 40 years); the role of superstitions and religious bans of various associated practices is diminished; and new technologies are developed which would allow women of older reproductive ages to have their own genetic children (freezing of eggs and ovarian tissue, cytoplasm donation, etc.).
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References
Brezina P.R., Y. Zhao (2012). The ethical, legal, and social issues impacted by modern assisted reproductive technologies // Human reproduction. Article ID 686253. 7 p. URL: http://dx.doi.org/10.1155/2012/686253 (assessed: 15.12.2016).
Centers for Disease Control and Prevention, American Society for Reproductive Medicine, Society for Assisted Reproductive Technology (2014). Assisted reproductive technology fertility clinic success rates report in 2012. Atlanta, GA: US Department of health and human services.
Chambers G.M., E.A. Sullivan, O. Ishihara, M.G. Chapman, G.D. Adamson (2009). The economic impact of assisted reproductive technology: a review of selected developed countries // Fertility and sterility. 91/6: 2281–2294.
Chambers G.M., V.P. Hoang, E.A. Sullivan, M.G. Chapman, O. Ishihara, F. Zegers-Hochschild, K.G. Nygren, G.D. Adamson (2014). The impact of consumer affordability on access to assisted reproductive technologies and embryo transfer practices: an international analysis // Fertility and sterility. 101: 191–198.
Damelio J., K. Sorensen (2008). Enhancing autonomy in paid surrogacy // Bioethics. 22/5: 269–277.
Dyer S., G.M. Chambers, J. de Mouzon, K.G. Nygren, F. Zegers-Hochschild, R. Mansour, O. Ishihara, M. Banker, G.D. Adamson (2016). International committee for monitoring assisted reproductive technologies world report: Assisted reproductive technologies 2008, 2009 and 2010 // Human reproduction. 31(7): 1588-609.
Ehrich K., C. Williams, B. Farsides, J. Sandall, R. Scott (2007). Choosing embryos: ethical complexity and relational autonomy in staff accounts of PGD // Sociology of health and illness. 29/7: 1091–1106.
Ethics Committee…(2009). Ethics Committee of the American society for reproductive medicine. Interests, obligations, and rights of the donor in gamete donation // Fertility and sterility. 91/1: 22–27.
Ferraretti A.P., G. Pennings G., L. Gianaroli, F. Natali, M.C. Magli (2010). Cross-border reproductive care: a phenomenon expressing the controversial aspects of reproductive technologies // Reproductive biomedicine. 20/2: 261–266.
Ferraretti A.P., V. Goossens, M. Kupka, S. Bhattacharya, J. de Mouzon, J.A. Castilla, K. Erb, V. Korsak, A.N. Andersen (2013). The European IVF-monitoring (EIM) consortium, for the European society of human reproduction and embryology (ESHRE), Assisted reproductive technology in Europe, 2009: results generated from European registers by ESHRE // Human reproduction. 28: 2318–2331.
Fortunato A., E. Tosti (2011). The impact of in vitro fertilization on health of the children: an update // European journal of obstetrics, gynecology and reproductive biology. 154/2: 125–129.
Garcia J. (1998). Profiling assisted reproductive technology: the society for assisted reproductive technology registry and the rising costs of assisted reproductive technology // Fertility and sterility. 69/4: 624–626.
Hamilton B.H., B. McManus (2012). The effects of insurance mandates on choices and outcomes in infertility treatment markets // Health economics. 21: 994–1016.
Hanna J.K. (2010). Revisiting child-based objections to commercial surrogacy // Bioethics. 24/7: 341–347.
Inhorn M.C. (2009). Right to assisted reproductive technology: overcoming infertility in low-resource countries // International journal of gynecology and obstetrics. 106: 172–174.
Isupova O.G., A.V. Belianin, A.A. Gusareva (2014). VRT-sovremennost' v pomoshch' traditsiyam [ART- modernity helping traditions] // Demoskop Weekly [Demoscope Weekly]. 615-616. URL: http://demoscope.ru/weekly/2014/0615/tema01.php (accessed: 12.04.2017).
Jadva V., T. Freeman, W. Kramer, S. Golombok (2011). Sperm and oocyte donors experiences of anonymous donation and subsequent contact with their donor offspring // Human reproduction. 26/3: 638–645.
James S., R. Chilvers, D. Havemann, J.Y. Phelps (2010). Avoiding legal pitfalls in surrogacy arrangements // Reproductive biomedicine. 21/7: 862–867.
Kamel R.M. (2013). Assisted reproductive technology after the birth of Louise Brown // Journal of reproduction and infertility. 14/3: 96-109.
Kupka M.S., T. D’Hooghe, A.P. Ferraretti, J. de Mouzon, K. Erb, J.A. Castilla, C. Calhaz-Jorge, Ch. de Geyter, V. Goossens (2016). Assisted reproductive technology in Europe, 2011: results generated from European registers by ESHRE, The European IVF-monitoring consortium (EIM) for the European Society of human reproduction and embryology (ESHRE) // Human reproduction. 31/2: 233–248.
Ledger W.L., D. Anumba, M. Marlow, C.M. Thomas, E.C. Wilson (2006). The costs to the NHS of multiple births after IVF treatment in the UK // Journal of obstetrics and gynecology. 113/1: 21–25.
Levens E.D., A.H. DeCherney (2008). Human oocyte research: the ethics of donation and donor protection // Journal of the American medical association. 300/18: 2174–2176.
Levine A.D. (2011). The oversight and practice of oocyte donation in the United States, United Kingdom and Canada // HEC Forum. 23/1: 15–30.
Macaldowie A., E. Lee, G.M. Chambers (2015). Assisted reproduction technology in Australia and New Zealand 2013 // Assisted reproduction technology series no. 18. Sydney: The University of New South Wales.
Meirow D. (2008). Fertility preservation in cancer patients using stored ovarian tissue: clinical aspects // Current opinion in endocrinology, diabetes and obesity. 15/6: 536–547.
Murphy T.F. (2009). Ethics and the prohibition of donor gametes in fertility medicine // Reproductive biomedicine. 18/supplement 1: 60–67.
Nikitin A.I, M.B. Anshina (2011). Istoriya EKO v Rossii [History of IVF in Russia] / M.B. Anshina, ed. Moscow: Media Sphera.
Omurtag K.R., A.K. Styer, D. Session, T.L. Toth (2009). Economic implications of insurance coverage for in vitro fertilization in the United States: a review // The journal of reproductive medicine. 54/11-12: 661–668.
Osberg B. (2006). For your first born child: an ethical defense of the exploitation argument against commercial surrogacy // Pennsylvania bioethics journal. 2/2: 42–45.
Paul M.S., R.E. Berger, R. Blyth, L. Frith (2010). Relinquishing frozen embryos for conception by infertile couples // Families, systems and health. 28/3: 258–273.
Petrov G.N. (1959). Protsess oplodotvoreniya vne organizma yaytsekletok nekotorykh mlekopitayushchikh zhivotnykh i cheloveka: avtoref. dis. na soiskanie uchenoy stepeni kand. med. nauk [Process of out-of-the-body fertilization of oocytes of some mammals and humans: Candidate of medical science dissertation]. Simferopol.
RAHR (2015). Rossiyskaya assotsiatsiya reproduktsii cheloveka [Russian association for human reproduction]. Otchet za 2014 god [2014 Report] // Problemy reproduktsii [Problems of reproduction]. 21/6:8-24.
Rao G.D., R.C. Chian, W.S. Son, et al. (2004). Fertility preservation in women undergoing cancer treatment // The lancet. 363/9423: 1829–1830.
Riggs D.W., L. Russell (2011). Characteristics of men willing to act as sperm donors in the context of identity-release legislation // Human reproduction. 26/1: 266–272.
Rusanova N.E. (2009). Bezdetnaya sem'ya v Rossii: politika gosudarstva i vybor suprugov [Childless family in Russia: policy of the state and couple’s choice] // Trud i sotsial'nye otnosheniya [Labor and social relations]. 8: 25-30.
Rusanova N.E., V.L. Gordeeva (2016). Vspomogatel'nye reproduktivnye tekhnologii: potrebnosti i regulirovanie pri nizkoy rozhdaemosti [Assisted reproductive technologies: needs and regulations in the condition of low fertility] // Narodonaselenie [Population]. 3(73):34-46.
Sauer J.L. (2009). Competing interests and gamete donation: the case for anonymity // Seton Hall law review. 39/3: 919–954.
Sharp R.R., M.L. McGowan, J.A. Verma, et al. (2010). Moral attitudes and beliefs among couples pursuing PGD for sex selection // Reproductive biomedicine. 21/7: 838–847.
Spandorfer S.D., K. Bendikson, K. Dragisic, G. Schattman, O.K. Davis, Z. Rosenwaks (2007). Outcome of in vitro fertilization in women 45 years and older who use autologous oocytes // Fertility and sterility. 87/1: 74–76.
Van Rooij I.A., L.F. Bancsi, F.J. Broekmans, C.W. Looman, J.D. Habbema, E.R. Te Velde (2003). Women older than 40 years of age and those with elevated follicle-stimulating hormone levels differ in poor response rate and embryo quality in in vitro fertilization // Fertility and sterility. 79/3: 482–488.
Zegers-Hochschild F., B.M. Dickens, S. Dughman-Manzur (2013). Human rights to in vitro fertilization // International journal of gynecology and obstetrics. 123: 86–89.
