Cervical, vaginal, or endometrial abnormalities that prevent conception may be cor­rected surgically (Ruiz-Velasco et al., 1997). Scar tissue, cysts, tumors, or adhesions, as well as blockages inside the Fallopian tubes, may be surgically removed. The use of di­agnostic techniques such as laparoscopy (la-puh-RAH-ske-pee) and hysteroscopy (hiss-stare-oh-OSK-coe-pee) are also common. In men, surgery may be required to re­move any blockage in the vas deferens or epididymis, or repair a varicocele (VA-ruh – coe-seal).










IVF is first attempted in the United States. First IVF pregnancy is reported in Australia but does not produce a child.

© Lester Lefkowitz/Corbis

TABLE 12.2 The Costs of Assisted Reproduction Tests, Treatments, and Adoption*






*Only 15 states mandate insurance coverage for infertility treatments (Arkansas, California, Connecticut, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas, and West Virginia). In these states, only certain treatments and procedures are covered.


Timeline: The History of Assisted Reproduction










A 42-year-old woman becomes a surrogate mother for her daughter after becoming pregnant with the daughter’s embryo.


Intracytoplasmic sperm injection (ICSI) for male infertility is introduced.



Embryo transfer procedure is patented.



Подпись: Ethical, Legal, and Moral Issues Involved in Reproductive Technology

in Real Life

any of the reproductive technologies raise ethical, legal, and moral questions with which many scientists and researchers are grappling. Should we be allowed to artificially join the ovum and sperm outside of the uterus? Should gay and lesbian couples use reproductive technologies to become parents? Should stem cell research and embryo cloning continue? Will this one day give rise to the manipulation of certain traits or genes in the creation of a "perfect" baby?

In addition, all of these procedures are very expensive. Expensive technologies produce very expensive children. Does expensive mean "better"? Does this set up higher ex­pectations for these children? Will people be disappointed if their expensive children are difficult in the future? Why

are people willing to risk their life savings on having biolog­ically related children when there are children waiting to be adopted?

In addition to these ethical and moral questions, sev­eral legal questions have arisen. What should be done with embryos that are fertilized and frozen for later use if a cou­ple separates? Whose property are they? Should they be equitably distributed to both partners? Should they simply be disposed of? Also, because this field is so lucrative, some physicians have been known to perform expensive infertil­ity procedures that may not be necessary.

What do you think about these reproductive tech­niques? Should a woman be able to "rent" her uterus for the development of someone else’s child? Should fertiliza­tion be allowed to occur in a petri dish?

Artificial Insemination

Подпись:Подпись:Artificial insemination is the process of introducing sperm into a woman’s reproductive tract without sexual intercourse. This is a popular option for both heterosexual and ho­mosexual couples. Ejaculated sperm, collected through masturbation, can come from a partner or from a sperm donor. The sperm is then specially treated and washed, and the healthy sperm are extracted. Several samples may be collected from men with a low sperm count to increase the number of healthy sperm. Once washed, sperm can be de­posited in the vagina, cervix, uterus (intrauterine), or Fallopian tubes (intratubal).

Men who decide to undergo sterilization or who may become sterile because of surgery or chemotherapy can collect sperm prior to the procedure. Sperm can be frozen for up to 10 years in a sperm bank. A vial of sperm from a sperm bank usually costs be-






Policy is drawn up by the American Society for Reproductive Medicine on what to do with abandoned embryos. First baby born that was conceived with intracellular sperm injection (ICSI)

First embryonic stem cells isolated.

Preimplantation genetic diagnosis (PGD) is used to select an embryo to create child who can serve as a bone marrow donor to save a sibling.

Congress allocates $900,000 to promote embryo adoption.

Society for Assisted Reproductive Technology study determines that there are 400,000 frozen embryos stored at IVF facilities in the United States.

Source: AFP, American Society for Reproductive Medicine, BBC, Blood lines/PBS, Canadian Broadcast. Co., Christian Medical Association, Fertility & Sterility, Monash IVF.

Personal Voices