Sunday, September 17, 2006

The Issues with ART

This post on Assisted Reproductive Techniques may end up being a long one, but please bear with me. Today I would like to raise the awareness on two categories of illicit infertility procedures, Artificial Insemination and In Vitro Fertilization. First, I will go into the details of each method then go from there.

Artificial Insemination(AI)
This category includes Intrauterine Insemination(IUI), Intravaginal Insemination(IVI), Intracervical Insemination(ICI), and both types of Intratubal insemination(ITI), which are Intrafallopian Insemination(IFI) and Sperm Intrafallopian Transfer(SIFT). These procedures involve taking the sperm of a man, weeding out those deemed less than acceptable (washing), and inserting them into different areas of the reproductive tract of a woman. All the methods are performed vaginally; except SIFT, where an incision is used to reach the fallopian tubes. Also a Doctors visit and anesthesia is needed for all methods other than IVI. With IVI, clients use a syringe at home to inject the washed sperm.

Now you may be thinking how are these tactics any different from the usual methods of conception? The issue is found in the depositing of the altered sperm through means other than marital intercourse. The actual introduction of the sperm to the egg is done through medical/surgical methods not via human anatomy and is therefore immoral. This is not the plan that God had for human procreation and sexuality.

In Vitro Fertilization(IVF)
IVF is the most extensive and time consuming fertility treatment on the market at this time. It encompasses but is not limited to common IVF, Gamete Intrafallopian Transfer(GIFT), Zygote Intrafallopian Transfer(ZIFT), and Tubal Embryo Transfer(TET). The main difference between these therapies is the placement of the embryo within the female reproductive tract, following their insemination. IVF, according to the Pacific Infertility Center, requires 8 steps from treatment preparation to pregnancy.

Step 1 Pre-cycle preparation
To prepare for an IVF cycle, you first meet with or talk to your physician, a board certified reproductive endocrinologist. You physician reviews your case, develops a treatment plan and recommends tests prior to starting IVF. Our nurse coordinator meets with or talks to you to review IVF, answers any questions, and schedules your medications. Medications include oral contraceptives (birth control pills), started in the month before the treatment cycle, and Lupron or Synarel, started just before finishing the oral contraceptives. Lupron or Synarel prevents early egg release from the ovary, or ovulation. These medications prepare you for the next phase, ovulation induction.

Step 2 Ovulation induction
Fertility drugs stimulate multiple follicles in the ovaries, each containing a single egg. Many fertility drugs are available, all of which share in common the hormone Follicle Stimulating Hormone, or FSH. FSH can be injected with a small needle just below the skin in the leg (Sub Q) or into the muscle of the buttock (IM). Different stimulation protocols are used to produce the best number and best quality of eggs.

Step 3 Oocyte retrieval
During oocyte retrieval the eggs are removed from the ovaries. A needle is guided by ultrasound into each follicle in the ovary to remove the fluid containing the egg. The ultrasound is performed vaginally; neither incisions nor surgery are required. The eggs are collected into a test tube, and passed to an embryologist, who prepares the eggs for insemination.

Step 4 Insemination and fertilization

The eggs are inseminated, meaning they are mixed with a sperm sample. This begins an amazing cascade of events which ends in a fertilized egg, known as a zygote, or embryo, the earliest stage of the developing human being.
Sperm samples which are not expected to fertilize on their own may be assisted by sperm injection, or Intracytoplasmic Sperm Injection, more commonly known as ICSI (ick-see).

Step 5 & 6 Embryo development & Embryo transfer
The embryos are left in a petre dish or test tube to mature and divide.
Then the embryos are placed into the uterus or womb using a catheter, a hollow plastic tube. The catheter is designed to be small and flexible so it slips easily through the cervix. This is a minor procedure that seldom requires anesthesia or sedation. Recent breakthroughs in the embryo laboratory allow us to grow embryos to the blastocyst stage. The biggest single advantage of the blastocyst transfer is a significant reduction in the rates of multiple pregnancy greater than twins. Another advance in reproductive technology is cryoperservation & frozen embryo transfer. If a pregnancy does not occur in the "fresh" IVF cycle, the patient can return at a later time for transfer of the remaining frozen embryos.

Step 7 The luteal phase

Within a normal cycle these are the days following ovulation but in IVF the are the important days following embryo transfer, when the embryo begins developing and implants in the lining of the uterus, is the luteal phase. Progesterone, a natural hormone, helps the lining of the uterus develop and support the pregnancy. Supplemental progesterone is given by injection, vaginal suppository, or vaginal gel. At the end of the luteal phase a pregnancy test is performed.

tep 8 Pregnancy
Once you are pregnant, you will remain on medication as prescribed until one week after your second ultrasound at 10 weeks from your last menstrual period. At that time, we individualize the remaining course depending on your age , whether you have multiple embryos, and your general ovarian health. You return to your obstetrician at around 10 weeks gestation.
If you do not conceive, you should schedule a follow-up visit with your doctor at our clinic so we can review the cycle and make plans for the future. This follow-up visit is very important to all of us.

The Problems with IVF

*One thing that should be addressed before we continue is that fertility drugs or medications that help induce normal ovarian function or ovulation are not immoral because they do not utilize medical/surgical means to assist the conception act.

Now, starting with step 1 the treatment requires the client to be on hormonal contraception for one cycle and during the last week, in addition, they take medication that prevents ovulation. Basically this shuts down the natural functions completely in preparation for extreme, artificially induced functions.

With step 2 there is only a problem when the issue of multiple births arise. Multiple births are common because of the FSH medication that purposely increases the number of eggs that mature and therefore the number of subsequent children in most cases. At times, physicians try to covience the client to abort "less viable fetuses" to decrease the number within the womb or to increase the success rate. Who are we to choose which children should be born? We all know that abortion is wrong, this fact is unwavering in all circumstances.

Steps 3 and 4 violate God's plan for human procreation by removing mature eggs from the ovaries and fertilizing them in a petre dish, as opposed to within a woman's reproductive system naturally. Furthermore, when the sperm does not fertilize the egg immediately on its own, Doctors use the method of ICSI, intracytoplasmic sperm injection, to join the cells via syringe. We should take the sperm's natural refusal to combine with the egg as a sign that a child should not be conceived in this manner.

The babies continue to develop throughout step 5, until the likelihood of multiple births, that is the embryo dividing into twins or other multiples, is decreased. Continuing into step 6, the maturing babies, usually several different embryos, are reintroduced into the woman's uterus. Several are inserted to increase the success rate of one surviving and implanting. This raises the abortion question again within IVF because it is typical for more than one embryo to implant, resulting in a multiple pregnancy. Also during this step, the wanted, uninserted embryos are drained of their cytoplasm and it is replaced with antifreeze for possible later use. This usually destroys some of the embryonic cells in the process. Even more disturbing than that, the less fortunate, unwanted embryos are simply disposed of as medical waste. This is also abortion!

Finally, the moral issues within step 7 entail the use of excessive amounts of the hormone progesterone; which is given to the clients to insure embryo implantation. If we look back at the pre-cycle preparation for this therapy, we see that the woman's natural cycle is stopped with the drugs Lupron or Synarel before ovulation. Since the cycle is stopped, these also prevent the uterus lining from thickening following the release of a mature oocyte, like it would naturally, in preparation for pregnancy. Also the uterus would now be unable to support life, therefore causing the embryos not to implant. The Doctors must go back and give progesterone to restart the client's system that they had previously stopped. This is used in hopes of restarting the woman's body so it will maintain a viable environment for the inserted embryos, implantation and pregnancy.

Overall, both categories of therapies are illicit because they inhibit our Father's master plan for the human body and the sacred marital act. These methods make God's perfect design out to be something that needs to be supervised, is deemed inferior and requires outside parties and improvement. We must have faith in God's plan and not try to undermine Him just because we are impatient with his timing! Is upholding the sanctity and value of life not more important than our self-centered desires?

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