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Evaluating Reproductive Technology: Benefits & Harms Rels 300 / Nurs 330 5 Februa ry 2014

Evaluating Reproductive Technology: Benefits & Harms Rels 300 / Nurs 330 5 Februa ry 2014. http://www.toonpool.com/user/1631/files/genetic_standardization_1770845.jpg. http://nccd.cdc.gov/DRH_ART/Apps/FertilityClinicReport.aspx. 2011 – CDC ART Reports. National Summary

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Evaluating Reproductive Technology: Benefits & Harms Rels 300 / Nurs 330 5 Februa ry 2014

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  1. Evaluating Reproductive Technology: Benefits & HarmsRels300 / Nurs3305 February 2014 http://www.toonpool.com/user/1631/files/genetic_standardization_1770845.jpg 300/330 - appleby

  2. http://nccd.cdc.gov/DRH_ART/Apps/FertilityClinicReport.aspx 300/330 - appleby

  3. 2011 – CDC ART Reports National Summary  99% of patients used IVF Success rates given for age groups, patient diagnosis, with/without donor eggs, # embryos transferred and/or frozen, # pregnancies per embryo transfer, % live births • 35 • 35 – 37 • 38 – 40 • 41 – 42 • 43 – 44  44 With own ova: range of live births from 40% (age  35) to 1% ( 44) With donor ova: live birth/single infant = 35% 300/330 - appleby

  4. http://www.cfas.ca/index.php?option=com_content&view=article&id=1290%3A2012-cartr-results&catid=1012%3Acartr&Itemid=668CANADIAN FERTILITY AND ANDROLOGY SOCIETY 300/330 - appleby

  5. 2012 Canada total cycles = 25,782 IVF/ICSI – intra-cytoplasmic sperm injection - own gametes IVF, natural – in vitro fertilization FET – frozen embryo transfers DO – donor gametes FET-DO – frozen embryo transfers with donor gametes Other 300/330 - appleby

  6. Pregnancy rate data 300/330 - appleby

  7. Pregnancy / Live birth data (2013)http://www.cfas.ca/index.php?option=com_content&view=article&id=1205%3Alive-birth-rates-2013&catid=929%3Apress-releases&Itemid=460 • The overall clinical pregnancy rate was 32% per cycle started • The overall live birth rate was 24% per cycle started • The live birth rates per cycle started, by age of the mother, were: • 33% for women under 35 years old • 24% for women aged 35-39 years • 10% for women 40 years old and over. 300/330 - appleby

  8. Pregnancy / Live birth data (1999)http://www.cfas.ca/images/stories/pdf/2001_press_release.pdf 1999: Live birth rates for 4,292 IVF treatment cycles (including intracytoplasmic sperm injection) = 21% 2013: Live birth rates for 14,866 IVF treatment cycles (including ICSI) = 24% 300/330 - appleby

  9. Are these rates higher or lower than you had imagined? Recognizing that you would most likely have to pay out of your pocket for each cycle of an IVF procedure, a 24% success rate (i.e., a live birth) seems • Encouraging • Discouraging • Fabulous • Outrageous If I were infertile, I would • Never • Possibly • Definitely • Enthusiastically Seek assistance from an assisted reproduction clinic. 300/330 - appleby

  10. Evaluating reproductive technologies • Whose personal dignity and autonomy are promoted or harmed? • What are the potential benefits of reproductive technologies? • Who are the beneficiaries? • What are the potential risks and harms of reproductive technologies? • Who is most likely to be harmed? • Are there justice issues in the provision of reproductive services? • Issues of fairness, equality, equitable access? 300/330 - appleby

  11. Procreative Liberty: Benefits and Harms According to John Robertson (p.131), “those who would limit procreative choice have the burden of showing that [one’s] reproductive actions” would result in tangible & substantial harms What sorts of potential harms might there be in NRTs? Who might be vulnerable to being harmed by procreative choices and reproductive technologies? 300/330 - appleby

  12. Procreative Liberty Thomas Murray (p.133) argues that procreative liberty • emphasizes individual autonomy • values independent exercise of rights,choice and control • favoursfreedom from limitations imposed by others • promotes contractual rights and obligations • Uses marketplace transactions – property ownership, buying & selling raw materials and products, paying for services The desire and choice to have children is a choice to initiate a very special relationship which is inconsistent with market values. (Murray) 300/330 - appleby

  13. Should there be Limitations on Procreative Autonomy? Procreative liberty promotes individual autonomy and freedom from interference From a bioethics perspective, autonomy must also be balanced with attention to beneficence • Contributing to the well-being and benefit of potential parents, infants, and donors • Also by non-maleficence • Ensuring that risks are minimized and harms are avoided for participants • And by justice • fair and equal opportunities & treatments that are provided in an equitable manner without bias or discrimination 300/330 - appleby

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