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Assisted reproductive technology (ART) is a medical intervention developed to improve an ‘infertile’ couple’s chance of pregnancy. ‘Infertility’ is clinically accepted as the inability to conceive after 12 months of actively trying to conceive. The means of ART involves separating procreation from sexual intercourse - the importance of this association is addressed in bioethics.
Some techniques used in clinical ART include: artificial insemination; in vitro fertilisation (IVF); gamete intra-fallopian transfer (GIFT); gestational surrogate mothering; gamete donation; sex selection and pre-implantation genetic diagnosis. Issues addressed in bioethics are the appropriate use of these technologies and the techniques employed to carry out procedures for quality and ethical reviews.
Assisted reproductive technology and its use directly impact the foundational unit of society – the family. ART enables children to be conceived who have no genetic relationship to one or both of their parents. Children can also be conceived who will never have a social relationship with one or both of their genetic parents, e.g. a child conceived using donor sperm. Non-infertile people in today’s society including both male and female homosexual couples, single men and women, and post-menopausal women are seeking the assistance of ART. Concerns in all situations include the child and his or her welfare, including the right to have one biological mother and father. The fragmented family created by ART can disconnect genetic, gestational and social child-parent relationships which have typically been one and the same in the traditional nuclear family.
Other important bioethical issues include the appropriate use of pre-implantation genetic diagnostic screening, use, storage and destruction of excess IVF embryos, and research involving embryos. ART research requires human participants, donors and donated embryos, oocytes and sperm.
Ethical issues that arise in ART research surround the creation and destruction of embryos. One approach in bioethics involves preserving justice, beneficence, non-maleficence and the autonomous interests of all involved. Bioethicists contribute to ethical guidelines and moral evaluations of new technologies and techniques in ART as well as topublic discourse that leads to development of national regulations and restrictions of unacceptable practices.