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Art by Owen Salisbury and Eric Lister

In vitro Fertilization (IVF)

The process responsible for test tube babies, in vitro fertilization was developed in 1978. The first child conceived using IVF was Louise Brown. When the first procedure was conducted it raised scathing critiques from politicians and the religious right. People said the procedure would result in horrible deformities or children without souls.

Today, thousands of infertile American couples each year use in vitro fertilization as a fertility treatment. The process, though effective, is difficult for women who subject themselves to the procedure. A week before the prospective mother’s period begins she enters a doctors office for a physical exam. Afterward she must take drugs to prevent her eggs from being released prematurely. Next she begins a round of hormone injections that stimulate her ovaries to produce multiple egg follicles. After 10 days, she returns to the doctor for an ultrasound. If the ultrasound confirms the existence of multiple follicles, she then begins another round of hormone injections, which cause the eggs to mature. After three days, a doctor passes a needle through her vaginal wall into her ovaries to retrieve the eggs. The eggs are fertilized in a petri dish in the clinic’s lab using the man’s sperm. The resulting embryos are allowed to grow and divide until they consist of eight cells each. These are then placed in the woman’s uterus. After this final procedure, the woman is subjected to three more weeks of hormone injections intended to thicken the lining of the uterus and increase the chances of a pregnancy.

All in all, the procedure causes a great deal of pain and discomfort. The success rate for any given IVF attempt is low and couples are often encouraged to try several times before the procedure finally results in a successful pregnancy. Because multiple embryos are implanted to increase the chances of a pregnancy, when the procedure is successful multiple pregnancies often result. In addition to being extremely uncomfortable, the series of hormone injections often causes bodily discomfort and changes in mood. The long-term effects of the hormone treatments are unclear, although early studies suggest that they can result in premature menopause.

Embryos not implanted during an IVF procedure – or ones that are stored and never implanted because couples have changed their minds – are often the cause of pro-life/pro-choice debates.

The union of sperm and egg in a laboratory has also resulted in legal custody battles. It is possible to have separate intended parents, sperm and egg donors, and surrogate mothers resulting in as many as five different individuals responsible for one child.

Although it is used commonly today, IVF still raises many ethical questions among medical practitioners. The procedure would have to be made much less difficult for all involved if it were to become a widespread method of reproduction.

Intracytoplasmic Sperm Injection (ICSI)

This procedure is used in conjunction with IVF for male fertility problems. If a man produces few sperm or sperm that have difficulty swimming, the sperm can be collected in the laboratory and injected directly into the woman’s eggs using a microscopic glass needle. The embryos are then implanted as in the normal IVF procedure.

Preimplantation Genetic Diagnosis (PGD)

This procedure is also used in conjunction with IVF. PGD is used to assist couples who are carriers for genetic disorders such as cystic fibrosis or Tay-Sachs, to ensure that their children will not inherit the disease. After embryos have divided to the eight-cell stage in the laboratory, one cell is removed from each one and undergoes genetic testing. Only embryos that test negative for a disease trait are implanted.

PGD raises many ethical considerations because parents can use the technology to select for or against certain traits in their children. Today, PGD procedures are closely regulated by panels of bioethicists to ensure that the technology is not used irresponsibly for say, cosmetic purposes.

In addition, this technology is also at the center of pro-life/pro-choice controversies.

Intracytoplasmic Nuclear Transfer (Cloning)

In a cloning procedure the nucleus containing the genetic material is removed from an egg, which has been retrieved by the same methods used in IVF. The nucleus is then replaced by the nucleus from a regular cell. After altering the electrical and chemical environment of the egg, it effectively becomes an embryo and begins to divide. This embryo has the same genetic material as the donor of the cell – it is a clone. This process has been used in animals, but is unsuccessful so far in humans. Advanced Cell Technology, a Massachusetts company announced last year that it had succeeded in its attempt, but the claims were discredited after it was discovered that the embryos had died after only a few cell divisions. In theory, the embryo can be implanted in a woman’s uterus, resulting in a pregnancy. This is what is known as reproductive cloning, which is of little interest to most researchers in humans. Recently, however a rogue Italian researcher by the name of Antinori claims to have impregnated a woman with the first human clone. His claims are still being reviewed at the time of this writing.

What most researchers are interested in is known as therapeutic cloning. This is when the cloned embryos are allowed to divide in the laboratory until they produce fetal stem cells. These embryos are never intended to be implanted. Many researchers see therapeutic cloning as a necessity to stem cell therapy because the resulting stem cells are genetically identical to their donor and therefore stand no chance of organ rejection.

Although some people see cloned embryos as the source of a pro-life/pro-choice issue, most public debate on the issue of human cloning results from the failure of the media or politicians to make distinctions between reproductive and therapeutic cloning.

Germline Genetic Engineering

This technology would be used in conjunction with IVF. The first cell of an embryo would have its DNA altered or added to by a disable d virus or by more advanced methods. Since all future cells will come from this first cell, this is an easy way of altering the DNA of the entire individual. The extent and variety of changes that can be made will increase greatly as genetic technologies advance and more of the human genome is deciphered.

Ethical considerations abound where this technology is concerned: Many people put it on a par with eugenics, bringing to bear all of its negative connotations. Others are concerned with the long-term effects on the human gene pool. Researchers interested in the technology claim that if the technology is made widely available it will sidestep the dark implications of traditional eugenics. They also claim to have arrived at methods that prevent genetic modifications from being passed between generations.

Artificial Chromosomes

Every person’s DNA is divided up into 46 chromosomes that lie within the nucleus of all your body’s cells (with the exception of sperm and eggs, which contain only 23 chromosomes that pair in reproduction to produce a new individual with 46). In experiments with mice, researchers have been able to introduce an entirely extra chromosome into cells. In theory, extra genes could be added to these chromosomes without tampering with an individual’s existing DNA. These chromosomes could be prevented from passing between generations with the addition of special genes that would cause the chromosome’s centromere – a portion of the chromosome needed for replication -to disassemble when exposed to a specific hormone. This hormone could be a chemical not normally produced in humans and taken as a pill or an injection.

If the addition of genes on this artificial chromosome interfered with the person’s existing genes, some of the existing genes might be disabled, also using technology common in mouse experiments.

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