**12.1 Directed gamete donation for assisted reproduction**

Rehmann-Sutter and Wienroth (2009) have identified the influence of reproductive technologies on perceptions and practices related to reproduction and beyond this, even to the cultural and societal imperatives that enable the understanding of the family and in particular motherhood, offspring and other issues related to them.

Ethical considerations arise from gamete donations from known donors as much as is the case with anonymous gamete donation already addressed. The availability of advanced micro-manipulative assisted reproductive technology prohibits the need for request on sperm donations, although such request may still occur for artificial insemination using donor semen (AID). Requests for directed oocyte donation however are common, usually in the treatment of ovarian failure. Directed gamete donations usually take into account various desirable characteristics, of the donor which may include the health status, character, social and cultural background and of course genetic makeup. The confidentiality issues raised in directed donation are more profound in that the identity of all the players, the health professionals, the donor and the recipient is known. Directed donations therefore require confidentiality that is determined by legal, professional ethical standard as well the relationship and understanding of the involved parties. Directed donation requires that the interest of the potential child and the other involved parties, the donor, the recipient and the health professionals be protected with respect to disclosure of identity, written informed consent of the donor and also recognition that the donor is not driven by pressure, coercion or financial consideration in making the decision to donate gamete. The disclosure to the children from directed gamete donation of their genetic origin may serve the purpose of averting consanguinity, or incest, amongst these offspring in the future. child

#### **13. Surrogacy**

Surrogacy implies the commissioning of a woman to carry a pregnancy whether or not on a commercial basis. It poses ethical challenges having been regarded occasionally the using of one person as a means to the ends of another (Warnock, 1987). Ethics demand that the autonomy of the surrogate mother should be respected and that surrogacy should not be commercialized. Ethical approval is required and the legal requirements for surrogacy in the concerned country should be complied with and duly explained to the concerned parties prior to the surrogate arrangement by the health professional.

#### **14. Multifoetal gestation (multiple pregnancy)**

Assisted reproduction requiring the use of ovulation inducing drugs and the need for multiple embryo transfer has been the main factor responsible for the increasing incidence of multiple pregnancies the world over. Multiple pregnancy has grave implications not only for the mother and the foetuses but also for the family, the community, the healthcare provider and the overall health services particularly in respect of the demands of expert on neonatal care, couples seeking for infertility treatment especially by assisted reproductive technology should therefore be adequately informed as to the possibility, and risks that may

Rehmann-Sutter and Wienroth (2009) have identified the influence of reproductive technologies on perceptions and practices related to reproduction and beyond this, even to the cultural and societal imperatives that enable the understanding of the family and in

Ethical considerations arise from gamete donations from known donors as much as is the case with anonymous gamete donation already addressed. The availability of advanced micro-manipulative assisted reproductive technology prohibits the need for request on sperm donations, although such request may still occur for artificial insemination using donor semen (AID). Requests for directed oocyte donation however are common, usually in the treatment of ovarian failure. Directed gamete donations usually take into account various desirable characteristics, of the donor which may include the health status, character, social and cultural background and of course genetic makeup. The confidentiality issues raised in directed donation are more profound in that the identity of all the players, the health professionals, the donor and the recipient is known. Directed donations therefore require confidentiality that is determined by legal, professional ethical standard as well the relationship and understanding of the involved parties. Directed donation requires that the interest of the potential child and the other involved parties, the donor, the recipient and the health professionals be protected with respect to disclosure of identity, written informed consent of the donor and also recognition that the donor is not driven by pressure, coercion or financial consideration in making the decision to donate gamete. The disclosure to the children from directed gamete donation of their genetic origin may serve the purpose of averting consanguinity, or incest,

Surrogacy implies the commissioning of a woman to carry a pregnancy whether or not on a commercial basis. It poses ethical challenges having been regarded occasionally the using of one person as a means to the ends of another (Warnock, 1987). Ethics demand that the autonomy of the surrogate mother should be respected and that surrogacy should not be commercialized. Ethical approval is required and the legal requirements for surrogacy in the concerned country should be complied with and duly explained to the concerned parties

Assisted reproduction requiring the use of ovulation inducing drugs and the need for multiple embryo transfer has been the main factor responsible for the increasing incidence of multiple pregnancies the world over. Multiple pregnancy has grave implications not only for the mother and the foetuses but also for the family, the community, the healthcare provider and the overall health services particularly in respect of the demands of expert on neonatal care, couples seeking for infertility treatment especially by assisted reproductive technology should therefore be adequately informed as to the possibility, and risks that may

**12. Pregnancy and delivery** 

amongst these offspring in the future.

prior to the surrogate arrangement by the health professional.

**14. Multifoetal gestation (multiple pregnancy)** 

**13. Surrogacy** 

**12.1 Directed gamete donation for assisted reproduction** 

particular motherhood, offspring and other issues related to them.

be associated with multiple pregnancy, particularly of the higher other variety. Obstetrics and gynaecological professionals involved in assisted reproduction should therefore aim at achieving singleton pregnancies and furthermore clearly inform their client and other interest group such as the press that multiple pregnancies arising from assisted reproduction constitute a complication rather than a fit. Where multiple pregnancies especially of the higher order variety occur, it is ethically preferred to reduce the number of foetuses than leave them alone, since this will increase the chances of survival and success of the assisted reproduction.
