Section 3 Ethics and Laws

**197**

**Chapter 12**

**Abstract**

Technology

*Justo Aznar and Julio Tudela*

considerations, loss of human embryos

cations of these techniques have been proposed [4].

birth rate (LBR) per ovarian stimulation cycle.

**1. Introduction**

**2. Efficacy of ART**

Bioethics of Assisted Reproductive

There is no doubt that for a couple who are having difficulties in conceiving, having a child is an objective good. However, it is also indisputable that assisted reproduction techniques raise clear ethical issues. In order to begin this bioethical reflection, it should be clearly established that the early embryo, which can be manipulated or destroyed using these techniques, is a living being of our species. We believe this is unquestionable from a biological point of view, and it therefore deserves our full respect. The bioethical assessment of assisted reproduction techniques includes analysis of the embryo losses caused by their selection and manipulation through preimplantation genetic diagnosis, 'social freezing' or the possible lack of rigour in the information provided by the clinics involved, to which must be added the higher morbidity reported in babies born as a result of these procedures.

**Keywords:** assisted reproduction, in vitro fertilisation, ICSI, bioethical

There is no doubt that for a couple who are having difficulties in conceiving, having a child is an objective boon. In an attempt to achieve this goal, many will avail assisted reproductive technology (ART) or natural family planning methods [1–3]. ART refers to a number of techniques, primarily: (a) in vitro fertilisation (IVF),

in which the fertilisation of an egg by sperm takes place in a laboratory setting; (b) intracytoplasmic sperm injection (ICSI), in which a single sperm is introduced into the egg to be fertilised, also in a laboratory setting; (c) artificial insemination, which involves artificially delivering semen to the female genital tract—the semen may be from the woman's own partner or a donor; and (d) gamete intrafallopian tube transfer (GIFT), which involves removing eggs laparoscopically after controlled ovarian hyperstimulation, followed by introduction of the mixture of the couple's eggs and sperm into the fallopian tube so that fertilisation occurs in the body, unlike IVF and ICSI, in which it takes place 'in vitro' although several modifi-

One important aspect to consider is the efficacy of these techniques, which is generally calculated based on two parameters: the pregnancy rate (PR) and the live

## **Chapter 12**
