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Choosing Assisted Reproduction

Social Emotional and Ethical Considerations

By Susan Lewis Cooper and Ellen Sarasohn Glazer

The following excerpt is from Chapter One "Emotional and Ethical Consideration of Assisted Reproductive Technology." This book is published by Perspectives Press: The Infertility and Adoption Publisher.

For the first time in history, as an outgrowth of in vitro fertilization technology and research, the three components of parenthood -- the genetic, the gestational, and the nurturant -- can be separated, so that the loss of one does not necessarily result in the loss of the others. For a man or woman who may not be able to conceive a child genetically connected to him or her, ovum donation or sperm donation offers the opportunity for gestation and parenting of a child genetically connected to half of the couple. For a woman unable to carry a pregnancy to term, gestational care may be the alternative of choice. For couples who cannot provide egg or sperm, but who wish to experience pregnancy, embryo adoption may be an alternative route to parenthood.

Reproductive choices are not made easily. As couples near the end of their biological options, most contemplate -- if only for a split second -- what it would be like not to be parents at all. If they decide that raising children is their primary goal, they begin to think about alternative routes to parenthood. The array of adoption and third party parenting options available challenges couples to examine the relative importance to them of gestational vs. genetic connections. Prospective parents must think carefully about what it would mean to them to be a parent without experiencing pregnancy, or a parent with no genetic connection to their child. Others contemplate what it would be like not to be parents at all...

"Just because we can do something, should we do it?" This is a question that has plagued scientists in the last half of the twentieth century. The field of reproductive medicine in particular has faced this question -- perhaps more than any other field. The array of parenting options afforded by reproductive technology is staggering. The development of in vitro fertilization has made it possible for one child to have as many as five different "parents" -- an ovum donor, a sperm donor, a gestational carrier, and two adoptive (rearing) parents. Furthermore, cryopreservation of sperm and of embryos has enabled people to preserve their potential fertility almost indefinitely. Cryopreservation of embryos has even enabled posthumous motherhood to be possible. The new parenting paths -- and configurations -- raise a profoundly difficult and often disturbing ethical question: Is it in the best interest of children to be created and parented through third, fourth, or even fifth parties?

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