Science and Technology Committee

Josephine,

so in this case you would make the decison to let the child die? This seems to contradict your statement "The wisdom of Solomon put the child first, and so should we."

With regard to your assertion that homosexuals and single women are availing themselves of the natural processes for having children - I am not sure why there is such an importance placed on 'natural' processes (I assume by that you mean sexual intercourse.)

I mean if a man can ejaculate into a pot and then a woman inseminate herself with the sperm - I am sure in your eyes that is probably not considered 'natural' but it does not involve medical intervetion.

I am not sure why conceving 'naturally' would mean that the child was put first anyway.

Please can you point me to the research which shows that IVF causes children to be born "with worrying genetic problems" I would be very interested to see that research.

You also state "It was always accepted that this was not the ideal way to solve infertility" - I am sorry but who accepted this?

Also, do you have any alternatives for solving infertility, if this is indeed not the ideal way? If it is not the ideal way should we then surely abandon it?

In comparision - breat cancer cures could be deemed not ideal - I mean they don't cure everyone and there are possible serious side effects of the drugs - should we then just abandon those as well?

I'm working backwards.

I agree with your statement regarding breast cancer treatment, that a cure may be used even if it only saves some, but cannot accept the whole as a legitimate analogy. It can only be paralleled to the risks the mother takes in IVF treatment, but not to the risks imposed as a result on the child (third party), let alone be used to justify the destruction of embryos (again third parties).

Ethical cures for infertility. Major causes of infertility are age, body weight, smoking, environmental factors (particularly for men's sperm count. Sexually transmitted diseases (particularly chlamydia) cause permanent damage to the reproductive tract. Tubal occlusion is a major cause of infertility. There are many possible solutions to these factors. And there are infertility treatments in practice using natural hormonal analysis, holistic health approaches, etc. which are having the same or better success rates than IVF. I will encourage somebody I know who is involved to put info up on the forum. And even IVF can be practised within an ethical framework where no surplus embryos are created and eggs rather than embryos are frozen.

As regards 'ideal way to solve infertility'. Ask anybody who has been involved with IVF how much they suffered, physically and psychologically, and financially - and suggest that they wouldn't have preferred to go along the 'natural' route. As regards 'natural', my first preference is for the joys of sexual intercourse, which I believe gives all parties a good start in life.

As regards problems associated with IVF, it would be immensely lengthy to elencate them here but can I suggest just in the first instance you go to www.humrep.oupjournals.org and call up 'risk factors'. I found 710 articles in the last 3 years alone. At a conference I attended in London last year, Professor Robert Winston expressed concerns about embryo freezing and ICSI, and stated that he had to acknowledge that IVF had been developed by experimenting on the patients, and many other specialists attending the conference agreed. It was a medico/legal event and some of the lawyers looked eager at the prospect of future litigation.

Natural v unnatural. We were made man and woman. Why? We are equal but different? Why? The only thing I can put my finger on is our ability to reproduce sexually. And breasts for feeding babies. But that is just the physical sides of things. I think, however, that human relationships are more than sperm meets egg, somehow or other, somewhere or other. We are a complex mixture of flesh and blood and spirit, coming into this world with a geneological and generational history, with a right to be part of a human tradition. In a programme on gay parenting produced by Channel 4, two little boys discussed their lesbian parents in terms of utter perplexity, and one of them felt particularly isolated because of problems he experienced in the playground. On another programme where a little girl was asked if her school friends knew her mother was a lesbian, she replied, "No, I would never tell anybody." You may well say that society should change. I don't agree. Accepting homosexuality does not mean we have to accept gay parenting.

One of the problems, in my opinion, of this particular forum is that it is concerned with technological issues alone, reducing every dilemma to the physical, but seems reluctant to engage in a richer bioethics which involves the whole human condition.

And finally - you are taking a far too literal reading of the 'wisdom of Solomon'. What this famous King did in those long gone days was identify which of two mothers really cared for her child. It is a comment on the unselfish nature of true parenting. Rather than expose a child to any attacks on its welfare, a virtuous adult would prefer to have no child.

"Major causes of infertility are age, body weight, smoking, environmental factors (particularly for men's sperm count. Sexually transmitted diseases (particularly chlamydia) cause permanent damage to the reproductive tract." - I am not sure what you are trying to suggest as 'ethical cures' to these fertility problems - that the woman has children earlier, loses wieght, gives up smoking, has protected sex etc. I am sure most couples would consider these factors. I understand that one of the most common causes of fertility problems in PCOS - and I am not sure how any of the above would help 'cure' that.

Yes alternative medicine has it's place - acupuncture may help increase chances of sucess with conception with IVF - but no-one would recomend that you stop taking the medicine your doctor has prescribed and replace that with homopathic remedies or whatever. However, the is room for more research to enable less invasive 'cures' for infertilty - I do think that the fertility industry has a vested interest in IVF and other techniques and that needs to be looked at - but that is not to say they are not the best options that may be available to some people.

If there are issues with the health of children resulting from IVF/ICSI and other proceedures then of course these need to be investigated. But I am not aware of any serious concerns that have affected children being born by these proceedures - the majority of children appear to be healthy. Of course if IVF etc caused increases in cancer rates or such like - then their would certainly be casue for concern.

"As regards 'ideal way to solve infertility'. Ask anybody who has been involved with IVF how much they suffered, physically and psychologically, and financially - and suggest that they wouldn't have preferred to go along the 'natural' route. As regards 'natural', my first preference is for the joys of sexual intercourse, which I believe gives all parties a good start in life." - I am sure any heterosexual couple would prefer not to have fertility problems - IVF is costly and stressful - but I bet most would say that they don't regret it, especially those who have had babies as a result. Other's who were unsuccessful may feel satisfied that they have given it their best and if they had never tried they would never of known.

"In a programme on gay parenting produced by Channel 4, two little boys discussed their lesbian parents in terms of utter perplexity, and one of them felt particularly isolated because of problems he experienced in the playground." - I disagree - I also saw that programme and felt the little boy interviewed described his parents relationship quite eloquently for someone his age. What he did seem perplexed about was the fact that other people could have a problem with him having two mums. However, I felt that programme was very poorly made and not very representative of lesbians and gays having children in the UK.

Whether you accept homosexuality and gay parenting or not - the fact is we are having families and will continue to do so in greater numbers in the future. Whether you and others agree with it or not we are here to stay and society will not disintergrate as a result!

Jules

NAPROTECHNOLOGY INFERTILITY TREATMENT – A NEW WAY FORWARD

As an alternative to IVF and the various artificial reproductive technologies currently being provided, promoted and funded by the NHS, NaProTechnology is a less invasive, far more successful, ethical approach which would cost the NHS a fraction of what IVF treatment is currently costing the NHS and the tax payer.

Unlike IVF procedures, with NaProTechnology, there is no increased risk of the following:
· Multiple pregnancies (which can cause serious danger to the health of mother and child)
· Major birth defects, low birth weight and prematurity (all of which place a heavy financial strain on the healthcare system)
· Long term disability among surviving infants
· Neonatal deaths
· Medical concerns about the safety of artificial techniques on a woman’s health

IVF is often unnecessary, incredibly invasive and can create serious financial and emotional strain for couples.

With NaProTechnology, there are none of the ethical dilemmas regarding the discarding of embryos, selective retention or hyper-stimulation and other health concerns. The underlying CAUSE is systematically and meticulously evaluated and treated with the use of the Creighton Model tracking system. This in turn assists with all future pregnancies (unlike IVF which is of no assistance at all). Finally and most appealing to couples is that conception occurs as an act of love, not in a laboratory.

Success rates are approx 40-60% and are expected to rise as this new reproductive science continues to be developed (IVF success can range from 10-25%)

Nicole Syed, FertilityCare Practitioner
London FertilityCare Centre
21a Soho square W1D 4NR
Tel: 0207 437 0892
Nicole@naprofertility.co.uk

Can you explain exactly what these treatments are and how they work - I have never heard of them before. Is there a website?

Jules

Apologies to Nicole for replying in her place but this forum is due to close in two hours and I'm not sure if she is planning to log in again. Natural fertility techniques are essentially a combination of tried and trusted medical approaches such as careful, specific alterations to diet and lifestyle, the teaching of natural family planning in order to plan the optimal time of the month for conception, and established treatments for common causes of infertility such as keyhole surgery for endometriosis. Because infertility is not a single disease this 'whole body' approach can be very effective. The natural fertility approach has the following advantages over IVF:

- it is statistically more effective, as Nicole has pointed out. This is especially true if you consider that many couples approach these clinics as a last resort after IVF has failed. Furthermore, IVF success rates are misleading since percentages are calculated on live births per couple; because so many IVF births are multiple, the percentage of couples that "take home a baby" is considerably lower.

- it actually helps to treat the cause of infertility rather than circumvent the problem as IVF does

- it avoids the ethical problems associated with out-of-body conception: many couples feel the whole approach to be more 'natural'

- it doesn't have the health risks associated with IVF (see Dr Allan's comments)

- it improves the woman's health even if conception is not achieved immediately. IVF failure is so devastating precisely because the effect is not cumulative: if a cycle fails the couple have nothing to show for their efforts

- because the techniques used are simpler than IVF, the treatment can often be cheaper.

You may ask why everyone isn't using natural fertility programs if these are so much better than IVF. I don't think there's a single answer to this but possible reasons might include:

- pervasive fixation on IVF and suspicion of anything which appears to be 'alternative' within the medical establishment

- many infertile couples may lack any knowledge of alternatives

- the tendency to lump such treatments together with scientifically dubious herbal treatments or homeopathic techniques

- the belief that modern natural family planning (NFP) is the same as the old-fashioned rhythm method (it isn't)

- the fact that NFP was/is typically taught by groups to which the media and some elements of the medical establishment are ideologically opposed (e.g. the Catholic Church). Note that here NFP is actually being used to achieve pregnancy.

Obviously, these techniques can only aid the ‘historical’ process of procreation and would not be applicable to many of the new scenarios proposed in this forum. Nor can these techniques overcome complete infertility.

We're discouraged from advertising third-party sites on this forum, but since you have specifically asked, I hope the moderators will not mind if I suggest www.lifefertility.co.uk as a starting point for more information.

I was browsing and noticed the request by Jules (11.3.2004) for articles on the medical risks in IVF. I thought the following might be of interest as a start:

1. Powell, K. (2003). Nature 422:656 - 658: "Seeds of Doubt"

2. Maher, E.R. et al. (2003). J. Med. Genet. 40:62-64. "Beckwith-Wiedemann syndrome and assisted reproduction technology (ART)."

3. DeBaun et al. (2003):Am J Hum Genet. 2003 Jan;72(1):156-160. "Association of in vitro fertilization with Beckwith-Wiedemann syndrome and epigenetic alterations of LIT1 and H19."

4. Goden, R. et al. (2003).Lancet 361(9373):1975-7. "Rare congenital disorders,
imprinted genes, and assisted reproductive technology."

5. Gicquel, C. et al. (2003) Am. J. Hum. Genet. 72(5):1338-41. "In vitro fertilization may increase the risk of Beckwith-Wiedemann syndrome related to the abnormal imprinting of the KCN1OT gene."