Navigation Links
Intrafamilial medically assisted reproduction
Date:1/20/2011

The ESHRE Task Force on Ethics and Law acknowledges the benefits that IMAR may bring to those choosing this approach and concludes that certain forms of IMAR are morally acceptable under certain conditions. The group advises to evaluate each request for IMAR individually, based on four ethical principles in health care: the respect for autonomy, beneficence and non-maleficence and justice.

The Task Force explains that the right for individual autonomy is elementary: any individual should have the principle of choice with whom to reproduce. It is understandable that couples wish to preserve some sort of genetic identity with the child, and hence may wish to choose a donor in the family. IMAR may facilitate a child's access to its biological roots and enable it to have contact with the donor or the surrogate mother. Often faced with no realistic alternatives due to long waiting times or lack of donors, IMAR may also be the only option available to these patients.

The ESHRE group recommends that fertility doctors should take into account the relevant regulations in their country when they assist a couple with IMAR. In some countries IMAR is illegal and the relevant laws against incest and consanguinity apply to protect the offspring from genetic risks and to avoid possible social disruptions and conflicts.

"Doctors should assess any possible psychosocial and medical risks related to the treatment," says Dr. Wybo Dondorp, deputy coordinator of the Task Force. "Doctors must therefore consider the principles of beneficence and non-maleficence together and aim at producing net benefit over harm for all parties involved."

Potential risks may affect several parties, including the future child. These risks can arise from intrafamilial conflict if parents feel threatened in their parental role or if they have different views from the collaborators on how the child should be informed of its genetic origins. Especially in cases of intergenerational IMAR, there are concerns that the child may be confused about his role in the family. The possible pressure on the donor or surrogate to collaborate can also lead to psychological problems. Adequate information on possible risks should be given to all parties. This includes both combined and separate counseling of recipients and collaborators to assess the voluntariness of the donation and to reduce potential conflict situations.

According to the principle of justice, doctors should treat similar cases in the same way. So if sister-to-sister oocyte donation is accepted so should brother-to-brother sperm donation. The justice principle also applies where IMAR may circumvent unjust exclusion if waiting times for donors are long or the treatment costs are too high without intrafamilial donors.

It is of paramount importance that recipients and collaborators give their informed consent. The ESHRE group is in favour of disclosure of information to the child if other relatives are aware of the familial collaboration. The counselor should offer support in any case and various strategies may be equally justified; while some would give priority to the child's right to know, others would be more concerned about the risk of confusion and accept a parental preference for secrecy.

Doctors should not accept a minor relative as a gamete donor or a surrogate. In the case of intended surrogacy the Task Force considers parenthood by the surrogate to be a precondition in order to collaborate in IMAR.

The paper gives special attention to (rare) cases of consanguineous IMAR, involving the mixing of gametes of persons that are genetically closely related. "The Task Force considers consanguineous IMAR between up to third degree relatives as acceptable in principle, subject to additional counseling and risk-reduction," says Professor Guido de Wert, coordinator of the ESHRE Task Force. "Here, genetic counseling is appropriate to assess the increased risk of conceiving a child affected by a serious recessive disease."

Part of adequate genetic counseling and good clinical practice in such cases is to offer carrier screening for those disorders that are more prevalent in the particular ethnic group. Given that fertility specialists have a co-responsibility for the welfare of the child, it may be morally justified to offer such genetic testing as a condition for access to assisted reproduction.

The group concludes that in some situations IMAR is morally acceptable as long as counseling of recipients and collaborators is applied in order to reduce potential psychosocial and medical risks. First-degree intergenerational IMAR needs special scrutiny, also in view of the increased risk of undermining autonomous choice. First- and second degree consanguineous IMAR is at odds with the spirit of anti-consanguinity and anti-incest legislation in most countries and should not be offered. The group encourages more research into the psychosocial implications of IMAR to contribute to adequate and moral guidance.


'/>"/>

Contact: Hanna Hanssen
hanna@eshre.eu
322-263-6466
European Society of Human Reproduction and Embryology
Source:Eurekalert

Related biology news :

1. Cermetek Introduces Medically Approved Modem Module
2. Children born after assisted reproduction at greater risk of congenital malformations
3. Cardiac arrest resuscitation: Passive oxygen flow better than assisted ventilation
4. Attitudes towards assisted reproduction and preimplantation genetic diagnosis
5. Research proves gender-bending chemicals affect reproduction
6. Biologists identify influence of environment on sexual vs. asexual reproduction
7. Why the biological clock? Penn study says aging reduces centromere cohesion, disrupts reproduction
8. Flowers do it, trees do it: Symposium on plant reproduction
9. European Society of Human Reproduction and Embryology Annual Meeting
10. Medicine residues may threaten fish reproduction
11. CSHL-Mexican team coaxes sexually reproducing plant to brink of asexual reproduction
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/3/2017)... 3, 2017  Data captured by IsoCode, ... detected a statistically significant association between the ... treatment and objective response of cancer patients ... predict whether cancer patients will respond to ... well as to improve both pre-infusion potency testing ...
(Date:3/29/2017)...  higi, the health IT company that operates the ... , today announced a Series B investment from ... The new investment and acquisition accelerates higi,s strategy to ... population health activities through the collection and workflow integration ... collects and secures data today on behalf of over ...
(Date:3/24/2017)... -- Research and Markets has announced the addition of ... - Industry Forecast to 2025" report to their offering. ... The Global Biometric Vehicle ... around 15.1% over the next decade to reach approximately $1,580 million ... estimates and forecasts for all the given segments on global as ...
Breaking Biology News(10 mins):
(Date:4/25/2017)... , April 25, 2017 ... has licensed its novel immune-modulating technology to an undisclosed ... and allergy. Tregitopes, pronounced T·rej·itopes, are ... immunoglobulin by EpiVax CEO Annie De Groot ... intravenous immunoglobulin G, an autoimmune disease therapy, Tregitopes ...
(Date:4/24/2017)... ... 24, 2017 , ... It is well established that ligand ... broad application of this cellular target engagement concept to drug discovery has been ... stabilization assays are valuable methods for particular applications, but they can require target-specific ...
(Date:4/21/2017)... ... 2017 , ... The University of Connecticut, in partnership with ... startups through the UConn Innovation Fund. The $1.5 million UConn Innovation Fund was ... , The UConn Innovation Fund provides investments of up to $100,000 to companies ...
(Date:4/21/2017)... ... April 21, 2017 , ... Frederick Innovative ... range of emerging technology-based businesses, recently earned a $77,518 grant from the Rural ... Founded in 2004, FITCI is Frederick’s first incubator. A non-profit corporation, FITCI is ...
Breaking Biology Technology: