- Executive Summary
Infertility has been a problem in the society since the beginning of time and much medical research has been carried out over the years to develop technologies. My aim is to discover how the progress of medical technology has impacted the evolution of infertility treatment methods. It will show the infertility treatment methods available in the past and the ones that are currently available to couples now, as well as possible future advancements in this field.
- Background/Introduction
This project will only be covering infertility and its treatment methods in developed countries. This is because infertility is more of a problem in developed countries than in developing countries. Studies show that a woman’s fertility declines as she ages. In couples where the woman is 35 or older, a third of them have infertility problems and this statistic jumps to two thirds when the woman reaches her 40s and in developed countries, there is an increasing trend of women choosing to start a family at a later age as they prefer to establish their careers first.
However, in developing countries where gender equality has yet to be achieved, a woman’s main role in society is still to bear children for their husbands and most women get married at a young age. In addition, the lack of availability and awareness of birth control in these regions contribute to uncontrolled birth rates and unsustainable growth of the population. Sophisticated medical technologies are more readily available in developed countries than in developing countries due to the economic discrepancies in these areas. This sums up our rational for focusing solely on the development of infertility treatment methods in developed countries.
- Historical Perspective (ie where we have come from)
Past Infertility Treatment Methods
Couples relied on unconventional methods in the hope of conceiving. In some societies, infertile couples believed in myths which had been passed down for generations.
For example, it was commonly believed that couples with infertility issues should adopt children as this act of charity would bring good luck into their households resulting in natural children being born later.
Other couples prayed to fertility idols for divine intervention. Another method used to deal with infertility was traditional surrogacy where an infertile woman arranged for another woman to be impregnated by her husband and then claimed the offspring as her own.
In addition, infertile couples were also treated with folk and medicinal remedies. In cultures where infertility was associated with stress levels, couples tried flower remedies where essences of flowers, plants and trees were used to promote a positive mental state, promoting relaxation, reducing stress and enhancing personal well-being.
Another such treatment was aromatherapy which people believed could aid in regulating menstrual cycles. In China, couples tried acupuncture, which is an ancient Chinese medical practice aimed at balancing the energy pathways in the body, to promote both physical and mental well-being. Herbal remedies were also used for women who had hormonal imbalances which caused irregular ovulation. However, there is no evidence to prove that any of these non-medical treatment methods were successful in helping couples conceive.
- Current Situation (ie where we are today)
Modern Infertility Treatment Methods
Surgical Treatment
In the case where men and women are infertile due to structural problems within their reproductive organs, surgical treatment is usually the only viable treatment option available. Surgery aims to correct these structural problems in order to achieve pregnancy and the severity of these problems determines the kind of surgical treatment adopted. These problems may be congenital - present at birth - or acquired. Some of the anomalies in males include erectile dysfunction, congenitally blocked vas deferens, undescended testes and cysts on the testes or within the scrota sac, while structural problems in females include malformed uterus, blocked fallopian tubes, ovarian cysts and severe endometriosis.
Fertility Drugs
Fertility drugs have been developed to aid women who suffer from hormonal imbalance. These drugs help women regulate their hormone levels and menstrual cycles. Among these drugs, the most commonly used one is Clomiphene – an oral drug which is a selective estrogen receptor modulator used mainly for ovarian stimulation. About 80 percent of women who take this drug ovulate and 40 to 50 percent of these women achieve pregnancy. The next commonly used drugs are gonadotropins which are injectable and increase egg production in the ovaries, which in turn increases the chance of pregnancy.
Intracervical Insemination (ICI)
ICI is relatively similar to IVI. In this process, a speculum is used to open a woman’s vagina to expose her cervix. One end of the catheter will be inserted into her cervix, and the other attached to a sterile syringe containing the sperm sample. The sperm is then injected into the cervix and a sponge is placed over the cervix to prevent the sample from leaking out. This process is carried out just before the woman ovulates.
In Vitro Fertilization
In 1978, Louise Brown, the world’s first “test-tube baby”, was born by In Vitro Fertilization in England. In 1992, researchers in Belgium reported successful pregnancies using Intracytoplasmic Sperm Injection (ICSI) which revolutionized treatment of male infertility.
IVF is the process of fertilization of an egg by manually combining a sperm and an egg in a laboratory dish. This procedure is usually followed by another procedure called embryo transfer, in which the embryo is physically placed in the female’s uterus.
IVF may be used to overcome female infertility where there are problems with the woman’s fallopian tubes. It also assists in male infertility, where there is low sperm count or motility, in which Intracytoplasmic Sperm Injection (ICSI) may be used.
Intratubal Insemincation (ITI)
Intratubal Insemination (ITI) is a less popular measure as it is a relatively more invasive and expensive procedure. In this process, a catheter is inserted through the woman’s vagina, cervix, uterus and into one of her fallopian tubes. The semen sample is then deposited into her fallopian tubes via the catheter. Another method is where a small incision is made in the woman’s abdomen and a tiny camera is inserted into her pelvic cavity. This camera locates the opening of the fallopian tube. A catheter is then inserted into her fallopian tubes and semen sample is deposited there.
Summary
These advancements in technology can be considered revolutionary, in the past, people were more reliant on nature, such as flowers and plants. However, after the inventions of such technologies, it has opened up more solutions for couples that are unable to bear children.
Social impacts
Previously, before the development of sophisticated infertility treatment methods, couples which were not able to conceive could only rely on adoption to have children. Now, infertility is a problem that is easily cured as there are many new infertility treatment methods available which boast of high success rates. Today, relatively few couples are hopelessly sterile.
Single women and same sex parents are now able to have children due to artificial insemination. However, there is controversy surrounding single parents and same sex parents being able to have children. Critics feel that these children’s upbringing may not be as good compared to if they were brought up by two heterosexual parents, although there is no evidence to prove this.
Infertility treatment is very expensive, and only rich couples are able to afford it. As a result, poor couples who experience infertility problems are often excluded from the benefits of infertility treatment due to economic inequality.
However, these methods are still unable to control the personality or character or the child. They are still very likely to take after those of their parents, or be influenced by their upbringings.
Therefore in the next part of my project, I would discuss the progression of these infertility treatment methods, and how they might progress in future.
- Future Considerations (ie where we might go)
Liberal Eugenics
Liberal eugenics is an ideology advocating the use of reproductive and genetic technology to give mankind the option of enhancing their future children’s characteristics and capabilities. Parents may voluntarily enter into this service out of the love for their offspring. The method involves the extensive use of PGD, where geneticists insert or remove genes that confer enhancing phenotypes, such as height and intelligence
Nanotechnology
Scientists have been advocating the use of nanotechnology in the medical field to perform high precision and difficulty level operations. There is ongoing research on the use of nanobots (the next generation of nanomachines) to aid infertility especially in couples where males suffering from low sperm motility. The nanobots will help to guide the chosen sperm to the egg so that fertilization can occur. However, these nanobots are not completely safe as the introduction of these foreign objects to the body may provoke a strong immune response. Also there are worries that these devices will reproduce and essentially get out of control, possibly "taking over" the natural system.
Social impact
If liberal eugenics is legalized, countries may use this technology to build a stronger and enhanced military force. For instance, babies’ genes may be modified to become more muscular and less prone to illnesses in the future.
Liberal eugenics may be used to produce intelligent children who may grow up to become extremely innovative and creative adults. If their intelligence is used for the greater good, such modified children will be very beneficial to the society in the future. For example, their intelligence can be especially useful in the medical field to develop cures for current terminal diseases. Similarly, the use of liberal eugenics to produce a more intelligent workforce could also lead to increased productivity and further technological advancements which could improve societal standard of living.
Furthermore, there is a high possibility that liberal eugenics can be employed to solve certain entrenched societal issues. For example, in countries rife with racism, parents may adopt liberal eugenics to modify their babies’ genes to make their skin colour more favourable so that they will not be subjected to racism in the future
- Conclusions
The development of infertility treatment methods has given new hope to many couples facing infertility problems. They have shown much promise in helping couples conceive, and tighter medical quality controls in hospitals has increased the likelihood of safe and successful pregnancies.
The move towards public awareness and de-stigmatization of infertility has further encouraged couples who were previously suffering in silence to seek treatment. Male infertility causes are being increasingly recognized, and women are now no longer singly implicated when infertility affects a marriage. Couples have come to understand that infertility is often a joint responsibility, and both husband and wife must be motivated to seek solutions.
