Ethical and Psychosocial Impact of Female Infertility

Abstract

This manuscript reviews research from the past year on the ethical and psychosocial impact of infertility on women and men. We discuss several issues surrounding ovarian stimulation, particularly high-order multiple births, egg banking (especially for research purposes), and diminished ovarian reserve. We also present recent work on distress and counseling, which includes greater attention to subgroups of infertile women. More research on issues confronting men has emerged recently, and we outline these with regard to their relationships with infertile women, or as the infertility patient. Last, we outline some ethical issues posed by newer procedures of fertility preservation and uterine transplant.

The Impact of Infertility on the Psychological Well-Being, Marital Relationships, Sexual Relationships, and Quality of Life of Couples: A Systematic Review

“…Four systematic reviews have been conducted on the effect of infertility on the psychological well-being, quality of life, and marital relationships of couples, as well as on the ethical issues involved (Chachamovich et al, 2010;Greil, 1997;Leyser-Whalen, Temple, & Phelps, 2012;Tao, Coates, & Maycock, 2012). The participants included couples and women who had not undergone treatment, couples and women undergoing in vitro fertilization/intracytoplasmic sperm injection/assisted reproductive therapy, couples and women whose attempts at in vitro fertilization/intracytoplasmic sperm injection/assisted reproductive therapy had failed, and couples and women who had quit trying to undergo in vitro fertilization/intracytoplasmic sperm injection/assisted reproductive therapy.…”

The Moral Superiority of Bioengineered Wombs and Ectogenesis for Absolute Uterine Factor Infertility

“…24 Whether children who were gestated in a transplanted uterus should be informed of this fact is another ethical consideration that mimics existing IVF, donor insemination, and adoption cases. 25 Additionally, Caplan et al claim that incidental fetal exposure to antirejection medication -for example, for a liver transplant patient who later becomes pregnant-is not morally equivalent to the deliberate exposure entailed in UTx, where the use of the drugs is "solely for the purpose of carrying a pregnancy." 26 Finally, it is worth noting that risk-benefit analyses of UTx have disregarded the impact of long-term immunosuppression on recipients under the assumption that the transplanted uterus would be removed, and with it the need for antirejection drugs.…”

Perspectives of 281 patients with Mayer-Rokitansky-Küster-Hauser Syndrome on uterine transplantation

“…Less than one-half of our participants considered the risks of the UTx procedure to themselves to be most important, compared to those of the donor and fetus, and one-fifth of participants considered the risk to self as least important. Pre-vious reports indicate that women undergoing infertility treatments are likely to pursue therapies with significant risks, as they perceive the benefits of the treatments (i.e., enhanced fertility) to outweigh the risks (24). It is therefore plausible that individuals with MRKH may be more likely to pursue risky procedures that may increase their chances of sustaining personal harm.…”