Tag: Fertility

Blog Posts (12)

December 9, 2016

Don’t feel comfortable asking others if they are having regularly scheduled unprotected vaginal penile penetrative intercourse? Then don’t ask


One of the first questions a newly married straight couple often gets from well-meaning friends and family is “when are you going to start trying?” For those of you who are wondering what this question is getting at, it is asking them if they are going to start to try to get pregnant. It is interesting to analyze the language used here. People typically talk about “trying” without ever specifying what they are in fact trying to do. Part of the reason for this may be because people assume the meaning is obvious from the context, such as “they’ve been trying for six months but haven’t gotten pregnant yet.” Another reason probably has to do with our societal discomfort talking about sex.

We use general and vague terms to imply that we are talking about sex, but often don’t feel comfortable out right discussing it. For example, the birth control pill is generally just referred to as “the pill.” There is still shame and stigma surrounding sex, particularly for women and sexual minorities, so it may be easier and safer for a woman to talk about being on “the pill,” even though everyone knows what she is referring to, than to overtly announce that she is using contraception.

Even though we as a society may not feel comfortable explicitly discussing sex, we still feel that it is our business. From a legal perspective, look at how carefully reproductive medicine is regulated. For instance, certain reproductive procedures (e.g. abortion and sterilization) can require waiting mandatory periods – something that is not common in other areas of nonelective medicine. In the social realm, family, friends, and even strangers feel they have the right to comment on a pregnant woman’s behavior, such as by telling her what she should and should not eat or drink.

Returning to the topic of “trying,” family, friends, and again even strangers often have no qualms about asking women about whether they are trying to conceive. This is especially the case for straight women who are recently married and women who are perceived as being near or at the end of their “biological clock.”

Asking women whether they are “trying” is problematic on many levels. First, it assumes that all women want to become pregnant with genetically related children. While this may be true for many women, it is not true for all women. There is already enough social pressure on women in our pronatalist society to have biological children so people should avoid adding to this pressure. Second, asking people if they are “trying” is just a euphemism for asking them if they are having regularly scheduled unprotected vaginal penile penetrative intercourse, which is usually not considered an appropriate topic, especially among strangers. It is typically seen as impolite to discuss sex under certain circumstances or with certain people and discussing reproductive sex (that is, sex for which one of the purposes is reproduction) should not be treated differently.

To summarize, if you don’t feel comfortable asking others if they are having regularly scheduled unprotected vaginal penile penetrative intercourse, then don’t ask them if they are “trying” to conceive.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

December 8, 2016

Don’t feel comfortable asking others if they are having regularly scheduled unprotected vaginal penile penetrative intercourse? Then don’t ask them if they are “trying” to conceive

 

One of the first questions a newly married straight couple often gets from well-meaning friends and family is “when are you going to start trying?” For those of you who are wondering what this question is getting at, it is asking them if they are going to start to try to get pregnant. It is interesting to analyze the language used here. People typically talk about “trying” without ever specifying what they are in fact trying to do. Part of the reason for this may be because people assume the meaning is obvious from the context, such as “they’ve been trying for six months but haven’t gotten pregnant yet.” Another reason probably has to do with our societal discomfort talking about sex.


We use general and vague terms to imply that we are talking about sex, but often don’t feel comfortable out right discussing it. For example, the birth control pill is generally just referred to as “the pill.” There is still shame and stigma surrounding sex, particularly for women and sexual minorities, so it may be easier and safer for a woman to talk about being on “the pill,” even though everyone knows what she is referring to, than to overtly announce that she is using contraception.


Even though we as a society may not feel comfortable explicitly discussing sex, we still feel that it is our business. From a legal perspective, look at how carefully reproductive medicine is regulated. For instance, certain reproductive procedures (e.g. abortion and sterilization) can require waiting mandatory periods – something that is not common in other areas of nonelective medicine. In the social realm, family, friends, and even strangers feel they have the right to comment on a pregnant woman’s behavior, such as by telling her what she should and should not eat or drink.


Returning to the topic of “trying,” family, friends, and again even strangers often have no qualms about asking women about whether they are trying to conceive. This is especially the case for straight women who are recently married and women who are perceived as being near or at the end of their “biological clock.”


Asking women whether they are “trying” is problematic on many levels. First, it assumes that all women want to become pregnant with genetically related children. While this may be true for many women, it is not true for all women. There is already enough social pressure on women in our pronatalist society to have biological children so people should avoid adding to this pressure. Second, asking people if they are “trying” is just a euphemism for asking them if they are having regularly scheduled unprotected vaginal penile penetrative intercourse, which is usually not considered an appropriate topic, especially among strangers. It is typically seen as impolite to discuss sex under certain circumstances or with certain people and discussing reproductive sex (that is, sex for which one of the purposes is reproduction) should not be treated differently.


To summarize, if you don’t feel comfortable asking others if they are having regularly scheduled unprotected vaginal penile penetrative intercourse, then don’t ask them if they are “trying” to conceive.

 

 

 The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.


November 3, 2016

Why we should recognize social infertility: the exclusion of lesbian and gay couples and single individuals from definitions of infertility

The diagnosis of infertility is an anomaly among medical conditions because it requires two people, whereas almost all other medical conditions require just one person. For instance, if I break my leg, my diagnosis and treatment does not include or depend upon anyone else within my web of relationships. In contrast, when physicians are assessing a patient for infertility, they inquire about the person’s presumed heterosexual partner. This is because the majority of medical definitions of infertility rely upon heterosexual activity as a prerequisite to determine if an individual is infertile. For example, the World Health Organization (WHO) defines infertility as “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.” 

One significant problem with this definition is that it cannot account for lesbian and gay couples and single heterosexual individuals. Lesbian and gay cisgender couples are not having sexual intercourse (i.e. vaginal penile sex), so they are automatically excluded from definitions of infertility. Single heterosexual individuals may be having intercourse, but it may not be “regular,” which we can presume to mean on a consistent basis, and they may not be having unprotected intercourse.  

Yet, lesbian and gay couples and single individuals, regardless of their sexual orientation, are all infertile in a sense because they are not able to sexually reproduce via intercourse. Some in the bioethics literature have used the term “social infertility” to refer to individuals who are unable to reproduce due to factors associated with their partner. This can include individuals in same-sex couples who are not able to engage in intercourse and individuals who do not have a partner and thus are not able to engage in intercourse. 

In recognizing social infertility, the WHO recently changed their definition of infertility to include lesbian and gay couples and single individuals. Unfortunately, insurance companies in the United States do not tend to recognize social infertility. For example, a lesbian couple in New Jersey is suing their insurance company because it will not cover infertility treatment for them. Between the two women, they have had six miscarriages, which shows they are not just socially infertile, but there are also physiological components to their infertility. However, their insurance company is stating that they have not demonstrated that they are infertile because they have not been having heterosexual intercourse. 

The idea of requiring lesbian and gay individuals to prove their infertility by engaging in vaginal penile intercourse is ridiculous, especially given that modern medicine has various ways of assessing an individual’s fertility (e.g. hormonal tests, ovarian reserve, sperm motility, etc.). We need a broader definition of infertility that does not depend upon an individual’s relationship, or lack thereof, with others. The new WHO definition is a step in the right direction to recognize social infertility as well as the fact that lesbian and gay couples and single individuals can experience physiological infertility on top of social infertility.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.
May 16, 2016

Taking a ride down the slippery slope

Did you know: we can now make sperm from embryonic stem cells (in mice).  Not only can we create this sperm, but we can use it to successfully fertilize an egg and develop into a fully grown mouse.  And what is the role of bioethics in this scientific discovery, according to the article?  A brief mention of theoretical ethical issues relegated to the end of the news article that no one reads far enough to see, anyway.

 

Scientific advancements in reproduction have occurred at an unbelievable rate.  We not only have the ability to create sperm, but we can also create an embryo using three genetic donors, choose or reject embryos based on their genetic traits, such as sex, and correct genetic defects by essentially cutting and pasting healthy DNA sequences over defective ones.  Conversely, using such technology, we also have the potential to clone human beings, choose or reject embryos based on traits such as hair color or athletic ability, and irreversibly alter a germ cell line, potentially leading to unknown negative effects in later generations.

 

While breakthroughs in reproductive technologies have the potential to address issues as important and varied as male infertility, uterine factor infertility, mitochondrial disease, genetic defects and disease, and even artificial gestation, one wonders whether anyone is stopping to ask: to what end?  How will we use this technology?  What are the short- and long-term effects?  How might this technology be misused?  And, my personal favorite, when will we start to regulate how and when we tinker with biology at a genetic level?

 

Despite the promise of treatment or eradication of genetic diseases using this technology, there is still a persistent and very realistic fear that this technology will be misused.  Even worse, the misuse may become so common as to be considered acceptable, particularly in our profit-driven fertility industry.  Will the desire to prevent Huntington’s disease also lead to the desire to enhance intelligence?  Can we really resist the urge to create so-called designer babies, and should we accept that while some may win the genetic lottery, others will be able to afford to stack the deck?

 

Bioethicists are sometimes viewed as obstructionists on the path of progress, unnecessarily blocking scientists from discovering all that can be accomplished through science and medicine. (For an excellent rebuttal, read here).  But the very purpose of the vast and diverse field of bioethics is to identify and acknowledge the normative implications of scientific advances and engage in a dialogue that directly addresses the “should” in a world of “could.”  Hence, the age-old question that is often asked but rarely answered: just because we can do it, does it mean we should?

 

In the world of reproductive technologies and germline manipulation, perhaps the answer, sometimes, is no.

 

 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

 

May 9, 2016

Bad Moms, Blameless Dads: Examining How the Media Portrays Age-Related Preconception Harm

As I discussed in a previous blog, the blame for fetal harm is generally directed at women. Some of my colleagues and I, including AMBI faculty member Zubin Master, were interested in examining how fetal harm, and more specifically age-related preconception harm, is portrayed in the media. Our findings were published earlier this year in the American Journal of Bioethics Empirical Bioethics.

Given the significant social change that many people today are delaying childbearing in comparison to previous generations, it is relevant to examine the media portrayal of older parental age and risk to future offspring. Furthermore, there is clear evidence that older parental age carries certain risks to offspring: older age in women and men leads to an increased risk of having children with autism and Down syndrome and older paternal age has also been linked to higher rates of children with schizophrenia. Many people get most of their scientific news from the media, so it is important to examine the accuracy and biases of the information.

Our results indicate that reproduction is still largely seen as the domain of women, rather than of couples or of men. We rarely found articles discussing reproduction as it relates to both women and men as the majority of articles were maternally focused. Even among the articles that were paternally focused, they almost always discussed maternal harm as well. However, the reverse – maternally focused articles containing discussions of paternal harm – were almost nonexistent. This pattern suggests that men alone are never seen as solely responsible for fetal harms, but rather that this responsibility is always shared with women.

Responsibility and blame typically go hand-in-hand and not surprisingly articles were four times more likely to blame women for fetal harms than men. The infrequency of paternal blame suggests that authors either do not recognize men’s contribution to harm due to ignorance or denial, or do not want to hold men responsible for harm. Even when men’s contribution to harm was acknowledged, the authors were more likely to absolve men from responsibility for harm by presenting reassuring information, such as the overall risk of fetal harm is quite low, in conjunction with factual information stating that older paternal age can increase risks to future children. The same sort of reassurance was not seen for women.

Although reproductive blame and responsibility is still typically assigned to women, newspapers are increasingly discussing the relationship between paternal age and preconception harm: no articles discussed this relationship in the 1970s or 1980s, 20% discussed it in the 1990s, and nearly 40% discussed it between 2000 and 2012. The increase in articles on paternal harm in the 2000s may be due to the increase in scientific data showing the connection between paternal age and harm, the growing body of social science literature on male reproduction, the rising medicalization of men’s sexuality and reproduction, as well as changes in social norms that make discussions of paternal role and responsibility in reproduction more commonplace.

However, despite the fact that newspapers are actually acknowledging and discussing paternal age and preconception harm, the primary focus of newspaper articles regarding preconception harm remains concentrated on women and articles are more likely to blame women than men for any harm. In short, our analysis of age-related preconception harm reflects the broader gendered social patterns regarding reproduction that tend to minimize, and even ignore, men’s role in and responsibility for reproduction.

 

 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

March 15, 2016

Should providers offer oncofertility to patients with a poor prognosis?

Whereas quality of life issues for cancer patients used to minimized, and sometimes even ignored, today there is more of a focus on cancer patients’ quality of life post-cancer. One such quality of life issue is oncofertility, which is fertility preservation for cancer patients. In many places, oncofertility is, or is becoming, the standard of care for cancer patients. But should it be offered to all patients? What about patients who have a very bad prognosis?

 Fertility preservation for patients with a poor prognosis raises a host of ethical issues. Providers may worry that discussing fertility preservation will give patients false hope about their prognosis. In other words, these patients may feel their providers deceived them by mentioning fertility preservation, leading them to believe that their prognosis is not as bad as they originally thought.

Yet, at the same time, pursuing fertility preservation may be a source of hope and happiness for patients during difficult times. It may furnish them with mental and physical strength, making them even more motivated to survive for the sake of their potential future children. Additionally, these patients, and their families, may feel a degree of inner peace knowing that part of their lives will continue on in the reproductive material even if they are never used.

Nevertheless, some may argue that, despite any personal and emotional benefits they may experience, offering patients with a poor prognosis fertility preservation options is an unjust allocation of resources. From a utilitarian perspective, it does not make sense to devote resources to patients who will likely not benefit from them. Put differently, resources should be allocated to those who have a high probability of a positive outcome, which means individuals with a poor prognosis should be placed lower on the priority list for receiving fertility preservation resources than individuals with a good prognosis.

On the other hand, if we take a deontological (duty-based, individual rights) approach, providers have a duty to care for their patients. Not offering fertility preservation to all of their patients, including those with a poor prognosis, may be seen as diminishing patient autonomy. According to this view, providers should be more concerned with the needs and rights of their individual patients than with social justice (i.e., fair allocation of resources).

For more on this topic, see my book chapter “Addressing the Three Most Frequently Asked Questions of a Bioethicist in an Oncofertility Setting” in Oncofertility Medical Practice, edited by T.K. Woodruff and C. Gracia.

 

 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

January 28, 2016

My Child, Your Womb

Gestational surrogacy contracts have been in the news again recently as a gestational surrogate reports that the intended father, having discovered that she is expecting triplets, is demanding that she undergo selective reduction to abort one of the fetuses.  Situations such as these, while often not reported, are not necessarily uncommon.  In 2013, a gestational carrier was offered $10,000 to abort when a second trimester ultrasound discovered congenital heart and brain abnormalities.  Despite a well-established Constitutional right to privacy that includes a pregnant woman’s right to procure – or refuse – an abortion, surrogacy contracts routinely include provisions that not only prohibit a surrogate from having an abortion unless there is a medical need, but also give the intended parents sole discretion to determine whether the surrogate should abort where there is evidence of a physical abnormality or other issue.  Such provisions have not been tested in court, but would almost certainly be unenforceable based on the surrogate’s Constitutionally-protected right to reproductive autonomy.


In India, where there is an estimated $400 million surrogate tourism industry, women agree to be surrogates in exchange for $5,000-7,000, which is far more than they could make otherwise.  In many clinics, surrogates live in dormitories for the duration of the pregnancy and their food and medical care is provided by the clinic.  There are also reports that some clinics have policies against pregnancies of 3 or more fetuses – meaning that selective reduction may occur as a matter of course to reduce the number of fetuses to 2 or 1.  If this is in fact happening, are the surrogates (or even the intended parents) aware of what is happening?  Are they given a voice in the medical care and treatments they receive?  Or are the decisions made by the intended parents or the clinic, and simply imposed on the surrogate?


Surrogacy, as with other assisted reproductive techniques, has been promoted in the name of reproductive autonomy – the right and ability to have more options and exert more control over reproduction.  But in cases such as these, where surrogates are pressured legally, financially and socially to have an abortion, whose reproductive autonomy are we honoring?  While it may be the child of the intended parents, it is the uterus of the surrogate.  The intended parents have an interest in the healthy development and birth of their child, which can be affected by congenital abnormalities, surrogate behavior, or the presence of multiples.  The surrogate has an interest in her own bodily integrity, her own health, and the treatments or procedures performed on her, even in connection with the gestation of another’s child.  Where these interests conflict, whose rights are stronger: the intended parents of the child, or the woman carrying it? 


It seems unconscionable that a woman could be forced to undergo an abortion based on enforcement of a contract.  It is equally disturbing to think that an intended parent would be prevented from objecting to an abortion of his or her child because the surrogate was making the decision to abort.  While both of these decisions in the context of a commercial surrogacy arrangement may be considered a breach of contract, and therefore may have monetary damages, what is left in the aftermath?  A parent whose unborn child was aborted without the parent’s permission?  A surrogate who has been abandoned with a newborn she never intended to keep?  These consequences are far weightier than could be compensated for by money.

 

The problem with blending the rights of reproductive autonomy is trying to separate them again when there is a conflict.  A surrogate will always have the right to determine what happens to her body, which includes the right to have or refuse an abortion, even if the child belongs to someone else.  Is it possible, then, to simultaneously protect the reproductive rights of both the surrogate and the intended parents?  Or will there always be an inherent imbalance of reproductive rights and the potential for coercion in the enforcement of commercial surrogacy agreements?


The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

June 29, 2015

iPhone App Will Track Sexual Activity and Reproduction

<div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Apple recently announced that they will update their health app, HealthKit, to include reproductive health. Many were critical of the original app because although it can track a wide range of health indicators, such as BMI, sleep, sodium intake, number of falls, etc., it neglected reproductive health. Specifically, <a href="http://fusion.net/story/100781/apple-ios-update-new-version-of-healthkit-still-doesnt-track-periods/">it is problematic</a> that the app includes some obscure health indicators, like selenium intake, but not menstrual cycle, which affects half of the population. While there are other apps that are specifically geared toward women's reproductive health, it is troubling that an iPhone app that comes standard with the phone would exclude something so central to women's health as menstruation. Some believe that the omission of reproductive health from HealthKit is due to the fact that the tech world, including Apple, is dominated by men.  </div> <div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><br /></div> <div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">The new the updated app is a huge improvement because it includes a variety of reproductive health indicators like menstruation, basal body temperature, and spotting. The broad range of reproductive health indicators helps women keep track of their reproductive health in general and specifically for women looking to prevent pregnancy and for women looking to achieve pregnancy. This is an important addition because too often reproductive health is overlooked or not considered part of "real" healthcare. The addition of the reproductive health category in HealthKit technology not only acknowledges the reproductive health issues specific to many women, but also normalizes them.</div> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></p>
May 19, 2015

Should someone who does not want biological children be diagnosed as infertile?

<p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">In my </span><a style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;" href="/BioethicsBlog/post.cfm/how-should-we-define-infertility-and-who-counts-as-infertile">last blog</a><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">, I discussed some of the problems with the definition of infertility, including that it is based mainly on women's bodies, which implies that men are less likely or not likely to be infertile, and it is based on heterosexual activity, which implies that single individuals and/or individuals in the LGBTQ community cannot experience infertility. I also distinguished between physiological infertility (i.e. infertility due to a biological condition such as low sperm count or blocked tubes) and social infertility (i.e. situational infertility, such as whether one has a partner and if so, if that partner is fertile and together one and one’s partner have the “right” parts to reproduce biologically). In this blog, I want to reflect more on that it means to be infertile and how the role social desire (i.e. the social desire to have biological children) plays in diagnosing this condition.</span></p> <p class="MsoNormal" style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Imagine two women with the same exact circumstances: they are both 30 years old, in long term heterosexual relationships, and have been having unprotected sex regularly for the last 3 years. The only difference is that one woman, Jessica, wants to have biological children, while the other woman, Katie does not. Should they both be classified as infertile? How does their desire to have or not have biological children shape their medical diagnosis? Should their partners be labeled as infertile too? Does it matter whether Jessica and Katie are physiologically or socially infertile in classifying them as infertile? Does their partners’ interest in having biological children or lack thereof factor into determining if Jessica and Katie are infertile?</span></p> <p class="MsoNormal" style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><strong style="line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="text-decoration: underline; color: #000099;" href="/Academic/bioethics/index.cfm">website</a>.</strong><span style="line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px;"> </span><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif;"> </span></p>
April 20, 2015

How should we define infertility and who counts as infertile?

<div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">The concept of infertility seems relatively straightforward, yet there are many myths, confusions, and disagreements regarding who counts as being infertile. According to the World Health Organization (WHO), <a href="http://www.who.int/reproductivehealth/topics/infertility/definitions/en/">infertility is</a> "a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.”Like many definitions of infertility, this one is based on a woman's body since she is the one who experiences pregnancy. However, this definition may make it more difficult to understand and recognize male factor infertility.Indeed, defining infertility based solely on a woman's ability to achieve pregnancy reinforces the myth that women are more likely to be infertile than men. In reality, women and men are equally likely to be infertile. The National Institutes of Health (NIH) <a href="http://www.nichd.nih.gov/health/topics/infertility/Pages/default.aspx">definition of infertility</a> is more inclusive: “the inability of a woman or man to conceive a child or the inability of a woman to carry a pregnancy to term.”</div> <div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><br /></div> <div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Another concerned with the WHO definition of infertility is that it is based on being in a heterosexual relationship.According to this definition and many others like it, people can only be considered infertile if they engage in "regular unprotected sexual intercourse." This definition does not explicitly state that this it is referring to heterosexual intercourse, which is problematic. Given the narrow scope of this definition, how then should we diagnose infertility in lesbian and gay couples and heterosexual individuals who are singleand not engaging in regular unprotected sexual intercourse.</div> <div><br /></div> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;"> </span></p>

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Published Articles (2)

American Journal of Bioethics: Volume 10 Issue 11 - Nov 2010

Review of Charis Thompson, Making Parents: The Ontological Choreography of Reproductive Technologies

American Journal of Bioethics: Volume 3 Issue 1 - Mar 2003

Providing Fertility Care to Those With HIV: Time to Re-examine Healthcare Policy

News (2)

April 16, 2012 3:13 pm

IVF can't beat biological clock, warns Yale fertility expert (BioNews)

A leading fertility expert in the USA has warned of young women’s serious misconceptions about their own fertility. Writing in the journal Fertility and Sterility, Professor Pasquale Patrizio, from Yale School of Medicine and director of the Yale Fertility Centre, says that clinicians should ‘begin educating women more aggressively’ – but goes further. He argues that young women who choose to delay motherhood for whatever reason should be offered the opportunity to have their eggs frozen as an act of preventive medicine.

April 13, 2012 11:24 am

Fertility treatment bans in Europe draw criticism (Fox News)

More than three decades after Britain produced the world’s first test-tube baby, Europe is a patchwork of restrictions for people who need help having a child. Many countries have strict rules on who is allowed to get fertility treatments. And recent court rulings suggest nothing’s likely to change anytime soon.