Embryo Project Encyclopedia

In June 2015, the Ethics Committee of the American Society for Reproductive Medicine, or ASRM, published “Use of reproductive technology for sex selection for nonmedical reasons” in Fertility and Sterility. In the report, the Committee presents arguments for and against the use of reproductive technology for sex selection for any reason besides avoiding sex-linked disorders, or genetic disorders that only affect a particular sex. When couples have no family history of a sex-linked disease, the use of reproductive technology for sex selection raises ethical questions about the application of sex selection technology to fulfill parental desires. “Use of reproductive technology for sex selection for nonmedical purposes” examines the ethical debate surrounding sex selection for nonmedical purposes and is an educational and ethical reference for physicians who are considering offering those services in their practices.

Fortunio Liceti studied natural philosophy and medicine in Italy during the first half of the seventeenth century. Liceti wrote greater than seventy works on a wide range of topics, including the human soul, reproduction, and birth defects observed in animals and human infants. In the seventeenth century, people commonly addressed birth defects using superstition and considered them as signs of evil, possibly caused by spiritual or supernatural entities. Liceti described infants with birth defects as prodigies and monsters to be admired and studied rather than feared. Liceti’s works established monsters as a possible subject of scientific inquiry and served as models for the future study of birth defects, a field later called teratology. Liceti was one of the first scholars to attempt to systematically categorize birth defects based on their causes, including multiple causes unrelated to the supernatural.

In 2016, Runaway Films released the documentary Vegas Baby. The film, directed by Amanda Micheli, follows three women who struggle with infertility problems as they undergo in vitro fertilization, or IVF treatment, to become pregnant. In IVF treatment, a woman’s egg is fertilized by a sperm outside of the woman’s body. Once the sperm fertilizes the egg, a fertility doctor places the fertilized egg back into the woman’s uterus. The three women in the film enter the I Believe contest hosted by the Sher Institute of Reproductive Medicine in Las Vegas, Nevada. A panel of judges chooses the winner, who is awarded a free single cycle of IVF treatment. Although only one of the women presented in the documentary wins the contest, the other two women still undergo IVF treatment. Vegas Baby brought awareness to both the infertility problems experienced by couples and IVF treatment as an alternative method for causing pregnancy.

In his 1991 article Screening for Congenital Hypothyroidism, Delbert A. Fisher in the US reported on the implementation and impact of mass neonatal screening programs for congenital hypothyroidism (CH) from the early 1970s through 1991. CH is a condition that causes stunted mental and physical development in newborns unless treatment begins within the first three months of the newborn's life. In the early 1970s, regions in Canada and the US had implemented screening programs to diagnose and treat CH as quickly as possible after the infant's birth. By 1991 many other countries had adopted the early screening program, and Fisher estimated that 10 to 12 million newborns per year were tested in the early 1990s. The screening programs, along with physician education and improved screening techniques, such as radioimmunoassay, helped significantly reduce the incidence of abnormal newborn development resulting from untreated congenital hypothyroidism.

In Australia in the 1940s, Norman McAlister Gregg observed a connection between pregnant women who contracted the rubella virus, or German measles, and cataract formation in their children's eyes. Gregg published his findings in the 1941 article Congenital Cataract following German Measles in the Mother in Transactions of the Ophthalmological Society of Australia. In the article, Gregg analyzed seventy-eight cases of congenital cataracts and suggested that the mothers' environmental factors could cause birth defects, otherwise known as teratogenic effects. Gregg's paper on the teratogenic effects of an environmental agent, the rubella virus, changed the study of birth defects to include viruses as potential causes or teratogens.

Fetal surgeries are a range of medical interventions performed in utero on the developing fetus of a pregnant woman to treat a number of congenital abnormalities. The first documented fetal surgical procedure occurred in 1963 in Auckland, New Zealand when A. William Liley treated fetal hemolytic anemia, or Rh disease, with a blood transfusion. Three surgical techniques comprise many fetal surgeries: hysterotomy, or open abdominal surgery performed on the woman; fetoscopy, for which doctors use a fiber-optic endoscope to view and make repairs to abnormalities in the fetus; and percutaneous fetal theray, for which doctors use a catheter to drain excess fluid. As the sophistication of surgical and neonatal technology advanced in the late twentieth century, so too did the number of congenital disorders fetal surgeons treated, such as mylomeningeocele, blocked urinary tracts, twin-to-twin transfusion syndrome, polyhydramnios, diaphragmatic hernia, tracheal occlusion, and other anomalies. Many discuss the ethics of fetal surgery, as many consider it contentious, as fetal surgery risks both the developing fetus and the pregnant woman, and at times it only marginally improves patient outcomes. Some argue, however, that as more advanced diagnostic equipment and surgical methods improve, advanced clinical trials in a few conditions may demonstrate more benefits than risks to both pregnant women and fetuses.

Anencephaly is an open neural tube defect, meaning that part of the neural tube does not properly close or that it has reopened during early embryogenesis. An embryo with anencephaly develops without the top of the skull, but retains a partial skull, including the face. Anencephaly is one of the most common birth defects of the neural tube, occurring at a rate of approximately one in one thousand human pregnancies. The condition can be caused by environmental exposure to chemicals, dietary deficiencies, or genetic mutations.

In 2012, the production company Waddell Media Production released the documentary The Baby Makers. The four-part series, directed and produced by Edel O’Mahony, follows multiple couples in Northern Ireland struggling with infertility problems as they utilize different treatments such as in vitro fertilization, or IVF, egg donation, and egg freezing. IVF is a procedure in which a woman’s egg is fertilized by a sperm outside of her body. Once the sperm fertilizes the egg, a fertility doctor places the fertilized egg back into the woman’s uterus. A narrator narrates the film, which features interviews with gynecologists and clinical embryologists. The Baby Makers brought awareness to infertility problems that couples in Northern Ireland experienced and IVF treatment, egg donation, and egg freezing as alternative methods for getting pregnant.

In 1983, researchers Alan Trounson, John Leeton, Carl Wood, Mandy Besanko, and Angelo Conti published the article “Pregnancy Established in an Infertile Patient After Transfer of a Donated Embryo Fertilized In Vitro” in The British Medical Journal. In the article, the authors discuss one of the first successful experiments using in vitro fertilization, or IVF, with the use of a human donor embryo at the Monash University and Queen Victoria Medical Center in Melbourne, Australia. Prior to the article’s publication, it was uncertain whether scientists could successfully use human donor embryos in IVF techniques. Although the pregnancy ended in a miscarriage ten weeks later, it showed that IVF was possible for those who needed to use someone else’s donated egg cells. Trounson and his colleagues’ paper provided a basis for future IVF pregnancies using donated embryos and helped develop a treatment option for men and women who could not conceive through sexual intercourse alone.

Edwin Carlyle Wood, also known as Carl Wood, was a physician who helped develop in vitro fertilization, or IVF, treatments. From 1964 to 1992, Wood worked as a professor of obstetrics and gynecology at Monash University in Melbourne, Australia, where he was one of the first in the world to lead a team of physicians to establish IVF as a proven treatment for infertility. IVF refers to a medical procedure in which scientists inseminate an egg cell with a sperm cell outside of the body, such as in a glass dish in a clinical setting. Wood helped establish some of the first successful IVF pregnancies and births, and his findings throughout his years of practice helped to standardize the procedure. Wood also advocated for the right for women to have an abortion, and co-founded the Family Planning Association of Victoria in Australia at a time when there were not many abortion clinics in operation. Through his early contributions to IVF, Wood provided new options for people to have offspring, which as of 2021, has up to a 21.3 percent chance of producing a live birth.