Transcript sociology of reproduction Wk_17 - C

Infertility and
‘miracle’ babies
Week 17
Sociology of Human Reproduction
Recap
• Considered the social construction of
motherhood and the family
• Considered the concept of ‘good
motherhood’
• Looked at ideas of fatherhood
Outline
• The background of assisted reproductive
technologies
• Consider infertility as a social concept
• Look at the implications for the division
between social and biological parenthood
Birth of a new Age?
•
25th July 1978 birth of Louise Brown
•
World’s first IVF baby
(‘test-tube’)
•
Since then rapid expansion
of technological treatments
for infertility and other
treatments based on these
procedures
Assistive Reproductive
Technologies
•
ARTs cover a range of
possibilities including:
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In-vitro fertilisation (IVF)
Intrauterine insemination (IUI)
Gamete intra-fallopian transfer (GIFT)
Intra-cytoplasmic sperm injection (ICSI)
Pre-implantation genetic diagnosis (PGD)
Using donor gametes (eggs and/or sperm)
• What do you know about ARTs? In general
terms are they a good or bad possibility?
Experimental medicine?
• Despite decades of research, ARTs are a
difficult and painful process which is
largely unsuccessful
• On average 75% of IVF attempts fail
– Age and reason for treatment related
• ARTs can carry serious health risks
Treatment cycle
• Drugs to suppress ovulation, then drugs to
induce ovulation
• Super-ovulation common (lots of eggs)
• injections, hormonal nasal sprays and numerous
tests
• Egg 'recovery’ (surgical procedure) and
fertilisation
• Developing embryo(s) will be placed in the
womb (max 3 in UK).
• Waiting to see if a pregnancy develops
Risks of treatment
• The cycle can fail at any point
• Drug reactions are fairly common
– hot flushes, nausea, mood swings,
– headaches, weight gain and heavy periods
• Ovarian-hyperstimulation syndrome (OHSS)
– Rare complication but can lead to permanent kidney
damage or death
• Increased risk of pregnancy complications
Controlling ARTS
• In the UK, people undergoing ARTs are
usually informed as to both the risks and
likelihood of failure
• HFEA oversees clinics and success rates
are publicised
• Despite the high risk of both treatment
side effects and failure, IVF retains a
general image of a benevolent technology
which produces ‘miracle babies’.
• Why do you think this is?
What is Infertility?
• No agreed diagnosis of infertility
• Inability to conceive whilst having regular
sexual intercourse over a period of time
(usually between 1-3 years)
• May include the inability to carry a
pregnancy to term
Infertility and ART
• ARTs are not a treatment for infertility
– They do not enable the body to go back to ‘normal’
functioning
• Labelling a couple infertile is not an exact
science
– ‘Unexplained’ infertility is common
• Estimates vary but significant numbers of people with
unexplained fertility would conceive without intervention in
time
– Only one partner may have a problem
Infertility and ART
• Individuals undergoing treatment may already
have children
– From previous relationships
– Adopted
– Children with disabilities
• Individuals may be undergoing
treatment for someone else
– Egg donation/egg sharing
• Decline in research in prevention of infertility
• Why do you think so many people turn to
ARTs given that they are so unreliable and
carry significant risks to health?
Infertility and Stigma
• Ideas about womenhood are interrelated
to motherhood
• Considerable stigma exists against
‘barren’ women
• Women who cannot conceive still feel
‘failures’
Choosing ARTs?
• Many women report that they felt they had
to ‘try everything’
• Consequently, ARTs are not just a option
• Their existence means that they have
become compulsory
Endless options
• ARTs are not a single option
• Treatment cycles can be varied depending
on earlier responses to drug combinations
• So trying everything is rarely possible
Choosing ARTs?
'IVF only makes life more difficult… I would have had to
accept it a long time ago if it weren't for IVF. At twentyeight I could have either gone for adoption or accepted
my situation so I'd be five years down the line towards
that and getting on with my life. Now you're in a better
position to do that when you're twenty-eight than when
you're thirty-eight. If you've missed all your career boats
and burned all your career bridges because you've spent
the last ten years chasing fruitless treatment you've
actually missed out a lot on life'
• (Beth Carter quoted in Franklin 1997:177/8)
• What impact do you think the existence of
ARTs has had on the experience of
infertility?
Biological imperative?
• Imbedded in ARTs is the notion that
biological parenthood is preferable
• It both builds on and reinforces the notion
that this is what makes ‘real families’
• How important really is a
biological link?
Biological imperative?
• Biological fatherhood used to be the basis of
inheritance
– Children as property rather than people?
• Genetic inheritance has now seen as
importance
– Bodies at risk?
• But good parenting is about the provision of love
and security
– Does not need a biological relationship
Biological Imperative?
• The biological imperative is further undermined
by the growing use of donor gametes
• In the UK, only expenses are allowed
• Egg donation is a developing market
• Recruitment of poorer
women common
• $6,500 plus expensive gifts
Choosing ARTs
• ARTs thus build on and reinforce preexisting cultural constructions
– All women should be mothers
– Biological links are more importance than
social parenthood
• Choosing ARTs therefore becomes the
‘normal’ choice for the involuntary childless
‘Alternative’ Families
• ARTs were developed to support
normative ideas about families
• But also allow possibility of other family
forms.
• Single women and gay and lesbian
couples increasingly use ARTS to have
their own ‘families’
• This can considered more problematic
than the health risks involved.
Summary
• ARTs are a product of its specific cultural
circumstances
• Its justifies its own existence though
pathologising infertility
• This reinforces ideas about the necessity
of biological parenthood