Dr. Musa Mohd. Nordin
MBBCh (Wales) FRCP (Edin) FAMM
Consultant Paediatrician & Neonatologist
Damnsara Specialist Hospital
MALAYSIA
INTRODUCTION
Dr. Edwards, an embryologist and Dr. Steptoe, a gynaecologist in the United Kingdom first pioneered the fertility technique called In Vitro Fertilisation Pre-Embryo Transfer ( IVF – ET ). In July 1978, they announced to the world the birth of the first test-tube baby, Louise Brown which was a landmark achievement in the science of reproductive medicine (1).
Since then, a myriad of assisted reproductive techniques have surfaced, further refining and superseding earlier technologies. Assisted reproductive technologies ( ART ) refers to all the techniques involved in the management of infertility that require the handling and manipulation of gametes and embryos and treatment modalities to induce ovulation or spermatogenesis. Techniques of invivo assisted reproduction facilitate the fertilization of the gametes within the reproductive tract of the wife. This may be achieved through the procedures of intrauterine insemination (IUI), intratubal insemination (ITI) and gamete intra fallopian transfer ( GIFT) (2). Mating of the gametes ocuur extracorporeally during invitro assisted conception. The modalities to facilitate the fertilization invitro followed by transfer into the reproductive tract include in vitro fertilisation and embryo transfer (IVF – ET), pronuclear stage tubal transfer (PROST), zygote intrafallopian transfer (ZIFT) and tubal embryo stage transfer (TEST) (3,4,5). More radical forms of micro-manipulation techniques have been recently developed to assist fertilization of men with severe infertility. These include intracytoplasmic sperm injection (ICSI) and micro injection of round spermatid nuclei into oocytes (ROSNI) (6,7)
Since the introduction of IVF-ET technology, well over 500,000 babies have been born. The probability of a successful pregnancy is dependant on a variety of factors including the age and the reproductive health of the wife and the husband. Eventhough reported success rates from ART programs can be very confusing and misleading, the probability of a successful outcome has improved from virtually zero to 30-50% at ART centers worldwide.
These new technologies in assisted reproduction has provoked considerable discussions and debates across all segments of human society. These revolutionary procedures in ART has probed the outermost boundaries of what is scientifically possible and acceptable. Micro manipulation at the very earliest stages of human development is a very delicate and sensitive issue with potentially explosive ethical, social, medico-legal and religious ramifications. Hence the turbulent and not uncommonly hostile controversies that has since evolved.
The Islamic Organisation for Medical Sciences (IOMS), first addressed this issue on human reproduction in May 1983. Human reproductive cloning, an offshoot of ART, which is currently attracting a lot of public and media attention was similarly addressed at this 1983 seminar. Since the IOMS seminar, there has been a multitude of medico-Islamic jurisprudence seminars to discuss various contemporary issues related to ART.
This essay attempts to examine the various bioethical facets of ART and present an Islamic perspective of the infertility problem and the bio-religio-ethics of ART.
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