Assisted Reproductive Technologies and Health-Related Issues Among Women and Children: a Research Review

Assisted Reproductive Technologies and Health-Related Issues Among Women and Children: a Research Review

Dignity: A Journal of Analysis of Exploitation and Violence Volume 6 Issue 2 Article 2 3-2021 Assisted Reproductive Technologies and Health-Related Issues Among Women and Children: A Research Review Laura Maria Corradi Università della Calabria, Italy, [email protected] Follow this and additional works at: https://digitalcommons.uri.edu/dignity Part of the Alternative and Complementary Medicine Commons, Bioethics and Medical Ethics Commons, Clinical and Medical Social Work Commons, Health Psychology Commons, Medical Humanities Commons, Science and Technology Studies Commons, Social Justice Commons, Sociology Commons, and the Women's Health Commons Recommended Citation Corradi, Laura Maria (2021) "Assisted Reproductive Technologies and Health-Related Issues Among Women and Children: A Research Review," Dignity: A Journal of Analysis of Exploitation and Violence: Vol. 6: Iss. 2, Article 2. DOI: 10.23860/dignity.2021.06.02.02 Available at: https://digitalcommons.uri.edu/dignity/vol6/iss2/2https://digitalcommons.uri.edu/dignity/ vol6/iss2/2 This Review Article is brought to you for free and open access by DigitalCommons@URI. It has been accepted for inclusion in Dignity: A Journal of Analysis of Exploitation and Violence by an authorized editor of DigitalCommons@URI. For more information, please contact [email protected]. Assisted Reproductive Technologies and Health-Related Issues Among Women and Children: A Research Review Abstract From their first use in the late 1970s until the mid-1990s, Assisted Reproductive Technologies (ART) gave rise to serious concerns by feminists internationally. Their questions ranged from asking about health risks to ethical and political problems inherent in these technologies. However, over the last 25 years, interest in women’s health which used to be central to feminist theory and politics, progressively decreased and with it concerns about ART. Today, while the medical literature about health risks in ART is increasing, the topic of women’s health in relation to reproductive technologies remains marginal in feminist discourse, social sciences, and the mainstream media. On the basis of recent medical studies, published in peer reviewed scientific journals, this article aims to begin filling this gap. The author discusses adverse effects of ART for three groups of people from a feminist perspective: egg providers; surrogate mothers; and children who are born through in vitro fertilization (IVF), heterologous embryo transfer (HET), and surrogacy. Among the numerous health problems are ovarian hyper-stimulation syndrome (OHSS), birth defects, tumours in children, chromosomal damage, and cardiac and metabolic diseases. Serious questions arise about the long-term health of women who undergo repeated hormonal stimulations, sell their egg cells, or “rent” their wombs as surrogate mothers—a process entailing the exploitation of economically vulnerable women. It also addresses some of the ethical issues arising, such as the importance of risk disclosure to potential IVF users, egg providers, surrogate mothers and intended parents; children’s right to access all details regarding their genetic origins and their birth mother; and relevant psychosocial problems related to the use of ART. This paper calls for renewed critiques of women’s experiences with reproductive technologies so that they can become, yet again, an important part of the feminist movement. Keywords assisted reproductive technologies, in vitro fertilization (IVF), egg donation, surrogacy, children born of surrogacy, short- and long-term health risks, ethical concerns, political implications for women’s social status, ethics, psychosocial problems, infertility epidemics, environmental health, birth defects, women’s health politics, divisions within feminism, common aims in feminism Creative Commons License This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License. Acknowledgements Dignity and the author thank Renate Klein, publisher at Spinifex Press, Australia, for her expertise in reviewing and editing this article. This review article is available in Dignity: A Journal of Analysis of Exploitation and Violence: https://digitalcommons.uri.edu/dignity/vol6/iss2/2 Corradi: Assisted Reproductive Technologies and Health-Related Issues Among Women and Children Volume 6, Issue 2, Article 2, 2021 https://doi.org/10.23860/dignity.2021.06.02.02 ASSISTED REPRODUCTIVE TECHNOLOGIES AND HEALTH-RELATED ISSUES AMONG WOMEN AND CHILDREN: A RESEARCH REVIEW Laura Corradi Università della Calabri, Italy 0000-0002-0621-3299 ABSTRACT From their first use in the late 1970s until the mid-1990s, Assisted Reproductive Technologies (ART) gave rise to serious concerns by feminists internationally. Their questions ranged from asking about health risks to ethical and political problems inherent in these technologies. However, over the last 25 years, interest in women’s health which used to be central to feminist theory and politics, progressively decreased and with it concerns about ART. Today, while the medical literature about health risks in ART is increasing, the topic of women’s health in relation to reproductive technologies remains marginal in feminist discourse, social sciences, and the mainstream media. On the basis of recent medical studies, published in peer reviewed scientific journals, this article aims to begin filling this gap. The author discusses adverse effects of ART for three groups of people from a feminist perspective: egg providers; surrogate mothers; and children who are born through in vitro fertilization (IVF), heterologous embryo transfer (HET), and surrogacy. Among the numerous health problems are ovarian hyper- stimulation syndrome (OHSS), birth defects, tumours in children, chromosomal damage, and cardiac and metabolic diseases. Serious questions arise about the long-term health of women who undergo repeated hormonal stimulations, sell their egg cells, or “rent” their wombs as surrogate mothers—a process entailing the exploitation of economically vulnerable women. It also addresses some of the ethical issues arising, such as the importance of risk disclosure to potential IVF users, egg providers, surrogate mothers and intended parents; children’s right to access all details regarding their genetic origins and their birth mother; and relevant psychosocial problems related to the use of ART. This paper calls for renewed critiques of women’s experiences with reproductive technologies so that they can become, yet again, an important part of the feminist movement. KEYWORDS Assisted Reproductive Technologies (ART), in vitro fertilization (IVF), egg donation, surrogacy, children born of surrogacy, short- and long-term health risks, ethical concerns, political implications for women’s social status, ethics, psychosocial problems, infertility epidemics, environmental health, birth defects, women’s health politics, divisions within feminism, common aims in feminism CIENTIFIC LITERATURE REPORTING HEALTH RISKS in assisted reproductive technol- S ogies (ART) is increasing. In February 2013, a medical study was carried out at The Hospital for Sick Children, Toronto University in Canada, by three scientists: Daria Published by DigitalCommons@URI, 2021 1 Dignity: A Journal of Analysis of Exploitation and Violence, Vol. 6, Iss. 2 [2021], Art. 2 Grafodatskaya: Cheryl Cytrynbaum; and Rosanna Weksberg. The results were pub- lished in the EMBO Report, a journal that communicates major findings indexed by the National Center for Biotechnology Information (NCBI), and it appeared in the US National Library of Medicine (part of the National Institutes of Health). The authors warn: There are health risks attached for both mothers and children that need to be properly understood and managed. … The most commonly cited health prob- lems pertain to multiple gestation pregnancies and multiple births. More re- cently, however, concerns about the risks of birth defects and genetic disor- ders have been raised. There are questions about whether the required ma- nipulations and the artificial environments of gametes and embryos are po- tentially creating short and long-term health risks in mothers and children by interfering with epigenetic reprogramming (Grafodatskaya et al., 2013). In September 2016, the Committee of the American Congress of Obstetricians and Gynecologists (ACOG-Women’s Health Care Physicians) endorsed a document titled Perinatal Risks Associated with Assisted Reproductive Technologies. After a review of existing studies, based on available data and expert opinion, the Committee published the following list of risks associated with ART: multifetal gestations, prematurity, low birth weight, small for gestational age, perinatal mortality, caesarean delivery, placenta previa, abruptio placentae, preeclampsia, and birth defects. Although these risks are much higher in mul- tifetal gestations, even singletons achieved with ART and ovulation induction may be at higher risk than singletons from naturally occurring pregnancies. They also issued the following recommendations: Before initiating ART or ovulation induction procedures, obstetrician–gyne- cologists and other health care providers should complete a thorough medi- cal evaluation to ensure that patients are in good health and should counsel these women about the risks associated with treatment. Any maternal health problems or inherited conditions should be addressed. Couples at risk of passing genetic conditions on to their offspring,

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