Ethical Issues in the Treatment of Infertility Essay

Introduction

Multiple pregnancies have been experienced in many cases. The embryos may range from two to even six in number. But research has indicated that probability of survival of the foetuses in multiple pregnancies is low compared to the double or single foetus. There are various health concerns to the child, which are experiences in many cases of multiple pregnancies. These issues include premature births, hearing loss, disability, vision problems, and delay in development among others. On the other hand, mothers also face many risks in multiple pregnancies. These risks include hypertension, miscarriage, and caesarean delivery among others. Therefore, pregnancy management becomes necessary. The paper therefore focuses on these risks and ethical concerns relating to the termination of some embryos in case of multiple pregnancies.

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Health Concern on the Child

Infertility treatment often brings on multiple pregnancies. There are health issues both the mother and the babies with multiple pregnancies. However, such case has health implications on the life of foetus and the mother. There are risks of premature birth, infant health problems and low birth weight. Even though every pregnancy has some kinds of risks, multiple pregnancies results to higher risks when it comes to pregnancy related complications.

The premature birth, for instance, is very common in multiple pregnancies. These babies in most cases get health problems. In some cases, the newborns have lasting disabilities. More than 60% of the twins and triplets are born premature ( Brezina, & Zhao, 2012). In most cases, they are born before the 37 weeks are over. Also, triplet are worse off because the higher the number of foetuses in the womb, the higher the risks of premature or early birth(Hod, Moshe, et al, 2016). At the time of birth, the premature babies usually have organs and bodies which are not matured completely. They are usually small, with low weight which is less than 2500 grams. These children require help eating, breathing, staying warm and fighting infections.

The issue of preterm labor therefore becomes a major concern in multiple pregnancies. According to the research, around 50% of twins,90% of triplets and almost all quadruplets either experience low birth weight or are all preterm( Brezina, & Zhao, 2012). Also, around 10% of the preterm babies do not survive. Even those that survive, their probability of experiencing problems like vision problems, hearing loss, delays and developmental disability is very high.

Health Concern on the mother

Pregnancy induced hypertension: Those mothers with multiple foetuses experience high risk of high blood pressure during pregnancy. This condition can raise the chances of placental abruption or early detachment of placenta. Another complication is anaemia. In multiple pregnancies, anaemia cases are more than twice as compared to the single birth.

Miscarriage cases are also common in multiple foetuses than single foetus. The vanishing twin syndrome phenomenon is very common in multiple foetuses as compared to single foetus. The vanishing usually takes place in the first trimester, whereby more than one foetus is diagnosed but miscarriage eventually. More so, the risk of pregnancy loss at later trimesters is common as well.

The case of twin-twin transfusion syndrome and abnormal amount of amniotic fluid cases are common in multiple pregnancies. Under the case of twin-twin transfusion syndrome, blood vessels usually connect within the placenta. Eventually, the blood is diverted from one foetus to the other. About 15% of twins with shared placenta usually develop these cases (Hod, Moshe, et al, 2016). More so, in the twins sharing the same placenta, amniotic fluid abnormality cases are common.

Caesarean delivery and postpartum haemorrhage are common in multiple pregnancies. The abnormal positions of the foetus increase the probabilities of caesarean birth. More so, the large area of placenta and over-distended uterus places the mother at a higher risk of bleeding. Such cases may result in death of the mother. Such cases usually happen under multiple pregnancies.

Therefore, there is need to manage multiple pregnancies because they pose threat to both the foetus and the mother. Some of the signs that indicate probabilities of multiple pregnancies include increased morning sickness, having uterus that is larger than expected at the time of pregnancy, increase in appetite, increased feta movements, which are felt in different parts of the abdomen at the same time, among others. But the management of such pregnancies have brought about ethical concerns. There is a question in number of embryos if the person can only afford or is able to carry one or two babies and not compromise her own health, or even the health of the foetus. The question here is that whether it would be ethical to discontinue the four embryos if one has six, so that the remaining two can grow normally.

Is it ethical to discontinue the other four embryos?

The health of the mother and that of the foetus may call for foetal reduction cases. However, selective termination remains ambiguous because it results in killing of innocent human beings. But at the same time, it would promote health survival of the remaining four embryos and reduce the hazards to the mother. Therefore, it is considered ethically preferable to terminate the lives of some foetuses rather than leaving all of them to survive because the probability of the six embryos becoming health is very low.

The relationship between termination of multiple pregnancies and abortion

The relationship between the selective termination and abortion brings about the major debate in the case of multiple pregnancies. Every life is important and should not be discontinued at whatever the circumstances, especially when this life is innocent. More so, Biblically, its only God who brought about life and human beings have no authority to terminate it. Therefore, one can argue that even though the multiple pregnancies,(say six in our case) have low survival chances, they can still survive. Also, all of them are innocent and it is not possible to note which four out of six lives one should terminate. Therefore, both procedure of termination of multiple foetus and that of abortion are similar, bringing about the ethical dilemma (Rao, 2015).

Conclusion

The multiple pregnancies have brought about debates ethical debates which focus on the health side and life termination. The selective foetal discontinuation or termination is closely related to abortion because it involves killing of innocent being. All the procedures involved in abortion are similar to those in multiple pregnancy termination. For instance, in our case, a mother has six embryos and would want to reduce them to two. Therefore, she has to kill or terminate four of them. However, focusing on the health concern of the mother and that of the embryos, it would be absolutely right to terminate at least four of the embryos.

References

Brezina, P. R., & Zhao, Y. (2012). The ethical, legal, and social issues impacted by modern assisted reproductive technologies. Obstetrics and gynecology international, 2012.

Hod, M., Jovanovic, L. G., Di Renzo, G. C., De Leiva, A., & Langer, O. (Eds.). (2016). Textbook of diabetes and pregnancy. CRC Press.

Rao, R. (2015). Selective Reduction:"A Soft Cover for Hard Choices" or Another Name for Abortion?.