In vitro fertilization and stem cells research presentation and its ethical considerations

1. In Vitro Fertilization and STEM Cells Research
AMERA C. MALACO
Ph.D. Biology 2

2. What Is In Vitro Fertilization?
 In vitro fertilization is a process by which a sperm and egg can be combined in a
laboratory. In vitro, translated literally, means "in glass." The resulting embryo or embryos
fertilized in laboratory equipment can then be transferred to the woman's uterus for further
growth and development. (learnreligions.com)
 In vitro fertilization (IVF) is the joining of a woman's egg and a man's sperm in a laboratory dish. In
vitro means outside the body. Fertilization means the sperm has attached to and entered the egg.(
National library of medicine)
 IVF is a form of Assisted Reproductive Technology (ART). This means special medical techniques are
used to help a woman become pregnant. It is most often tried when other, less expensive fertility
techniques have failed.

3. There are five basic steps to IVF
 Step 1: Stimulation, also called super ovulation

4. Indications
 IVF is done to help a woman become pregnant. It is used to treat
many causes of infertility, including:
 Advanced age of the woman (advanced maternal age)
 Damaged or blocked Fallopian tubes (can be caused by pelvic
inflammatory disease or prior reproductive surgery)
 Endometriosis
 Male factor infertility, including decreased sperm count and blockage
 Unexplained infertility

5. Risks
 IVF involves large amounts of physical and emotional energy, time, and
money. Many couples dealing with infertility suffer stress and
depression.
 A woman taking fertility medicines may have bloating, abdominal pain,
mood swings, headaches, and other side effects. Repeated IVF
injections can cause bruising.
 In rare cases, fertility drugs may cause ovarian hyperstimulation
syndrome (OHSS). This condition causes a buildup of fluid in the
abdomen and chest.

7. IS IN VITRO FERTILIZATION UNETHICAL?
In vitro fertilization (IVF) is morally objectionable for a number of
reasons:
 1. The destruction of human embryos
 2. the danger to women and newborn infants, and
 3. the replacement of the marital act in procreation

8. In Vitro Fertilization: Ethical Issues
“guidelines designed to safeguard against abuses in the field of ART that commodify
and dispose of children and abuse the marriage bond”
1. All assisted reproductive procedures should be performed upon
married couples only.
2. The wife must contribute the egg and the husband must contribute
the sperm.
3. Masturbation must not be required
4. Fertilization must take place inside the woman’s body
5. “Spare” embryos must not be discarded, frozen, or experimented
upon, and procedures such as “selective abortion” (pregnancy
reduction) must not be used

9. Three general moral principles
1. Evil may never be committed in order to achieve a good end.
2. A method of assisted reproduction is acceptable only if it serves as a
means to facilitate or help the act of intercourse in attaining fertilization. It
is not acceptable if it substitutes for the sexual act itself. IVF and other
such ARTs are disqualified under this criteria.
3. The Church teaches that homologous procedures may be permissible,
but heterologous procedures, which involve the third-party donation of
either sperm or ovum, are never morally permitted.

10. Islamic perspectives on IVF
In the Quran, God comforts those who face fertility difficulties:
"To God belongs the dominion of heavens and earth. He creates what He wills. He
bestows female (offspring) upon whom He wills, and bestows male (offspring) upon
whom He wills. Or He bestows both males and females, and He leaves childless whom
He wills. For He is All-Knowledgeable All-Powerful." (Quran 42:49-50)
Most Islamic scholars are of the opinion that IVF is allowable in
instances where a Muslim couple is unable to conceive in any other
way. Scholars agree that there is nothing in Islamic law which
forbids many types of fertility treatment, provided the treatments do
not go outside the bounds of the marriage relationship. If in vitro
fertilization is chosen, the fertilization must be done with sperm from
a husband and an egg from his wife; and the embryos must be
transplanted into the wife's uterus.

11.  Some authorities stipulate other conditions. Because masturbation is
not allowed, it is recommended that the collection of a husband's
semen be done in the context of intimacy with his wife but
penetration. Further, because refrigeration or freezing of a wife's eggs
is not allowed, it is recommended that the fertilization and
implantation occur as quickly as possible.
 Assisted reproductive technologies that blur marital and parental
ties—such as donor eggs or sperm from outside the marriage
relationship, surrogate motherhood, and in-vitro fertilization after a
spouse's death or divorce of the married couple—are forbidden in
Islam.

12. STEM Cells Research
What is Stem Cell Research?
 Stem cell research is a relatively new technology that takes primitive
human cells and develops them into most any of the 220 varieties of
cells in the human body, including blood cells and brain cells.
(infobloom.com)
 Stem Cell Research offers great promise for understanding basic
mechanisms of human development and differentiation, as well as the
hope for new treatments for diseases such as diabetes, spinal cord
injury, Parkinson’s disease, and myocardial infarction.

13. What Are Stem Cells?
 Stem cells are the raw-materials of the human body — they are
the ones that generate all other body cells having specialized
functions. Stem cells have not yet been committed to a
developmental route that will create a specific tissue or organ; they
are regarded as ‘undifferentiated’ cells.
 Differentiation is the process of transforming into a certain cell
type. Other cells of the body lack the potential to produce new cell
types on their own. This therefore, impedes their growth and
restoration following a disease or injury. And this is where stem
cells can help in the treatment of several health conditions.

14. WHERE DO STEM CELLS COME FROM?
 Stem cells serve as the bedrock for each of the organs and
tissues of the body. There are many distinct types of stem cells
originating from various parts of the body and are generated at
various periods during our lifetimes.
 Embryonic stem cells
 Induced pluripotent stem cells
 Perinatal stem cells
 Adult stem cells

15. • Embryonic Stem Cells:
 These are stem cells derived from the inner cell mass of the
blastocyst — a cluster of cells that develops shortly after an egg
gets fertilized by a sperm. embryonic stem cells (escs) are
pluripotent, which may produce every cell type found in the fully-
formed adult body.
• Induced Pluripotent Stem Cells:
 These refer to adult stem cells that have been reprogrammed in
the lab to give them traits similar to the embryonic stem cells.

16. • PERINATAL STEM CELLS:
 Amniotic fluid surrounding a fetus contains perinatal stem cells. Through the
process of amniocentesis, these stem cells are taken from a pregnant woman.
These cells have the potential to quickly convert into other cell types, making
them extremely strong regenerative medicine agents.
• ADULT STEM CELLS:
 These are stem cells found in most adult tissues, including the bone marrow
and fat tissues. Usually, they are present in small quantities, but can be
harvested and then cultivated to the required amount.

17. MESENCHYMAL STEM CELLS
 These are adult stem cells that are presented in the body since birth and can
develop into a variety of cell types. they may be obtained from the bone marrow,
the adipose tissue, the umbilical cord tissue, the placenta. they are also known as
stromal stem cells and can develop into a variety of distinct cell types in the body,
including:
• Bone cells
• Neural cells
• Skin cells
• Corneal cells
• Chondrocytes
• Muscle cells

18. HOW STEM CELL THERAPY CAN TREAT DISEASES
 Stem cell therapy, otherwise called regenerative medicine,
uses stem cells or their secretome (the set of expressed
proteins) to enhance sick, dysfunctional, or wounded tissue
repair response.
 In scientific research, stem cells may be differentiated into the
required adult cell type before being transplanted. The mature
cells are then used to replace tissue that has been destroyed
by illness or injury.

19. This form of therapy might be utilized for a variety of purposes. For
example:
• Neurons that have been injured by a spinal cord injury,
• a stroke,
• Parkinson’s disease,
• Alzheimer’s disease, or other neurological issues are replaced.
• Generate cartilage to heal arthritic damage.
• Replacement of any other injured or diseased tissue or organ.

20. Ethics of Stem Cell Research
1. ETHICAL ISSUES ON DERIVING STEM CELLS AND THEIR SOURCE
a. The use of human embryonic stem cells for research or therapeutic
purposes.
b. The use of surplus/spare embryos formed during IVF application.
c. The use of fetal tissue that is obtained as a result of pregnancy
termination (miscarriage/intentionally induced)
d. Creating embryos to be used in the stem cell researches

21. 2. Ethical Issues on Research Process
a. Ethical issues in the context of women’s rights/reproductive right
b. Informed consent from volunteers during research process
c. Confidentiality of privacy/hiding of information during research process

22. 3. Ethical Issues on Clinical Phase and Afterwards
a. Problems caused by commercial concerns’ being leading and
determinant in researches
b. Advertisement/misinforming the society/miraculous treatments/sharing
research results, whose hypothesis is not proven, with the public
c. Reflecting some treatment methods, efficiency of which has not been
proven, as miraculous treatments during research process.

23. Shari'ah Perspective on Stem Cells Research . By Imran Siddiqi, a Ph.D. in Genetics
Questions:
Having recognized that in vitro fertilization is permissible in Islam
1. After an artificial fertilization and is not yet in the womb of its mother, be
considered a human being, with all the rights of a human being?
 According to the Shari'ah we should make a distinction between actual life and
potential life. Also we should make a clear distinction between the fertilized ovum
in the dish and the fertilized ovum in the womb of its mother.
 As a result, the remaining embryos would have either been frozen indefinitely or
destroyed. If these embryos were treated as full human, it would have been
forbidden to produce them in excess and to destroy them later. No one treats
them as humans. Destroying such embryos is not called and cannot be called
abortion.

24.  Muslim jurists have made a clear distinction between the early stages
of pregnancy (first 40 days) and its later stages. It is mentioned that if
someone attacks a pregnant woman and aborts her baby in the early
stages of her pregnancy, that person's punishment will be less than
that of the person who does that during full pregnancy. And if he kills
the child after the birth, then he is liable to be punished for homicide.

25. 2. The second question is whether according to the Shari'ah it is acceptable to destroy an embryo for
the sake of research, even if this research can potentially cure many otherwise fatal diseases?
 The embryo in this stage is not human. It is not in its natural
environment, the womb. If it is not placed in the womb it will not survive
and it will not become a human being.
 So there is nothing wrong in doing this research, especially if this
research has a potential to cure diseases.
 However, it is important that to establish strict rules against the misuse of
embryos. Research on embryos has the potential for misuse, for
instance in regards to the donors of these cells, and we should anticipate
what these misuses might be and establish safeguards against them.

26.  In making rules the authorities should also clarify that there is a
difference between the use of "spare" embryos from in vitro
fertilization procedures which would be destroyed regardless, as
compared to the deliberate production of embryos for stem cell
research. Each year thousands of embryos are wasted in fertility
clinics around the world. Such embryos should not be wasted, they
should be used for research.

27. T H A N K Y O U