This document summarizes a presentation on biosafety and bioethics related to in vitro fertilization (IVF) techniques. It discusses various IVF methods like ICSI and PGD. It notes key milestones in IVF including the first successful birth and oldest mother. The presentation addresses ethical concerns around religious views, profit motives, genetic selection, older patients, and medical errors. Case studies are provided on a deaf couple seeking a deaf child and families affected by IVF mix-ups. Global regulatory frameworks for IVF are also summarized.

1. Course Name: Biosafety and Bioethics
Presenters: Maleeha Aamir and Misbah Habib

2.  Topics:
I. In Vitro Fertilization (IVF):
I. IntraCytoplasmic Sperm Injection (ICSI)
II. Cytoplasmic Transfer
III. Embryo Splitting
IV. Frozen Embryo Transfer
V. Preimplantation Genetic Diagnosis (used with
IVF)
VI. Mitochondria Replacement Therapy
VII. In Vitro Gametogenesis (IVG)
VIII.Zygote Intrafallopian Transfer (ZIFT)

3. • Background:
• Infertility defined as inability to conceive after a year of trying.
• Psychological trauma in women due to societal norms, i.e.
“Infertility in women equates to their failure on a personal, emotional
and social level”
• Causes of Infertility: Age, toxins, infections, habits, weight.
• Infertility affects 13-14% of reproductive-aged couples.
• Infertility prevalence in Pakistan: 22%, primary infertility 4%.

4. First
successful
IVF birth
Oldest
woman
[66] gives
IVF birth
8M
children
born
globally
via IVF
• Milestones In IVF:

5. • In Vitro Fertilization:
• Definition:
“In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined
with sperm in vitro ("in glass").”

6. • Process of IVF:

7. • Types of IVF:
ICSI Embryo Splitting Frozen Embryo Transfer

8. Preimplantation Genetic
Diagnosis
Mitochondria Replacement
Therapy Cytoplasmic Transfer

9. Zygote Intrafallopian Transfer In Vitro Gametogenesis

10. • IVF Movie:
• Maybe Baby (2000)

11. • Celebrities Who Have Undergone IVF:

14.  Ethical Concern #1:
(Religious Response)
• Diverse reactions based on religious beliefs
• Varied stances within different religious sects
• Denial, partial permission, and sacred acceptance
• Ethical Concerns of IVF Methods:

15. Catholicism
Lutheranism
(the donor must not involve a
third party)
Anglicanism
(the donor must not involve a
third party)
Methodism
Christianity

16. Hinduism:

17.  Islam:
• Generally accepted with conditions
• No third-party donation (sperm, eggs, embryos, uteruses)
• Sunni-Shi'a debate on third-party donation

18. • Fatwa by Gad al-Haq of Al-Azhar University

19. Ethical Concern #2:
(Preimplantation genetic diagnosis or screening)
• PGD used in IVF for genetic embryo info
• Choice to transfer defect-free embryos
• Controversy: Selection of "desirable" traits
• Embryo screening linked to ethical debates
• Potential embryo viability risks
• Equated with abortion, "Playing God"
• Misuse concern: Discrimination, stigma
• International variations in PGD regulations
 Do you think Preimplantation genetic diagnosis is ethically appropriate? To what
extent? Should it be banned?

20.  Case Study # 01:
(A Disable wanting its own like to be born)
• A deaf British couple, Tom and Paula Lichy, have petitioned to create a deaf baby using
IVF. Some medical ethicists have been very critical of this approach.
• "Intentionally culling out blind or deaf embryos might prevent
considerable future suffering, while a policy that allowed deaf or blind parents to select
for such traits intentionally would be far more troublesome."
-Jacob M. Appel

22. Ethical Concern #3:
(Profit desire of the industry)
• IVF industry's profit desire may prioritize money over patients' well-being.
• Risky practices like transferring too many embryos to increase success rates.
• High costs due to patents and monopolies make IVF unaffordable for many.
• Industry accused of exaggerating infertility rates and overusing treatments.
• Focus on profit may overlook social and emotional aspects of infertility.

24.  Ethical Concern #4:
(Older Patients)
• Professor and physician Dominic Wilkinson wrote in Oxford University’s popular
philosophical blog Practical Ethics about some common arguments against
permitting older women to have IVF, i.e.
1. Having an older mother is harmful.
2. Being pregnant while older is harmful.

26.  Ethical Concern #5:
(Mix-ups)
• Gamete misidentification, embryo transfers.
• Legal actions & paternity disputes.
• IVF provider legal consequences.
• Causes: Labeling, patient placement.

27.  Case Study # 01:
(Vanner and Donna Johnson, from Utah)
• Surprise revelation after 10 years.
• Discovered through 23andMe DNA kit.
• “When my results showed up, showing two sons
immediately and seeing our oldest was a half-sibling to his younger brother,
through me, we knew there must’ve been something wrong.”
-Ms Johnson told Fox 59.
• Ms Johnson's realization of a fertilization error.

29. Case Study # 02:
(Mix-up of a Los Angeles couple Alexander and Daphna
Cardinale)
• Cardinales' IVF Shock: Child not genetically related
• Suspicions: Different appearance from first child
• DNA test confirms non-biological connection
• Fertility clinic's error: Wrong embryo transfer
• Unintended surrogate situation for another couple

31.  Global Legal/ Regulatory Frameworks:
• Bans IVF for sex selection under Pre-
Conception and Pre-Natal Diagnostic
Techniques Act, 1994
• Bans IVF for unmarried individuals and
specific infectious diseases, 2003

32. • Lifted restrictions on single and infertile
people using IVF in 2002.
• Some states maintained restrictions
temporarily.
• Federal regulations: screening, donation limits.
• State bills attempted IVF as adoption.
• Had a complete ban on IVF, ruled unconstitutional
in 2012.
• Inter-American Court of Human Rights
overturned the ban in 2012.
• IVF legalized in 2015; facing legal challenges.