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1. PRESENTATION GOALS
 Introduction
 Moral aspects of human reproduction
Types of HRTs
 Contraception
 Sterilization
 Abortion
 Assisted reproduction
 Surrogate motherhood
 Conclusion

2. Introduction Definition
Reproduction - process by which living beings
transmit their genes and give birth to a new
generation of living beings. The act or process of
reproducing is specifically the process by which
plants and animals give rise to offspring and which
fundamentally consists of the segregation of aportion
of the parental body by a sexual or an asexual
process and its subsequent growth and
differentiation into anew individual.

3. Introduction Life depends on
the presence of DNA and its
family of genes. The process of reproduction makes
it possible for living beings to transmit their genes to
the next generation of life. There are essentially two
types of reproduction: asexual reproduction, which
requires only one parent, and sexual reproduction,
which requires two parents . As far as human
reproduction is concerned, the act is sexual and
naturally requires two parents from different sex
(male and female).

4. MORAL ASPECTS OF HUMAN
REPRODUCTION
Human reproduction is a complex and controversial
field of ethics . Reproductive freedom - the freedom
to decide whether or not to have children. Denying
this liberty denies or imposes a crucial self-defining
experience and thus denies persons respect and
dignity A negative right – must be free from
interference A deeply held moral and legal value.

5. MORAL ASPECTS OF HUMAN
REPRODUCTION

People have the right to access to other
methods of their choice for regulation of
fertility which are not against the law . They
have the right of access to appropriate health-
care services that will enable women to go
safely through pregnancy and childbirth and
provide couples with the best chance of
having a healthy infant.

6. MORAL ASPECTS OF HUMAN
REPRODUCTION
3. Men and women have the right to be informed and
to have access to safe, effective, affordable and
acceptable methods of family planning of their choice
. They have the right to access to other methods of
their choice for regulation of fertility which are not
against the law . They have the right of access to
appropriate health-care services that will enable
women to go safely through pregnancy and childbirth
and provide couples with the best chance of having a
healthy infant.

7. Types of HRTs 1. Artificial
insemination by husband (AIH)
 2. Artificial insemination by donor (AID)3. In
virtro fertilization (IVF)Egg donation Embryo
Donation4. Surrogacy5. New Genetics6.
Human Cloning7 .Stem Cell Research8. Sex
selection

8. CONTRACEPTION
 Term birth control was introduced by Margaret Sanger
in 1914The deliberate use of artificial methods or other
techniques to prevent pregnancy as a consequence of
sexual intercourse . Contraception prevents pregnancy
by interfering with the normal process of ovulation ,
fertilization, and implantation . Major forms of
contraception are : barrier methods(condom or
sheath);hormonal contraceptive pills ; Intrauterine
devices(coil);male or female sterilization.

9. CONTRACEPTION
 Arguments against contraception:
•Contraception artificially interrupts the natural
process of conception. •Contraception
encourage illicit sexual activity.

10. CONTRACEPTION Arguments
in favor of contraception:
 •Women have the right to control their fertility as a
part of their body functioning (right to self-
determination)•Contraception reduces potential
harm for maternal and child health by preventing
unwanted pregnancies and pregnancies that are
too closely spaced as well as adverse effects on
mental health and social wellbeing of women due
to these events

11. STERILIZATION
 Sterilization is an irreversible medical procedure that
renders an individual incapable of sexual reproduction
and with profound physical and psychological effects.
Types of sterilization: •Voluntary sterilization –a form of
birth control wanted by a person •Forced sterilization -a
person is sterilized after expressly refusing the
procedure, without his/her knowledge or is not given an
opportunity to provide consent. •Coerced sterilization -
when financial or other incentives, misinformation, or
intimidation tactics are used to compel an individual to
undergo the procedure.

12. STERILIZATION
 Voluntary sterilization is an acceptable form of family
planning. •An ethical requirement is that performance
of sterilization be preceded by the patient's informed
and freely given consent. Information for consent
includes: •that sterilization should be considered
irreversible; •that alternatives exist such as reversible
forms of family planning; •that life circumstances may
change, causing a person later to regret consenting to
sterilization; •that procedures have a very low but
significant failure rate.

13. ABORTION
 Abortion is the focus of some of the most intense social, cultural,
political, religious, and ethical debates Termination of pregnancy
brings out conflicts between the rights of three persons:1.
mother’s rights the fetus's rights 3. father’s rights Ethical
consideration on abortion include variety of questions with
controversial answers, such as : Is a fetus a person with rights ?
Has the unborn child the right to life? Does the woman have
ethical obligations to the fetus? Does the woman have the right
to decide for termination of the pregnancy ? Is it ethical to force a
woman to carry a pregnancy to term ? Is sexual activity ethical if
it can lead to an abortion ? Does the woman have ethical
obligations to the father?

14. ABORTION
 The codes of conduct and various
declarations are opposed to the termination of
pregnancy. •The World Medical Association
Declaration of Geneva (1948): “I will maintain
the utmost respect for human life, from the
time of conception”. •The Hippocratic Oath: “I
will not give to a woman a pessary to cause
abortion….”

15. ABORTION
 Abortion laws differ between the countries
from being very liberal and allowing abortion
on request without any limitations to being
very restrictive and allowing abortion only to
save the life of the mother Up to week or later
Allowed only to save mother’s life or
prohibited Abortion allowed in case of abuse,
incapacity to care for the child or immaturity

16. ASSISTED REPRODUCTION
Assisted reproductive technology(ART) is a
medical intervention developed to improve an
‘infertile’ couple’s chance of pregnancy.
‘Infertility’ is clinically accepted as the inability to
conceive after 12 (24) months of actively trying
to conceive. It also refers to an inability to
sustain a pregnancy, which is demonstrated by
repeat miscarriages.

17. ASSISTED REPRODUCTION
Two-party assisted reproduction – methods applied to the
partners in heterosexual infertile couples that use only
their own genetic and biological reproductive capacities
Third-party assisted reproduction –methods applied to
those who cannot reproduce using only their own genetic
and biological capacities (donor is included)Heterosexual
and same-sex couples and single women and men who
seek to have biologically connected children, assisted by a
“donor” who provides sperm, eggs, or gestational services,
usually for a fee.

18. ASSISTED REPRODUCTION

Two-party assisted reproduction – methods applied to
the partners in heterosexual infertile couples that use
only their own genetic and biological reproductive
capacities Third-party assisted reproduction –methods
applied to those who cannot reproduce using only their
own genetic and biological capacities (donor is
included)Heterosexual and same-sex couples and
single women and men who seek to have biologically
connected children, assisted by a “donor” who provides
sperm, eggs, or gestational services, usually for a fee.

19. ARTIFICIAL INSEMINATION

Ethical issues Is it acceptable to provide AI to
postmenopausal women, to single women or
lesbian couples? What are ethically acceptable
criteria for choosing a donor? Is it ethically
acceptable to use the donated sperm after the
death of the donor? (most of the countries prohibit
this).Danger of inbreeding – limitation of the
number of AI, e.g. in Bulgaria –three effective
inseminations are allowed with one donor’s sperm

20. SURROGATE
MOTHERHOOD
 Surrogate mother is a woman who agrees to
bear a child for another woman with the
intention of handing over the child to someone
else after the birth (intended parents).IVF is
used to create embryos with the wife's eggs
and husband's sperm. The embryos are
transferred to the uterus of the surrogate
mother. If the procedure succeeds, the baby
will be the biological child of both husband
and wife.

21. SURROGATE MOTHERHOOD
ETHICAL CONSIDERATIONS

Diminishing the value of expecting a child to simply
being pregnant, “human incubator” for someone else’s
child Commercialization –the surrogate mother is
exploited because of her socio-economic status and
her dignity is jeopardized The effects on surrogate’s
family members and family life Should the husband of
the surrogate mother give his informed consent as well
? Respect for autonomy of the surrogate mother – to
what extend the parents can control the life stile of the
surrogate mother?

22. IN VITRO FERTILIZATION
IVF poses a lot of clinical and ethical considerations •Hormone
stimulation is needed to harvest sufficient number of oocytes for the
procedure and is related to several risks– infection, ovarian hyper
stimulation syndrome, multiple pregnancies and others
•Preimplantation genetic diagnosis(PID) of genetic diseases is done
to the embrios. Selective transfer of the embrio is morally justified by
preventing the suffering related to genetic defects and disorders for
the prospective children and for their parents •PID can endanger the
reproductive autonomy; to set a precedent for positive eugenics;
rises concern about cloning of human embrios; gives less value to
life of disabled and discriminates them; selection of embrios with
best tissue match for a very sick sibling

23. IN VITRO FERTILIZATION

IVF poses a lot of clinical and ethical
considerations •Selective reduction of the
fetuses in utero can be requested by the
family or suggested by the doctor in a case of
multiple pregnancies •Number of IVF cycle
•Financial burden •Depression in women after
unsuccessful IVF cycle

24. IN VITRO FERTILIZATION

IVF poses a lot of clinical and ethical considerations •
What to do with extra embryos that were not used for
implantation? •Criostorage of all embryos for next
attempts of implantation. How good are the thawed
embryos? •Informed consent of parents for storage or
use of gametes or embryos –statutory limits of 10 yrs.
for gametes and 5 yrs. for embryos; what to do with
them if the person who consented dies or
incapacitated; consent specifies if they can be used for
treatment of a specified person, for the treatment of
others, or for research