“What world do we want for tomorrow? It is on this question that the General Assembly of Bioethics opens today, the first sequence of the revision of the bioethics law which should take place at the end of the year. First part of the discussion: reproduction, embryonic development, as the press kit says. More poetic translation: realization of the desire for a child for all.
What is the difference between IVF and ART?
For a long time, the problems of bioethics and fertility were summed up by IVF, In Vitro Fertilization, which is however only one of the techniques of what is called MAP, Medically Assisted Reproduction. PMA is the set of clinical and biological practices, where medicine intervenes, more or less directly, in procreation. And in this area, the debate has been raging for several years, requiring urgent and delicate arbitrations.
But here we are… The law indeed imposes a revision of the rules of bioethics every 7 years. The previous one dated from 2011. The next six media months will be resolutely ethical.
Why a review on this subject?
This revision is necessary for several reasons: the advancement of science and permanent research make it possible to move fairly quickly from dreams to reality, even more so when marketing can act as a catalyst. It is also an area which is easily invited into politics, hence the passion for debates in the name of the great republican principle: “for all”.
Why use these techniques?
A child for all couples who cannot have one.
About one in six couples have difficulty having children.
What are supernumerary embryos?
If the problem is of a “mechanical” nature, but that both parents have ova and sperm capable of fertilization, 1978 and the birth of Louise Brown, the first “Test tube baby” will remain that of the birth of IVF, In Vitro Fertilization, which has continued for many years. to improve.
To the point that a few spermatozoa are sufficient today to fertilize a few embryos and that we also know how to avoid multiple pregnancies from the start. Indeed, the stimulation of the ovaries being more effective than the need, the majority of the couples have embryos in “too”. Few ethical issues with IVF; rather satisfactions, except for the problem of these supernumerary embryos, which research is in dire need of. A little more clarity on the conditions of use will be welcome, because without news of the couple for 5 years, the center can end the storage of embryos.
Will the donation of sperm (and oocytes) remain anonymous?
If the man cannot deliver sperm, sperm donation can solve the problem quite easily. For a long time and without real ethical problems, even if the specialized centers, the CECOS, regularly alert on the needs of donors. The situation will not get better with recent news and the story of this young man who found his biological father thanks to an investigation, not within the reach of everyone, but effective. This adventure risks giving the idea to others … But above all it opens the discussion on the ethical “merits” of anonymity which is currently the rule. Will donors be as generous tomorrow if a few unknown children come to claim their obvious rights in the event of proven paternity? A file which was not specially provided for in this review, but which will inevitably arise.
For the woman who cannot make eggs available to the maternity project, egg donation (this is the stage when the egg is ready to be fertilized) exists and obeys the same ethical rules as donation. of semen.
Can we put sperm or oocytes “aside”?
For the man, it is simple and inexpensive. This consists of freezing sperm straws in nitrogen and making them available on demand. The cases of sampling, before for example chemotherapy or medical chemical castration, are numerous and well organized. Another use to be debated is the post mortem use by the widow.
For women, the freezing of oocytes for medical reasons is also perfectly possible in our country.
Can we keep eggs for a later pregnancy, without medical reasons?
This preservation, for reasons of “precaution of life” is prohibited. However, the requests are more and more numerous, because the desire for motherhood is more and more frequent after 35 years. We know the difficulties at this age, hence the desire of many women to do stimulation before this age, and to have oocytes collected, which then remain available to the future mother, as soon as she has found a potential father. Most of the women who take this step therefore go to Belgium and especially to Spain, where, for several thousand Euros, a few prescriptions complicit in French doctors (for the period during which the candidate’s ovaries are stimulated before the sample), the oocytes are collected and stored in liquid nitrogen.
There is great pressure for the review to address this problem.
Same sex couples
For those who do not want to make an adoption but actively participate in the child plan, several solutions exist.
PMA for all?
For female couples who have artificial insemination performed on one or the other of the women, the technique is simple and the same as for a hetero couple where the man is sterile. The problem arises when declaring the child, who cannot have two legal “mothers”! Among the hot issues of this bioethical review, PMA for all is certainly the one that will be the most discussed since the Secretary of State for Gender Equality recently confirmed Emmanuel Macron’s campaign promise: in 2018, the PMA for All Women will be presented to Parliament.
Today, the couples who want to do it officially go, either to Belgium or to Spain, and then find themselves facing a legislative vacuum.
What is surrogacy?
For male couples where one of the two wants to be the biological father, there is only one possibility: surrogacy, Surrogacy, what we used to call “surrogate mothers”. For the moment, the law is categorical, it is prohibited, and it is not intended that the legislative debate will be open.
In conclusion, many subjects, probably passionate, some of which will inevitably take to the streets.
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