Introduction increase in infertility rates from 5.4% in 1984



Involuntary childlessness or
infertility by circumstance occurs when a couple is unable to conceive due to a
preventative medical condition. These issues may include defective egg or sperm
production, or reproductive organ abnormalities such as the inability to carry
a child to full term …etc. According to an article published by
Global News Canada, research collected by Canadian fertility experts have
concluded a sharp increase in infertility rates from 5.4% in 1984 to 15.7% in
2011 with a steady plateau up until now. (Kozicka, 2016) i.     Fortunately,
assisted reproductive technology (ART) has developed and is available for those
unable to conceive naturally on their own. In the past, couples unable to
conceive had two choices: adopt or remain childless. Now couples may utilize
ART methods to conceive a child with their own genes or to weed out defective
genes that carry diseases. (Ward & Belanger, 2015) ii. The importance
of infertility education and awareness should be not underestimated.
Infertility is considered a global health issue and is defined as a “disease of
the reproductive system and results in disability.”  (World
Health Organization, 2017) iii. 
In the fight against this reality, couples may choose surrogacy or vitro
fertilization to aid in conception. In addition to investigating the options
available, we must also consider the social factors surrounding infertility to
gain a deeper understanding of the issue.

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Assisted Reproductive Technology




Surrogate mothers are fertile women who carry a child
for another person. In this process there are four options:

the mother’s egg may be used with a donor sperm

the father’s sperm may be used with a donor egg

both the mother’s egg and the father’s sperm may be used or;

a donor egg and sperm is used to a donor embryo which is then
implanted in the surrogate through artificial insemination

This method of
conception has also opened the door for single and gay men to become fathers
without resorting to adoption. (Ward & Belanger, 2015) iv.

In Vitro Fertilization (IVF)


This method involves
removing eggs from a woman’s body and fertilizing them with her partner’s sperm
within a laboratory setting. One or more embryos may be implanted in the
woman’s uterus with the intention and hope of one becoming a baby. Additional
embryos are then frozen and stored for future use. The success rate of the
treatments depends on various factors such as the woman’s medical history, age,
the number of embryos used…etc. In fact, only less than 1/3 of IVF cycles are
successful. (Ward &
Belanger, 2015) v. This process is generally used when the woman’s fallopian
tubes are blocked.      These treatments
are very expensive and are not usually covered by medical insurance. However,
in an effort to help those faced with the financial burden, Ontario has
implemented a government-funded fertility treatment plan available through
select clinics. The eligibility requirements can be investigated further on the
Government of Ontario website.

Sociological Factors


Relationships & Marriage


             Infertility affecting
couples can take a toll on the relationship. Women are left feeling unfulfilled
and unworthy, due to the pressure imposed by society to bear children. Men
often feel as though they do not live up to standards associated with manhood.
When there is a strong desire to have a child, there could be resentment
against the infertile partner. Similarly, when couples seek medical assistance
to aid in conception the effects of infertility on the relationship are still
evident. Couples often schedule their sexual activities around when the woman
is ovulating, which can make sex less spontaneous. (Ward & Belanger) vi

Ethical and Social Issues


            When it comes to the issue of infertility and the use of
ART, many people become divided in opinion. There those who condemn the use of
such technology as unnatural. Similarly, some go as far as asserting that the
inability to conceive is god’s will. Others are accepting and consider such
advancements as progress. (Ward & Belanger, 2015) vii.          As mentioned previously, those
who are single and those in a homosexual relationship use these methods to
conceive. This forces people to reconsider the conventional notion of what
makes a family, which in turn promotes an array of attitudes and opinions.   One the most conversional ethical issues
surrounding the use of ART methods is the concept of ‘designer babies’.
Designer babies are defined as “A baby whose
genetic make-up has been selected in order to eradicate a particular defect, or
to ensure that a particular gene is present”. (Oxford
Dictionaries, 2017)viii  ART techniques have become so advanced
people may now choose the characteristics they want their baby to have. This
may include selecting the desired gender, genetic testing to eliminate disease
and disabilities or seeking a donor with preferred traits for egg or sperm
donation. We are left to consider whether or not we are holding our children to
the same unrealistic standards we hold ourselves to. It also raises the
question of how we assess the worth of those born with abnormalities or
undesired traits.



            According to the Canadian Agency for Drugs and Technology
in Health, one cycle of IVF can cost anywhere between $10,000 and $20,000
depending on the amount of medication needed. (Canadian Agency for Drugs and Technology in Health,
2010) ix.  In Canada, a few select provinces
such as Ontario and Quebec have implemented government-funded plans. Similarly,
countries such as Sweden, Australia and Israel have also made efforts to make
ART treatments accessible. In regions where no such assistance exists, those
seeking help are forced to pay out of pocket.



            The legality surrounding the use of ART is
significant. For instance, the Assisted
Human Reproduction Act, 2004 sets out the parameters regarding surrogacy in
Canada.  For example, although permitted
in other countries, section 6(1) of the Act prohibits a person from paying another
to be a surrogate mother; known as commercial surrogacy.  Surrogacy without payment is referred to as
altruistic. Furthermore, the Act clarifies matters of informed consent, minimum age,
privacy, the handling of embryos, offences and enforcement…etc.  Unfortunately, the validity of surrogacy
contracts are not addressed in the Act, which can make for a sticky situation
if a surrogate mother wanted to keep the child after birth.  In Ontario, it is unclear what a judge would
decide in this case, due to a lack of precedent. Although it is more likely
that the well-being of the child would be the ultimate determinant when
compared to the principles of contract law alone. One noteworthy case involved
a judge in the U.S granting primary custody to the biological father and his
wife, with the surrogate biological mother with visitation rights. This
decision was made in the best interest of the child. (Ward
& Belanger, 2015) x.  With such ambiguity in Canadian law surrounding surrogacy parental
rights and custody, we can anticipate that similar cases will be heard in Canadian
courts at some point in the future.  


            After investigating and researching
the social phenomenon of infertility, I have learned that it is a common issue
affecting people around the globe and ART methods are the subject of great social
and ethical debate. In my opinion, nothing
much can be done to persuade people to accept the use of ART; it will always be
a subject under scrutiny. People tend to reject what they do not understand, so
education and awareness will always be the best combatant. In order to improve
the chances for people suffering from infertility to become parents, ART must
be more accessible. It is the right of individuals to have children and
infertility should be treated like any other disease. Therefore, all provinces
and territories must implement a coverage plan to assist with the costs of the
treatments; not just select regions.        Furthermore,
the legality surrounding surrogacy contracts/agreements must be clarified either
by federal legislation or provincial family law. As of now, the law is ambiguous
and place a burden on the court to make their own decision regarding parental
rights/custody should the surrogate contest in court. When considering the best
interests of a child, the supporting laws should be clear and binding, rather than
arbitrary and inconsistent. Government intervention plays a big role in improving
the lives of those seeking ART treatments to conceive.