22/07/2024
Lecture 9: Reproduction – By Mathews Okoth
I. Introduction
Modern science has demonstrated the days when there was one ‘simple’ way of
producing children are long past. Technological advances have given us a wide range
of options of producing children. In 1978, the first ‘test-tube’ baby was born, and
assisted reproductive technology (ART) has since then been widely used in various
countries. In its origin, technological advances in reproduction was spurred by
infertility, though increasingly, even medically fertile couples are embracing
medically assisted reproduction. Infertility may be said to arise where a couple fails
to conceive after twelve months of unprotected sexual intercourse.
According to conventional knowledge, infertility is believed to arise from obesity,
smoking, heavy alcohol use, tight underwear, using laptop, hot baths, and delaying
the age at which women seek to start a family.
Childlessness can be profoundly distressing to some people. There is often a loss of
self-esteem mixed with feelings of grief, anger, and sometimes guilt about the source
of the infertility. Many people also experience a sense of isolation from family
members and friends. Having children is firmly embedded in the everyday social
and family interactions in which most people take part. As friends and siblings go
through life, milestones in their children lives – school events, graduations,
weddings, birth of grandchildren – continually remind those without children of
their childlessness. Some women regard it as one of their primary roles to produce
and raise children, and so, experience infertility as, in a sense, a failure to be a ‘real
woman.’ Men similarly regard infertility as a lack of manliness, notwithstanding that
many infertile couples would make wonderful parents. The distress of infertility has
seen people to go at great lengths financially, emotionally, and physically in order to
have a child using medically assisted reproduction.
Infertility has social consequences too. Politicians are known to bemoan the low
number of children being born in Kenya, or parts of Kenya. Critiques of this view
question the economic benefit of children if a country’s economy cannot adequately
sustain their health and welfare.
The distress of some persons notwithstanding, there are also a great number of
people who do not regard infertility as a tragedy. Such people may have no wish to
have children. Therefore, to them, infertility is a boon enabling them to avoid the
difficulties of contraception and the burdens of parenthood. The parents accept
infertility as their ‘lot’, without experiencing childlessness as a huge loss.
1
, The different viewpoints notwithstanding, reproductive technology has given both
fertile and infertile persons greater autonomy in reproduction.
Reproductive Autonomy
Reproductive autonomy is the idea that one’s reproductive choices as to when,
where, how and with whom to have children should be a private matter in which the
State should not interfere. The State’s role should be facilitative of those individual
choices to help couples who need treatment from infertility, or help in having
children through reproductive technology, achieve those aims.
Reproductive autonomy covers a wide range of issues:
§ From contraception to abortion; and
§ From cloning to sex selection of the embryo for implantation.
Much of the discussion about reproductive autonomy centers on the rights of
women. This is because reproduction place in the context within which women’s
bodies, needs and interests have a central role. Men also have reproductive interests,
but those interests are subordinate to the women’s interests.
II. Techniques of Assisted Reproductive Technology (ART)
§ Cryopreservation
This is a reproductive technology that involves freezing of a donor’s sperm, eggs
or embryo, and implanting either of them in a woman’s fallopian tube or uterus at
the optimum time in a woman’s menstrual cycle. This process is also helpful to fertile
individuals who are about to undergo a surgery or treatment that may render them
infertile, so that they can retain the option of reproduction in the future.
§ Intrauterine (or assisted) insemination by husband/partner
Intrauterine insemination involves a husband’s or partner’s sperm being injected in
the woman, where it fertilizes the egg
§ Donor insemination
Donor insemination is used where the woman has no partner, or her partner is
infertile. It involves the insemination, that is, introduction of semen into the
reproductive tract of a female, via her vagina, into the cervical canal or into the
uterus itself.
§ Egg (oocyte) donation
Egg donation is necessary where the woman has no healthy eggs. A woman willing
to donate eggs will have a very invasive hormonal treatment and then eggs are
2
Lecture 9: Reproduction – By Mathews Okoth
I. Introduction
Modern science has demonstrated the days when there was one ‘simple’ way of
producing children are long past. Technological advances have given us a wide range
of options of producing children. In 1978, the first ‘test-tube’ baby was born, and
assisted reproductive technology (ART) has since then been widely used in various
countries. In its origin, technological advances in reproduction was spurred by
infertility, though increasingly, even medically fertile couples are embracing
medically assisted reproduction. Infertility may be said to arise where a couple fails
to conceive after twelve months of unprotected sexual intercourse.
According to conventional knowledge, infertility is believed to arise from obesity,
smoking, heavy alcohol use, tight underwear, using laptop, hot baths, and delaying
the age at which women seek to start a family.
Childlessness can be profoundly distressing to some people. There is often a loss of
self-esteem mixed with feelings of grief, anger, and sometimes guilt about the source
of the infertility. Many people also experience a sense of isolation from family
members and friends. Having children is firmly embedded in the everyday social
and family interactions in which most people take part. As friends and siblings go
through life, milestones in their children lives – school events, graduations,
weddings, birth of grandchildren – continually remind those without children of
their childlessness. Some women regard it as one of their primary roles to produce
and raise children, and so, experience infertility as, in a sense, a failure to be a ‘real
woman.’ Men similarly regard infertility as a lack of manliness, notwithstanding that
many infertile couples would make wonderful parents. The distress of infertility has
seen people to go at great lengths financially, emotionally, and physically in order to
have a child using medically assisted reproduction.
Infertility has social consequences too. Politicians are known to bemoan the low
number of children being born in Kenya, or parts of Kenya. Critiques of this view
question the economic benefit of children if a country’s economy cannot adequately
sustain their health and welfare.
The distress of some persons notwithstanding, there are also a great number of
people who do not regard infertility as a tragedy. Such people may have no wish to
have children. Therefore, to them, infertility is a boon enabling them to avoid the
difficulties of contraception and the burdens of parenthood. The parents accept
infertility as their ‘lot’, without experiencing childlessness as a huge loss.
1
, The different viewpoints notwithstanding, reproductive technology has given both
fertile and infertile persons greater autonomy in reproduction.
Reproductive Autonomy
Reproductive autonomy is the idea that one’s reproductive choices as to when,
where, how and with whom to have children should be a private matter in which the
State should not interfere. The State’s role should be facilitative of those individual
choices to help couples who need treatment from infertility, or help in having
children through reproductive technology, achieve those aims.
Reproductive autonomy covers a wide range of issues:
§ From contraception to abortion; and
§ From cloning to sex selection of the embryo for implantation.
Much of the discussion about reproductive autonomy centers on the rights of
women. This is because reproduction place in the context within which women’s
bodies, needs and interests have a central role. Men also have reproductive interests,
but those interests are subordinate to the women’s interests.
II. Techniques of Assisted Reproductive Technology (ART)
§ Cryopreservation
This is a reproductive technology that involves freezing of a donor’s sperm, eggs
or embryo, and implanting either of them in a woman’s fallopian tube or uterus at
the optimum time in a woman’s menstrual cycle. This process is also helpful to fertile
individuals who are about to undergo a surgery or treatment that may render them
infertile, so that they can retain the option of reproduction in the future.
§ Intrauterine (or assisted) insemination by husband/partner
Intrauterine insemination involves a husband’s or partner’s sperm being injected in
the woman, where it fertilizes the egg
§ Donor insemination
Donor insemination is used where the woman has no partner, or her partner is
infertile. It involves the insemination, that is, introduction of semen into the
reproductive tract of a female, via her vagina, into the cervical canal or into the
uterus itself.
§ Egg (oocyte) donation
Egg donation is necessary where the woman has no healthy eggs. A woman willing
to donate eggs will have a very invasive hormonal treatment and then eggs are
2
