IVF: Modern miracle or risky procedure?

OutlineWhat is IVF?

Feminist and non-feminist responses to IVF

IVF as context-specific

Accounting for treatment failure

What is IVF?In-vitro

FertilisationA laboratory

procedureA process of

assisted conceptionEggs are removed

from ovariesMixed with sperm

in lab1 or 2 embryos re-

implanted in womb

What is ICSI?Intra-cytoplasmic

Sperm InjectionEggs removed and

single sperm injected

Used when sperm count low or problems with shape/motility

First success in 1993

Today 52% of IVF cycles in UK involve ICSI

Facts and figures (HFEA 2009 and 10)45,264 patients in 2010 (up 5.7% from 2009)57,652 cycles of treatment12,714 live births (2,441 multiples)Success rates (with “fresh” eggs):

Overall live birth rate 25.2% (down 0.6%)Women under 35: 33.7%Women 35-37: 27.5%Women 38-39: 19.7%Women 40-42: 12.5%Women 43-44: 5.1%Women 45+: 1.5%

HFEA = Human Fertility and Embryology AuthorityEstablished 1991

Source: HFEA Website

Source: HFEA Website

Funding IVFNICE: PCTs should offer up to 3 cycles on

NHS if woman is aged 23-39 and couple have not conceived after 3 years or have an established cause of infertility

2005: 22% of PCTs providing 1 cycle, 58% taking steps to achieve that

2007: 36% of PCTs providing 1 full cycle 27% providing 2 cycles 5% providing 3

3 PCTs not providing any

Source: 2008 Interim Report on NHS Infertility Provision

Resisting IVFOn what grounds is IVF opposed, and by

whom?

Non-feminist responses“Pro-life”: embryos

are “alive”Cases of embryo

“adoption”US – “snowflake

babies”

Disruption of normative reproductive categoriesIntergenerational gamete donation

Fragmentation of parenthood (social, genetic and gestational)

Temporal disruptions (e.g. twins born years, even decades, apart)

Feminist responses: FINRRAGEFeminist International Network for

Resistance to Reproductive and Genetic Engineering

Reproductive technology as experimental and abusive of women

Taking women’s health care out of women’s hands and into men’s

Critiques of FINRRAGEToo generalising about “women” and

“men”

Assumption of natural womanhood outside of culture

Cannot account for women’s involvement (outside of complicity / false consciousness)

But….Centralises women’s bodies in the debate

International perspectiveRace / class discriminationShowed links between industries (e.g. farming / fertility medicine)

Women as users, not recipients / victimsRayna Rapp: women as “moral pioneers”

Women actively use IVF, rather than simply being passive recipients / victims of it.

Policing of own bodies is experienced as empowering / resistant – “doing something about it”.

IVF as context specificIVF in the context of population

controlIVF as a technology of privilegeIVF as a technology of selection (e.g.

sex)IVF tourism (secrecy / finances)IVF for a heterosexual couple; for a

surrogacy; for a single woman….

IVF failure – blaming women?Women do most of the “work” of IVF:

Information gatheringOrganising appointments / tests (for both partners)

IVF focuses on women’s bodiesDifferent standards of “fertility” for

men and womenTechnology succeeds, but women fail

“Poor perfomer”Liz: I thought, well… I was just

sitting there thinking… gosh, they can’t… I feel labelled! You sort of… like a school report – could do better.

“crap eggs” (Stephanie)“[I’m] rubbish at producing eggs”

(Jenny)“[I never] did that well with the

eggs” (Jane)

Masculinity / virility / fertilityMen’s sexual performance is called into question

Inhorn wants to correct misnomer that IVF doesn’t impact on men

Required to provide semen on demand

May be invasive collection

Coping with failure‘IVF only makes life more difficult… I would have had to accept it a long time ago if it weren’t for IVF. At twenty-eight I could have either gone for adoption or accepted my situation so I’d be five years down the line towards that and getting on with my life. Now you’re in a better position to do that when you’re twenty-eight than when you’re thirty-eight. If you’ve missed all your career boats and burned all your career bridges because you’ve spent the last ten years chasing fruitless treatment you’ve actually missed out a lot on life’.(Beth Carter in Franklin, 1997, pp. 177-8)

Success ‘To start with we felt a bit unsure and the idea of having to have IVF took getting used to. We were hit quite hard  emotionally. I thought it was going to work first time so it was a shock when it didn't… When you are trying for a baby it takes all the spontaneity out of sex so it is quite a strain. We would get quite excited when having the embryos replaced and then feel utterly despondent when it didn't work. But we worked through it giving each other support. In many ways it brought us closer together’.Caroline and Andrew, daughter Adelaide born following 4th IVF cycle, Testimony on HFEA web-site

ConclusionIVF is a new reproductive technology that is

in high demand

Failure is still the most likely outcome

It both affirms, and disrupts, normative reproductive categories

It has been the focus of considerable opposition from both feminists and non-feminists, but on very different grounds

It’s a social technology, context-specific