Respecting Your Beliefs
At Genea we absolutely respect your beliefs. Because of this, we have taken the care to devise acceptable assisted conception programs for virtually all faiths - Christianity (including the Brethren), Islam, Judaism (including supervised Kosher treatment cycles), Hinduism and Buddhism. We guarantee that your eggs and your sperm will never be used in a way that you have not explicitly or implicitly consented to.
When does life start?
There are many views on the moment that represents the beginning of a new life. Some people believe that it is the instant that the sperm enters the egg, for others it is the moment that the genetic material of the two parents come together (this happens some time after fertilisation and is called syngamy), while others again place it at certain developmental milestones of the embryo or fetus, such as implantation, nervous system development or "sentience".
Because of these questions, some people face a moral dilemma when considering cryostorage (freezing) of embryos after an IVF cycle. Embryos are often cryostored if there are more produced than are necessary for a single embryo transfer. It enables a number of embryo transfers while stimulating the ovaries with hormones only once.
For many people, this option is very attractive, since it is the ovarian stimulation that is the most expensive and complicated part of an IVF cycle. But it does mean that there are often embryos produced that will never be transferred. For some people this is not a morally acceptable situation.
Syngamy literally means 'married together'; and is the moment when the genetic material from the egg and the sperm join to become one. It occurs in the fertilised egg about 20 hours after the sperm has entered. A few hours before syngamy the sperm's chromosomes and the egg's chromosomes are visible as separate spheres (or vacuoles) called pronuclei.
At this stage
- We know the egg has been successfully fertilised
- The male and female genetic material have not yet combined
- The zygote (as it's called) can be transferred to the fallopian tube (by laparoscopy or vaginally, by ultrasound-guided catheter)
- The fertilised, pre-syngamy egg can be "frozen" (cryostored) for a later decision on its transfer or dissolution (i.e. allowing it to dissolve away).
What are the special options and alternatives?
- To provide sperm without masturbation, semen can be collected in a non-sperm-toxic silastic condom during sexual intercourse. These special condoms are available from Genea.
- To avoid any manipulation of eggs outside the body, consider IUI intrauterine insemination of prepared sperm at ovulation, which can be stimulated to produce multiple follicles (although with a chance of high multiple pregnancy, such as triplets).
- To avoid fertilisation outside the body, consider GIFT - gamete intrafallopian transfer, in which unfertilised eggs are transferred with separate sperm into the fallopian tube at laparoscopy.
- To avoid producing more eggs than will be used, consider natural cycle IVF (without ovarian stimulation, but with in vitro fertilisation).
- To avoid producing more fertilised eggs than will be used, we can fertilise just two or three recovered eggs after stimulation.
- To avoid producing more embryos than will be used yet still have the medical benefit of freezing fertilised eggs that have not yet become embryos, we can freeze extra fertilised eggs before syngamy.
Special approaches for religions
The available options depend on the moral significance of the stages of egg collection, fertilisation, embryo formation, implantation, and subsequent development. We will accord with your beliefs and those of your religious or theological advisor, if you have one.
The Brethren have made use of ovarian stimulation and IUI at Genea.
Catholics have varied enormously in their practical position as papal decrees have sought even to prevent masturbation or intercourse with an intact condom. In vitro fertilisation with cryostorage prior to syngamy has been acceptable to some of our observing patients.
Some Christian couples might have a preference for IVF with PGD (preimplantation genetic diagnosis) over prenatal testing of the fetus for genetic disease prevention, as prenatal testing may lead to a difficult decision as to a termination of pregnancy.
The use of donated sperm (or eggs) has generally been unacceptable, and male sperm recovery techniques such as ESA and TESE are popular.
Genea has experience with the conduct of strictly Kosher treatment programs, including rabbinical supervision of all egg and sperm manipulations, avoidance of procedures during menstruation, and strict observance of the Sabbath.
Read A Jewish View of Infertility and its Treatment by Dr Devora Lieberman
Hinduism and Buddhism
These faiths are generally very tolerant of the range of procedures available, including the use of donated reproductive tissues.