Ethical, Legal Aspects of Infertility Treatment

Ethical, Legal Aspects  of Infertility TreatmentEthical, Legal Aspects  of Infertility Treatment

One of the five leading causes of divorce in the country is infertility of one of the spouses, according to official reports.

A recent survey of 17,000 couples indicates that 2.2% of Iranian couples are infertile, said Mohammad Mehdi Akhundi, head of the Avicenna Infertility Clinic (AIC) affiliated to the Avicenna Research Institute (ARI) established in 2003 in collaboration with the medical center of the UKSH University in the northern German city of Luebeck.

“Around 40% of infertility is due to male problems, 40% due to female problems, and 15% of the cases are due to problems in both; the causes for the remaining 5% are unknown,” the Persian-language weekly ‘Salamat’ quoted him as saying.

At present, there are 3 million infertile couples in the country and the figure is increasing by 15% each year.

“Ovulation induction, in vitro fertilization (IVF), intrauterine insemination (IUI), a type of fertility treatment, embryo donation and finally surrogacy are methods currently performed in the country to help infertile couples,” he said.

“Third party reproduction’ methods like sperm donation, is not accepted in Iran. As there is no law in this regard, it is considered an illegal activity,” he said, adding that most countries have strict laws on sperm donation and place limits on how many children a sperm donor can beget. The main reason for this restriction “is the risk of accidental consanguinity or inbreeding between donor offspring.”

Reza Samani, secretary of the Medical Ethics Committee at Iran’s top infertility treatment center, the Royan Institute’s Research and Clinical Center for Infertility and Reproductive Health, says the institute has no plans to undertake sperm donation for conceptions.

“Currently, there are 85 infertility treatment centers in the country. If sperm donation is resorted to in some of them I am not aware of it,” he said.

  Ethically Unacceptable  

Sperm banks cannot completely guarantee that the sperm they provide are disease-free or free of genetic abnormalities.  Although genetic testing and disease screening techniques are advanced and sensitive, they are not foolproof, Samani said adding that, “for this reason and other reasons we believe that sperm donation as well as egg donation is unethical.”

Currently in Iran, embryo donation is the only ‘third party reproduction’ method which is legally allowed. The Parliament has passed the Embryo Donation to Infertile Couples Act and its bylaw which can be considered as a successful example of legalization of third party reproduction in the country. It permits embryo donation through artificial insemination from legally married couples to infertile couples. The Health Ministry is responsible to monitor all licensed infertility clinics in embryo transfer procedures.

However, according to an article in ARI’s Journal of Reproduction and Infertility, July-Sept. 2015 issue, many of the legal aspects of this method are not specified in the enactment and “this uncertainty, especially regarding the rights and duties of recipients and the child, causes important problems which generate more concerns. While the enactment is an important step, yet it is an insufficient measure in this field. Important issues have been left unanswered and unclear which should be considered by legislators in any future revision of the act.”

“We are also in need of specific and comprehensive laws for all kinds of infertility treatments to prevent any legal or ethical issues that may arise.”

In the past Iranian year (ends March 19), “we have been trying to draft laws for all kinds of infertility treatments,” he said, expressing hope for cooperation from the authorities in devising the relevant laws.