Ethical and legal concerns related to infertility

Reproductive research and treatment raise numerous ethical and legal concerns. The American Society for Reproductive Medicine has issued a number of statements about ethics and responsibility, which you can review on its Web site at http://www.asrm.org/Media/Ethics/ethicsmain.html.

Multiple pregnancy

Transferring several fertilized eggs during assisted fertilization techniques (as for in vitro fertilization) increases the likelihood that you will conceive two or more fetuses at once. Multiple pregnancy increases the risk of prematurity, low birth weight, mother and infant health complications, and disability of one or more children. Talk to your doctor about how you can increase your chances of conception while decreasing the probability of having a multiple pregnancy.

Embryos

If you are planning to use assisted reproductive technology to conceive, your clinic may offer to freeze (cryopreserve) extra fertilized eggs for future conception attempts. Whether or not your clinic asks you to sign a consent form, be sure to provide written instructions for the handling of any fertilized eggs that you don't use. As you do so, consider what you want done with them in the case of death, divorce, or separation, or should the clinic be unable to contact you in the future.

Donor eggs or sperm; surrogate mother

If you are planning to use eggs or sperm from someone you know, or to have a woman carry your fetus until birth, talk to your clinic or an attorney experienced in this area. Draw up a contractual agreement that defines the extent and limits of all parties' rights and responsibilities to the future child and your family.