Protocolo de obtención y aplicación del P-PRP

Assisted reproductive technologies have enabled millions of people in the world who otherwise would not have been able to do so, to have children. Assisted reproductive technologies were from the start meant to initiate pregnancy without sexual intercourse, and allow infertile heterosexual couples to have children. In this regard, Golombok, MacCallum and Rutter noted that donor insemination, which is one of the variances of ARTs, has been successfully used as an alternative for couples with an infertile male partner to have children.213

213

Golombok, MacCallum and Rutter “Families with children conceived by donor insemination: a follow up at age twelve” 2002 CD 952.

63 It was not conceivable for a woman to fall pregnant without sexual intercourse with a man until 1978 when Steptoe and Edwards made possible the fertilisation of an egg in a test tube and the transfer of the embryo into a woman’s body in order to initiate pregnancy in the absence of sexual intercourse. 1978 marked the dawn of a new era in medical technology. The achievement of Steptoe and Edwards opened the way to a new technology of reproduction, which has a range of techniques and is referred to as ARTs.214

Assisted reproductive technologies are therefore the use of non-coital technologies to conceive and initiate pregnancy.215 They consist of an array of techniques enabling people to reproduce without engaging in sexual activity at all. Some techniques are used to initiate pregnancy and others more specifically used to increase the possibility of pregnancy and/or to test for the presence of certain genes, so that prospective parents can choose which embryo to implant after in vitro fertilisation.216

There are three principal ways of initiating pregnancy: Alternative insemination, the prescription of fertility-enhancing drugs, and in vitro fertilisation. Alternative insemination (AI) is also known as artificial insemination. It refers to several procedures, all of which involve inserting sperm into a woman’s body. The sperm is placed in the woman’s vagina, cervix or fallopian tubes.217

Fertility enhancing drugs, as suggested by their name, are drugs that can be taken orally or through injection. The most common drug used is Clomiphene Citrate (brand name Clomid or Serophene), which is taken through the mouth to enable women who are not ovulating or are ovulating irregularly to produce one or more mature eggs. Gonadotropins are the drugs that can be taken through injection. They

214

Carara and Filippi 2010 HRU 98.

215 Robertson 2005 CWLR 324. 216 Galpern 2007 CGS 7-9. 217 Galpern 2007 CGS 9.

64 have the ability of stimulating the ovary for the production of more follicles in one cycle.218

Although there are many techniques used in ARTs, in vitro fertilisation and related procedures (gamete intra fallopian transfer (GIFT) and zygote intra fallopian transfer (ZIFT)) are the most invasive ARTs used. GIFT and ZIFT are variations of in vitro fertilisation (IVF).219 Sperm donation, donation of eggs and embryo donation also fall under GIFT and ZIFT.220

Surrogacy, a procedure in which a woman is recruited for the purpose of bearing and giving birth to a child that she agrees to hand over to individuals or couples she contracted with,221 is also a variety of ARTs. Golombok et al have described two types of surrogacy: Partial or genetic surrogacy, in which the surrogate mother and the commissioning father are the genetic parents of the child; and full surrogacy or non-genetic surrogacy, in which the commissioning parents (mother and father), or only one of them, are the genetic parents of the child.222 In other words, in genetic surrogacy the surrogate mother is inseminated with the sperm of the commissioning father. This would suggest that her egg was used in the procedures through which she will become pregnant. However, in non-genetic surrogacy, the egg and the sperm respectively of the commissioning mother and father or a donor are used and the embryo is transferred in the surrogate mother’s womb.

It is worth noting that with partial surrogacy conception happens through artificial insemination, and in the case of full surrogacy conception is achieved through IVF. Artificial insemination, fertility enhancing drugs, in vitro fertilisation and its related procedures, as well as surrogacy as described above are not the only ARTs that are used to treat infertility, genetic screening techniques also form part of ARTs.223

218 Galpern 2007 CGS 9. 219 Galpern 2007 CGS 9. 220 Galpern 2007 CGS 9. 221 Galpern 2007 CGS 11. 222 Golombok et al 2004 DP 400. 223 Robertson 2005 CWRLR 324.

65 In summary, ARTs include the fairly simple procedure of artificial insemination, the use of an artificial instrument to inject sperm into the uterus of a woman who will carry and eventually give birth to the child.224 It also includes more complex procedures which manipulate both eggs and sperm outside of a woman’s body before inserting them, or the resulting zygotes or embryos, into her fallopian tubes or cervix respectively.225

As a result, children who are born through ARTs are born to parents who sometimes do not share all the traditional factors of marriage, genetics, gestation, and intended parenthood. In the case of homosexual marriage, the intended parents can be two mothers or two fathers, who may or may not include a genetic parent, a gestational mother or both.226