Contraception The contraceptive pill Most contraceptive pills contain synthetic hormones similar to progesterone and oestrogen. These prevent the secretion of LH and FSH from the anterior pituitary gland, There is therefore no development of secondary follicles in the ovary (which is caused by FSH) and no ovulation (which is caused by a surge of Li), Potential advantages of the use of contraception ‘© Family size can be kept to the level desired by the parents, which could poten- tially reduce poverty and make it more possible for each child to have a better standard of living, including better nutrition, health care and education. ‘© Partners who do not wish to have children for reasons such as the risk of inher- iting a genetic disorder can still have an active sex life. ‘© Use of the contraceptive pill can enable women to determine their own fertility, so they can avoid having an unwanted child even if their partner does not take this responsibility, ‘© Use of contraception avoids unwanted pregnancies and therefore reduces the number of abortions; abortion is stressful for a woman (and her partner) and is held to be morally undesirable by many people, Potential disadvantages of the use of contraception ‘© With no fear of becoming pregnant, a woman may be more prepared to have sexual intercourse with more partners; there is evidence that the widespread availability of contraception has increased promiscuity among young people. ‘© Sexual intercourse with more partners increases the risk of the spread of diseases such as HIV/AIDS, and can also increase the risk of marriage breakdown or stress. * Aman may feel that he can have intercourse with his female partner whenever he wishes, even if she does not want this.In-vitro fertilisation ‘In-vitro’ means ‘in glass’, and refers to the fact that fertilisation occurs in glassware (for example a Petri dish) in the laboratory, rather than ina woman's oviduct. © The woman is given hormones to induce the development of secondary follicles and ovarian follicles in her ovaries. These may include LH and FSH. The dosage is large enough to cause several follicles to develop simultaneously. © Once the follicles have developed, the woman will be given the hormone human chorionic gonatropin (hCG). This will stimulate the formation of a corpus luteum, which will secrete progesterone. This is necessary to prepare the woman's oviduct and endometrium to receive an embryo. © Oocytes will then be harvested from her ovaries, under general anaesthetic. * On the same day, semen is collected from the woman’s partner. The sperm are washed and placed in a fluid that contains nutrients that will enable the sperm to become ready to fertilise an egg (capacitation). * Each egg is placed in a separate dish, and sperm are added. Any embryos produced are ready to be transferred to the woman's uterus after three to five days. Ethical implications of IVF For many women and their partners, IVE makes it possible for them to have a family when otherwise they could not. However, there are some potential negative aspects that need to be considered. Points of view of different individuals can be widely different, sometimes because of religious or cultural viewpoints, but sometimes because of a person’s own moral viewpoint. Some of these issues are outlined below. © Generally, two five-day old embryos are transferred. However, some doctors prefer to transfer more embryos. This can lead to multiple embryos developing in the uterus, which are less likely to be healthy than a single one. © Iis possible for a woman to have children using sperm from a man who is not her partner. Some people believe this is not ethically acceptable. There are also difficulties if the man who donated the sperm does not want any resulting children to know that he is the father. © itis possible for a woman who is long past child-bearing age and who has reached the menopause to have children in this way. This could mean that a child is born toa mother who will not have a sufficiently long active life to care for him or her. © While many people think it is important that a woman should have the right to bear a child, others feel that there are enough children in the world already and that a person who is biologically unable to have one should not be treated, especially if the cost is borne by tax-payers or if her treatment prevents the treat- ment of someone else with a life-threatening condition.* Some of the embryos resulting from IVF will not be implanted. They could be allowed to die, or they could be used for research. Some people are concerned that we do not have the right to dispose of embryos in this way. © iis possible for semen from a partner to be collected and frozen. A woman could then have his child by IVF after the partnership has broken up, or after he has died, without his permission. © The embryos produced by IVF are usually tested to ensure they are viable (able to survive) before implanting them. This may include checking for the presence of undesirable alleles such as those that can cause genetic conditions like cystic fibrosis. 1t is also possible to choose an embryo of a particular sex. There are wide variations in people’s views of the ethics of these choices.