MEDIA BRIEFING: IVF, sex selection and surrogacy: Release of the NHMRC Ethical guidelines on the use of assisted reproductive technology

Embargoed until: Publicly released:

***BRIEFING RECORDING NOW AVAILABLE*** Around 1 in 25 women who give birth in Australia use some form of assisted reproductive technology (ART) to achieve their pregnancy. The use of ART, however, is not without controversy and there are important ethical considerations in both the clinical and research contexts. The National Health and Medical Research Council (NHMRC), through the work of the Australian Health Ethics Committee (AHEC), has a well-established role in the provision of ethical advice for ART. On April 20 the CEO of NHMRC will issue the Ethical guidelines on the use of assisted reproductive technology in clinical practice and research, 2017 (the ART guidelines).

Organisation/s: National Health and Medical Research Council (NHMRC)

Media Briefing/Press Conference

From: Australian Science Media Centre

Around 1 in 25 women who give birth in Australia use some form of assisted reproductive technology (ART) to achieve their pregnancy. The use of ART, however, is not without controversy and there are important ethical considerations in both the clinical and research contexts.

The National Health and Medical Research Council (NHMRC), through the work of the Australian Health Ethics Committee (AHEC), has a well-established role in the provision of ethical advice for ART. On April 20 the CEO of NHMRC will issue the Ethical guidelines on the use of assisted reproductive technology in clinical practice and research, 2017 (the ART guidelines).

The previous ART guidelines were issued in 2004, with only the research guidelines updated in 2007. The 2017 update ensures that the ART guidelines provide contemporary advice to support the ethical conduct of ART in clinical practice.

Fertility and IVF clinics must adhere to these ART guidelines in order to be accredited.

This briefing will present the guidelines and will cover a number of issues including:

  • information giving, counselling and consent requirements
  • sex selection for non-medical purposes
  • the use of donated gametes and embryos
  • surrogacy
  • pre-implantation genetic testing
  • the collection and use of eggs and sperm from persons who are deceased or dying, and the use of stored eggs, sperm and embryos after the death of a person.

Copies of the embargoed material will be available from 17:00 AEST Wednesday 19 April on Scimex for journalists with a login. They are also available on request - contact us on (08) 7120 8666 or by email.

Further information about the development of the ART guidelines is available on the NHMRC website.

Speakers:

  • Professor Anne Kelso AO is CEO of the National Health and Medical Research Council
  • Professor Ian Olver AM is Chair of the Australian Health Ethics Committee, NHMRC

Date: Thu 20 April 2016
Start Time: 09:00am AEST
Duration: Approx 45 min
Venue: Online

Attachments:

  • Australian Science Media Centre
    Web page
    Briefing playback link

Expert Reaction

These comments have been collated by the Science Media Centre to provide a variety of expert perspectives and reflect independent opinion on this issue. Feel free to use these quotes in your stories. Views expressed are the personal opinions of the experts named. They do not represent the views of the SMC or any other organisation unless specifically stated.

Dr Tereza Hendl is a bioethicist and Postdoctoral Research Associate at the Centre for Values, Ethics and the Law in Medicine at the University of Sydney

The NHMRC has just published new guidelines with guiding principles for clinical practice with assisted reproductive technologies. One of the purposes of the recent review was to revisit current regulations on sex selection in Australia. 
 
The 2017 ART guidelines uphold a ban on sex selection for non-medical reasons. This is the right decision as sex selection based on gender preference involves a risk of harm to future children and society.

The practice is based on the assumption that there are two types of children, boys and girls, they have essentially different personalities and traits and offer significantly different parental experiences. Allowing sex selection for social reasons would send out a message that it is acceptable to create children to fit preconceived binary gender roles.

The practice is ethically troubling because it does not take a child's individuality into account and can limit children's opportunities to develop freely in gender nonconforming ways. 
 
While the upholding of the ban on sex selection is desirable, the reasoning provided by Australian Health Ethics Committee (AHEC) to justify the decision is troubling because the Committee fails to provide ethical arguments supporting its conclusions.

The AHEC states that the ban remains for two reasons: because sex selection for non-medical reasons is legal in 2 states and because there is not enough evidence that the Australian population supports the practice.

These are not ethical arguments but merely logical fallacies. As a society, our decisions about ethics should not be based on what is currently legal or which views are currently most popular. Important ethics and policy decisions should be based on a robust ethical analysis and discussion. 

The absence of ethical arguments supporting the policy on sex selection for non-medical reasons in the NHMRC guidelines is thus problematic.

Last updated: 20 Apr 2017 3:06pm
Associate Professor Mark Bowman is a fertility Specialist and Genea Medical Director

Genea supports a couple’s right to exercise reproduction choice. Sex selection, particularly for the purposes of family balancing, can be consistent with the responsible exercise of reproductive choice and the formation of a family.

We have respectfully disagreed with the National Health and Medical Research Council’s (NHMRC) regulatory ban on the practice since it was put in place and we believe today’s decision by the NHMRC not to revoke the regulatory ban continues a situation whereby individual Australians’ personal freedom to make informed reproductive choices is arbitrarily restricted.

Last updated: 20 Apr 2017 3:01pm
Professor Kelton Tremellen is a Gynaecologist and Professor of Reproductive Medicine at Flinders University

At present, sex selection is possible outside of IVF.

Non-invasive prenatal testing (NIPT), a process in which foetal DNA is isolated from the mother's blood from 10 weeks of pregnancy, can be used to determine the sex of the unborn child. It has been reported that some couples are using NIPT technology to identify the sex of their naturally conceived child and then terminating the pregnancy if that child is not of the desired sex.

One can therefore argue from a harm minimisation perspective that it is better to allow couples to undergo IVF and pre-implantation genetic screening of an embryos sex when the potential baby is only 5 days old (100 cells), rather than terminating a well established pregnancy. However this is obviously a ethically charged dilemma and needs careful further consideration, with clear guidelines on who can access this treatment. 

I personally am in favour of allowing couples with two or more children of the same sex to access IVF-related sex selection to enable them to have a child of their desired gender. However, it is probably best that this treatment should be entirely self-funded by the couple themselves (no Medicare access).

Last updated: 20 Apr 2017 2:58pm
Dr Hannah Brown is a Research Fellow at the University of Adelaide, Robinson Research Institute, ARC Centre of Excellence for Nanoscale BioPhotonics

This morning, the National Health and Medical Research Council released updated guidelines for the use of Assisted Reproductive Technology in Australia, the first major update in 10 years. While it will clearly take time to find all the changes in the thorough 140 page document, major changes appear to address:

  1. Increased transparency and detail around counselling and consent for patients (including “the requirement for the disclosure of any financial interests of the clinician related to the services recommended”)
  2. Expansion of the details surrounding the use, storage and destruction of donor gametes and embryos, providing more information and clarity (likely in response to changes seen globally in use of foreign surrogates and adoption etc.)
  3. What appears to be some flexibility in the rules surrounding the use of non-medical sex selection. It would appear that a large amount of consultation on the scientific, social, political, ethical (etc.) has been conducted and that while updated guidelines “do not support the use of sex selection techniques for non-medical purposes”, they note that further public debate is required and that states and territories have the capacity to legislate on non-medical sex selection.

Of particular surprise was the short statement addressing emerging technologies. New technologies including:

  • "in vitro maturation"  - finishing growing the egg in the dish, currently in use, globally
  • "genetic editing of human embryos" - CRISPR/Cas9 technologies recently published in human embryos for research purposes, publicised with the possibility to one day repair genetic mutations in DNA in human embryos and cure disease (this same gene editing technology in clinical trials for cancer already)
  • "mitochondrial transfer/donation" - to create 3 person babies, preventing the transmission of genetic mitochondrial diseases, already legislated in the UK

all received little attention, and will almost certainly require updates/statements in the near future.

Last updated: 20 Apr 2017 2:55pm

News for:

  • Australia

Multimedia:

  • Briefing recording

    Media briefing recording

    File Size: 6.5 MB

    Attribution: AusSMC

    Permission Category: © - Only use with this story

    Last Modified: 20 Apr 2017 11:01am

    Note: High resolution files are only available for download by registered journalists.

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