Scientific stratagems to bypass the objections.
Now IVF is well accepted by 90% of the World population, no matter what their religious background or affiliation is.
At first, in the 70’s and 80’s, IVF was not well accepted. Every religion and all metaphysicians (preachers, priests, rabbi, imams, gurus …) had all their own idea or interpretation about God’s opinion regarding the process.
First when does LIFE really begin? At the time of fecundation? At the time of cell differentiation? When we see the first heart beat? The jury is still out and we will probably never know for sure.
Nobody was objecting about surgical collection of maternal gametes (eggs or oocytes).
- Sperm collection: Many were frowning about the method of obtaining a sperm sample by masturbation although it’s is the cleanest way from the laboratory point of view. We could bypass the difficulty by advising “coitus interruptus” or withdrawal in a cup. We have even designed special condoms for collection that do not contain any spermicidal product.
- Fertilization out of the body: The other main objection was about fertilization that needs to happen “in corporis” or in the maternal body and not in the lab’s Petri dish. Several stratagems were used to satisfy religious critics.Here are 2 examples.
GIFT: It’s amazing how physicians or scientists with imagination were able to bypass the problem. One of my junior fellows from Augusta, an Argentine young man by the name of Ricardo Asch came up with a good idea. Once sperm and egg were collected they were placed together in a physiologic medium then surgically inserted via laparoscopy through the end of the tube forcing fertilization in the Fallopian tube where it naturally occurs. He used a clever acronym to name the process: GIFT (gamete intra fallopian transfer), the major drawback being that we need normal tubes to perform a GIFT. Drawback, you need normal tubes.IVC: Another smart way was IVC (Intra Vaginal Culture) designed by Claude Ranoux. Placing sperm, oocytes and medium in a hermetically closed plastic container without CO2. For 48 hour incubation and fertilization in the body (upper vaginal canal). After 48 hours the embryo were retrieved and inserted in the uterine cavity.
- Congelation or cryopreservation of embryos. We have to do our best to avoid multiple gestations. Therefore we never transfer more than 2 embryos. Twin gestations are tolerable. What to do with the supernumerary embryos? We have no other options but freeze the extra or supernumerary embryos hoping that the couple will come in one or two years to claim the remaining of their offspring. Nowadays when the couples object to embryo congelation, we suggest to fertilize only 2 eggs and freeze the remaining eggs.Nobody objects to freezing gametes oocyte or sperm but some will still object to embryo freezing.