Infertility impact

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]



Infertility has an impact on couples ethically, psychologically and socially.

Ethical Impact

There are several ethical issues associated with infertility and its treatment.

  • High-cost treatments are out of financial reach for some couples.
  • There is debate over whether health insurance companies should include cover for infertility treatment.
  • There is some grey area around the legality and status of embryos fertilized in vitro and not transferred in vivo.[1]
  • Anti-abortion lobby groups oppose the destruction of embryos not transferred in vivo as they believe in the personhood status of embryos, regardless of transfer in vivo or not.
  • IVF and other fertility treatments have resulted in an increase in multiple births, provoking ethical analysis because of the link between multiple pregnancies,premature birth, and a host of health problems and financial strain due to the same on couples.
  • Religious leaders' have differing opinions on fertility treatments. [2]
  • Infertility caused by DNA defects on the Y chromosome are passed on from father to son. Natural selection is the primary error correction mechanism that prevents random mutations on the Y chromosome, it also prevents the same defect from passing on to the next generation. Fertility treatments for men with abnormal sperm (in particular ICSI) only defer the underlying problem to the next male generation.

Psychological Impact

  • Infertility may have profound psychological effects.
  • Both partners involved are prone to being anxious about conceiving, which itself plays a role in increasing sexual dysfunction.
  • Marital discord often develops in infertile couples, especially when under pressure to make medical decisions.
  • Women trying to conceive often have clinical depression rates similar to women who have heart disease or cancer[3].
  • Even couples undertaking IVF face considerable stress, especially the female partner.

Social Impact

  • In many cultures, inability to conceive bears a stigma.
  • In certain social groups, couples face rejection due to not conceiving and bearing children. Societal rejection may cause depression or anxiety in couples involved.

Legal Impact

  • There are legal ramifications around infertility as well. Ownership of frozen embryos is a much debated issue, particularly after the time of storage has lapsed. [4]
  • Some courts have ruled to grant frozen embryos all legal rights which are granted to living humans since they have the potential to be born.[5]
  • Some other courts have granted frozen embryos a property status, which means they are similar to any other human tissue as property.
  • The third position some courts have ruled on is that frozen embryos deserve certain, but not all rights as they are neither property nor full fledged human beings before birth.
  • Around 4 million workers in the U.S. used the Family and Medical Leave Act (FMLA) in 2004 to care for a child, parent or spouse, or because of their own personal illness. Many treatments for infertility, including diagnostic tests, surgery and therapy for depression, can qualify one for FMLA leave.


  1. Koeferl Puorger UP, Buergin M, Wunder D, Crazzolara S, Birkhaeuser MH (2006). "Surplus embryos in Switzerland in 2003: legislation and availability of human embryos for research". Reprod Biomed Online. 13 (6): 772–7. doi:10.1016/s1472-6483(10)61023-1. PMID 17169194.
  2. Schenker JG (2000). "Women's reproductive health: monotheistic religious perspectives". Int J Gynaecol Obstet. 70 (1): 77–86. doi:10.1016/s0020-7292(00)00225-3. PMID 10884536.
  3. Domar AD, Zuttermeister PC, Friedman R. The psychological impact of infertility: a comparison with patients with other medical conditions.J Psychosom Obstet Gynaecol. 1993;14 Suppl:45-52. PMID 8142988.
  4. Sheinbach DM (1999). "Examining disputes over ownership rights to frozen embryos: will prior consent documents survive if challenged by state law and/or constitutional principles?". Cathol Univers Law Rev. 48 (3): 989–1027. PMID 12611403.
  5. Schuster TG, Hickner-Cruz K, Ohl DA, Goldman E, Smith GD (2003). "Legal considerations for cryopreservation of sperm and embryos". Fertil Steril. 80 (1): 61–6. doi:10.1016/s0015-0282(03)00503-x. PMID 12849802.

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