Reproductively a life gets complete once offspring are produced and where an individual fails to accomplish that task the prognosis is incomplete life cycle. As such every species lives with the objective of given birth to the succeeding generation. Humans, likewise, have the great desire to produce children once they get married after reaching to the reproductive age. Nevertheless, there are many who are unable to do so owing to various physiological, psychological and other reasons. Inability in fertilization of the egg with the sperm is one of the causes which prevent many parents from giving birth to children.
Man, since the times immemorial, has been seeking a cure for the causes of infertility in human species including the cause of inability to fertilize egg. It is the outcome of the untiring efforts of men in this area which has resulted in the development of various techniques and cures which aid people to produce children, those people who normally fail to produce them. Among these methods and techniques In-vitro Fertilization is the one. The increased rate of infertility in married couples makes this technique even more important, in a sense, their only hope.
In-Vitro Fertilization (IVF) is one of the Assisted Reproductive Techniques (ARTs), also called Medical Assisted Conception (MAC). It is a process in which a woman through hormonal manipulation is made to have several simultaneously developing ova. Hormonal ovarian stimulation can be used to treat ovulation or may increase the likelihood of conception in idiopathic infertility by increasing the number of mature oocytes.
Ovarian stimulation may also accompany intrauterine insemination. These are needle aspirated at the proper time under ultrasonic guidance. In the lab, sperm is made to fertilize the ova. When they reach the 4-8-cell stage they are transferred into the uterus. The uterus has already been prepared by hormones to be ready for implantation of the transferred eggs. The current success rate of this technique is 20-30%. IVF has many modifications which include Gamete intra-fallopian transfer (GIFT), Intracytoplasmic Sperm Injection (ICSI) and others.
Developing a technique in medical science in the modern times is comparatively easy than to making that technique operational and acceptable to the people. There are various moral, ethical, religious, cultural and social conditions that the techniques must fulfill before it is used on a larger scale. IVF with its various modifications mentioned in the foregoing lines has also been made subject to the scrutiny of fulfilment of these conditions. For Muslims it has been subjected to the Islamic rulings, and laws, and is declared permissible if it satisfies the following conditions.
*First, the IVF must involve a legally and Islamically married couple.
*Second, the sperm must be from the husband, and the eggs from the wife.
•Fourth, the procedure must be conducted by a competent and trustworthy team in order to reduce the chances of failure or mixing of zygotes and pre-embryos of different couples. Further rulings regarding this is that if there is a legal reason for the woman to be exposed to a person other than her husband for treatment, that person should be a Muslim woman if there is one who can do the job; if not found, then a non-Muslim woman; if not found then a trustworthy Muslim doctor; if not found then a non-Muslim doctor.
*It should not be an act of surrogacy which is prohibited in Islam.
*Finally, not more than the appropriate number of fertilized eggs should be transferred to the uterus for many fertilized ova are produced which many centers freeze and use them unethically in other cases of fertilization.
It is permissible to use them for medical research with the consent of the couple and within the appropriate guidelines. However, The International Islamic Fiqh Academy of Organization of Islamic Conferences (OIC-IFA) in 1990 refused the freezing of the pre-embryos as occurrences of mixing of gametes and pre-embryos happened.
Artificial reproduction is not mentioned in the primary sources of Shari’ah. However, when procreation fails, Islam encourages treatment, especially because adoption is not an acceptable solution. Thus, attempts to cure infertility are not only permissible, but also encouraged. The duty of the physician is to help a childless couple to achieve successful fertilization, conception, and delivery of a baby.
All assisted reproductive technologies are permitted in Islam, if the semen source, ovum source, and the incubator (uterus) come from the legally married husband and wife during the span of their marriage. According to Islam, a man’s or woman’s infertility should be accepted if it is beyond cure. That is why assisted reproduction was widely accepted after prestigious scientific and religious bodies and organizations issued guidelines, which were accepted by concerned authorities in different Muslim countries.
These guidelines included a Fatwa from Dar El Iftaa, Cairo (1980) and a Fatwa from the Islamic Fiqh Council, Makkah (1984), the Islamic Organization for Medical Sciences (IOMS) in Kuwait (1983), the Fatwa of International Islamic Fiqh Academy in 1986, and the International Islamic Centre for Population Studies and Research, al. Azhar University.
These guidelines are followed by most Muslims.
Another form of ART is surrogacy. There are two types of surrogacy, partial and complete. In partial surrogacy, a couple will solicit or commission a woman to be artificially impregnated by the “husband” semen. The surrogate will then carry the pregnancy to term, and upon birth, give the baby away to the soliciting couple. In this case, the child will have the rearing father as the biological father, a rearing mother, and a biological birth mother.
In a complete surrogacy, the commissioning couple will undergo IVF. The embryo produced by IVF is transferred then to a surrogate woman. The surrogate gives the baby to the soliciting/rearing couple at birth. In this case, the biological parents are the rearing couple, and the surrogate is the birth mother.
The Fatwa of the Islamic Fiqh council of Makkah in 1984 allowed surrogacy by replacing the embryos inside the uterus of the second wife of the same husband who provided the spermatozoa. In 1985, the council withdrew its approval of surrogacy.
Cryopreservation and the use of preserved gametes and pre-embryos is another related issue which has been dealt thoroughly by the Islamic scholars, and schools. In medical terms, cryopreservation is the freezing and storage of gametes, zygotes, or pre-embryos. Essentially, cryopreservation is used for patients who have been diagnosed as having a disease where treatment from the disease may result in infertility but is it also used for the purposes which are not ethically, and by Islamic rulings, acceptable like donating them to other couples.
Cryopreservation in itself entails no infringement of the Islamic law, but scholars have cautioned that the frozen embryos are the exclusive property of the couple who produced the gametes, and may be transferred only to the same wife in a successive cycle, restrictively during the duration of the marriage contract.
Storing the husband’s sperm for the purpose of impregnating the wife in the event of his death is illegal. Under Islamic law, death terminates the marriage contract, and the widowed wife is free to remarry after the mandatory waiting period (al-’Iddah). The cryopreserved sperm or pre-embryo of an ex-husband in case of divorce should not be used either, as divorce equally renders the union void, legally.
Cryopreservation of gametes or gonads before exposure to radiotherapy or chemotherapy or for social reasons is allowed. These gametes or gonads can be used for conception later on by their owner. The cryopreserved gonads can be re-implanted after the end of chemotherapy or radiotherapy, based on the request of the owner of the gonads.
According to favourable Islamic viewpoint that for every disease there is a cure and so is the case with the diseases and deformities in reproductive system and mechanism. And, as Islam, encourages procreation every possible step should be initiated, and every technique adopted, cure these deformities, disorders and diseases, including the inability to fertilized normally.
In this respect stress has been found to be reducing fertility. Research has shown that stress in women due to any cause disrupts the hormonal communication between the brain, the pituitary, and the ovary, interfering with both the maturation of an egg and the ovulation process. Thus the stress can affect fertility, and cause fertility, both by the altered regulation of pituitary hormones and from the abnormal nervous-system influences on the ovaries and fallopian tubes.
In case of man, both physical and emotional stress is known to affect the fertility. Sperm counts, motility, and structure are altered under stress. Problems such as impotence and difficulties with ejaculation are often caused by the emotional distress in men.
So by going the famous dictum of prevention is better than cure, emphasis should be laid upon the ways which prevent the chances of normal fertilization, Stress free life could go a long way in that direction. And in case the preventions fails to yield the desired ends, IVF can safely be resorted to. Shari’ah permits that if the conditions mentioned above are met.
Recent research has shown that suffering from involuntary childlessness may be nearly equally distributed between women and men, but men have more difficulty in communicating this emotional crisis. The psychological impact of infertility is a complex, integral part of the condition which must be taken into account by all treatment services associated with assisted reproduction.
Finally, Islam is a flexible religion, adaptable to the necessities of life, and what is unethical in one situation may become ethical in another situation or at another time. Islam enjoins the purity of genes and heredity to avoid mixing of genes. It deems that each child should relate to a known father and mother. Adoption is not allowed and so if IVF is the way out to find cure to one’s infertility it can safely be resorted to, subject to the fulfilment of the guidelines of the Shari’ah. Rest Allah knows the best.
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