Iranian Journal of Medical Ethics and History of Medicine

Development of new methods of treatments for infertility has given rise to a serious question as to the access to such methods. Determination of the ones who can access the mentioned treatments and the limits of this access, depends to the definition of infertility. The Law of the method for Embryo Donation to Infertile Couples according to Iranian legislature considers the infertile couple who “cannot reproduce in accordance with credible medical certificate” as eligible to receive the donated embryo. However, applicants for modern infertility treatment methods have gone beyond infertile couples and include those couples who wish, based on credible medical evidence, to avoid having unhealthy children, especially by using donation methods or surrogacy. Accordingly, having supported a preventive approach to ARTs, a new concept of infertility will appear on the horizon. Expanding this concept to couples who are considered fertile from a common medical perspective but give birth to seriously unhealthy children shall inevitably lead us to revise the common legal concept of infertility. Therefore, by resorting to ethical reasoning, laws, and regulations of various legal systems and Fiqhi opinions we can develop another interpretation of Embryo Donation Law and argue for the access of the “perceived as infertile” couples to the infertility treatment with the help of third parties.

Modern infertility treatment methods, along with favorable results, sometimes bring about unfavorable consequences. Multiple pregnancy is one of those consequences that puts the health of mother and life of fetus in danger. Fetal reduction, namely removing one or more fetuses with aim of preserving pregnancy and also certain preventive measures such as transfer of fewer fetuses into uterus of mother in each cycle of In Vitro Fertilizations (IVF), is one of solutions to tackle this unfavorable consequence. In a number of legal systems, along with a permission to conduct fetal reduction, precise provisions on the number of transferable fetuses are enacted. A comparative study of fetal reduction in countries in which there is an experience of legal encounter with this issue shall open a horizon for the legislator and policy makers in the field of health in Iran, where there is no consistent laws or regulations in this context, so that they adopt an appropriate approach to the problem. It seems that a fetal reduction permission, limiting regulations on the number of transferable fetuses, and proper insurance coverage embody an appropriate legal system in the context of fetal reduction.