Alternative Parenting: A Practitioner’s View

Abstract

A parent is defined as one who brings forth offspring.¹ In most cases, offspring result from a husband and wife producing gametes that lead to conception in the mother’s uterus. Unfortunately, this is not always the case, and approximately 15% of reproductive age couples are faced with infertility and left to choose between expensive treatment, adoption, or a foster child.² New hope for these couples arrived in 1978 when Steptoe and Edwards reported the first livebirth from in vitro fertilization (IVF).³ In vitro fertilization offered women with tubal disease a new technique that would give them a chance at pregnancy. Yet, despite the promise of various assisted reproductive technologies (ART) such as in vitro fertilization, gamete intrafallopian tube transfer (GIFT), and zygote intrafallopian tube transfer (ZIFT), many couples still face a childless life. This is particularly true of couples in which the female has either premature ovarian failure or an abnormal or absent uterus. Not until egg donation and surrogacy became available did women with these afflictions have the opportunity to become pregnant. Hence, the introduction of alternatives to treatment, involving principally third parties, has dramatically broadened the spectrum of treatable cases. While the use of third parties is relatively new to the management of infertile females, there is a strong tradition in treating males. Therapeutic donor insemination has long been used in couples limited by male factor infertility.⁴