Medical reproductive techniques, collectively referred to as MPA (Medically Assisted Procreation), encompass the manipulation of eggs and/or sperm to facilitate pregnancy[1]. These techniques can address specific challenges in achieving conception without necessarily addressing the underlying causes of infertility.
Notable MPA methods include artificial insemination and in vitro fertilization, which are available to individuals and couples of childbearing ages diagnosed with infertility by a healthcare professional or those who have faced difficulties conceiving despite repeated attempts. In France, the practice of MPA is overseen by the French Agency of Biomedicine.
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Artificial insemination
This MPA technique involves the collection and preparation of sperm, either from a partner or a donor, followed by its direct injection into the uterus of the woman desiring to conceive, synchronized with her ovulation. In most instances, the woman initially undergoes hormone therapy (ovarian stimulation), accompanied by ultrasound scans and hormone level assessments. Fertilization naturally occurs within the woman’s body.
The eggs utilized in this procedure belong to the woman who will carry the pregnancy. Consequently, the woman is legally recognized as the mother of the child due to the genetic connection and the pregnancy.
In cases of surrogate motherhood, it is feasible to employ artificial insemination. This entails the ‘surrogate mother’ establishing a genetic link with the embryo, utilizing sperm from either the commissioning men or a donor provided by the commissioning parents.
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In vitro fertilization (IVF)
IVF IVF is a more invasive technique than insemination, as it entails the union of an egg and sperm within a laboratory setting. IVF can be performed using either the couple’s own gametes or donor gametes (either sperm or eggs).
The hormonal stimulation of follicles is considerably more extensive in IVF compared to insemination. Once the follicles reach maturity, they are harvested and transported to the laboratory alongside sperm. In some cases, the gametes can be cryopreserved before the procedure.
Fertilization occurs outside the woman’s body, and subsequently, the embryos are transferred into her uterus. Like insemination, in IVF, the woman desiring a child is considered the mother throughout the gestational (pregnancy) process, even if she is carrying an embryo created from eggs that are not her own.
During surrogacy procedures associated with IVF (In Vitro Fertilization), the “surrogate mother” undergoes the transfer of embryos, which can originate from one of the following sources: either both clients, although it is uncommon for the commissioning woman egg to be used in such cases, as in these situations, the woman would typically opt for IVF or insemination herself (exceptions include cases where women choose not to become pregnant or pregnancies with high-risk factors such as cancer, etc.), or solely from the commissioning man, or from two gamete donors.
Classifying surrogacy as a medically assisted reproductive technique is misleading and abusive.
The surrogacy process encompasses various stages, extending beyond the scope of medical procedures within the field of reproduction. Certain aspects, such as surrogate recruitment, contract signing, and parental transfer, involve numerous participants who do not have a medical background, including agencies, lawyers, advertisers, and financial institutions. Primarily, surrogacy functions as a social market practice rather than a medical one (for further information, refer to the fact sheet titled “A Social Market Practice, not a Medical One”).
In contrast to genuine medically assisted reproductive techniques, where women autonomously choose to undergo these intricate medical procedures on their own bodies, surrogacy entails the instrumentalization and exploitation of the body of a third party, rather than a voluntary choice made by the woman herself.
Motherhood through MPA is not the same as reproductive exploitation through surrogacy.
Medically Assisted Procreation (MPA) serves as a reproductive method for women or couples who contribute sperm and/or eggs to conceive a child. The crucial distinction lies in the fact that the woman desiring to have this child is the one who will carry the pregnancy. In scenarios involving IVF with oocyte “donation,” she is unequivocally recognized as the child’s mother, regardless of any genetic connection.
Conversely, in the context of surrogacy, where pregnancy is initiated through IVF, using gametes unrelated to the surrogate mother, her maternity is denied, compelling her to acknowledge that the unborn child is not hers; she is not its mother. This represents a glaring contradiction with no justification other than the instrumentalization of the surrogate mother for the benefit of others. Furthermore, it constitutes a serious violation of the principle established in France by Article 56 of the Civil Code, which unequivocally states that the mother is the woman who gives birth.
[1] https://www.inserm.fr/dossier/assistance-medicale-procreation-amp/#:~:text=L’assistance%20m%C3%A9dicale%20%C3%A0%20la,la%20cause%20de%20l’infertilit%C3%A9.