In vitro fertilization, surrogate motherhood, and sex organ transplants.

The efforts of Drs. Patrick C. Steptoe and Robert G. Edwards in England culminated in the birth of Louise Brown on July 25, 1978, as a result of in vitro fertilization and reimplantation of the human embryo into the mother's womb.' The same investigators later reported the birth of a boy by this technique. 2 Since then, several hundred babies have been born by this methodology. More recently, fertilized ovum removal from the womb of one woman and its implantation into a recipient mother has been accomplished with the birth of healthy infants. This chapter examines the legal, moral, ethical, and religious issues involved in in vitro fertilization and reimplantation of the human zygote either into the biologic mother's womb or into a surrogate or host mother's womb. Other related issues will also be mentioned where appropriate. For example, basic principles related to the paternity or maternity of the offspring of in vitro fertilization and reimplantation are derived from experience and knowledge about artificial insemination. The latter subject in turn relates to genetic screening and prenatal diagnosis. If amniocentesis reveals the presence of twins, one of whom is normal, the other being afflicted with a serious genetic defect, a serious medical and moral dilemma occurs. It is now possible to selectively terminate or abort the abnormal fetus by intracardiac puncture and exsanguination and to deliver