Artificial Insemination: Artificial insemination is an important topic for Forensic Medicine students of MBBS

Artificial insemination is an important topic for Forensic Medicine students of MBBS

1. 4/8/2015 1

2. ARTIFICIAL INSEMINATION Dr. VISHAL B. SURWADE, MD. Assist. Professor, FMT. 4/8/2015 2

3. By the time, you realize that, your parents were right, you have a child who thinks you are wrong!! 4/8/2015 3

4. Assisted parenthood Who is a parent? How does person become a parent? Person gets married and in due course he becomes parent In some cases married couple does not produce a child Such cases are then to be investigated and accordingly corrected. 4/8/2015 4

5. It requires two to produce a child a husband and a wife The defect or disease may also be either in the husband or in wife Husband may be either impotent or sterile Similarly the wife may be sterile Artificial insemination is one of the methods to treat defect in husband 4/8/2015 5

6. A.I. is the insemination of the woman by artificial means (instruments). Here the semen is deposited by instrument into the genital tract of the woman (vagina, cervix or uterine cavity) A.I. is following types- A.I.H.( Homologous ) A.I. D.( Donor ) 4/8/2015 6

7. Indications-   Husband is impotent but fertile ( A.I. H. ) Inability to deposit semen in vagina due to defect & malformation eg : hypo & epispadias A.I.D: Husband is sterile Rh- incompatibility between husband and wife Husband is suffering from hereditary disease, which is to be avoided in the offspring.   4/8/2015 7

8. In case of A. I. D. choice of the donor- The donor should be- 1.Below forty years of age 2.Married 3.Parent himself (should have his own child) 4.Free from any hereditary disease 5.Rh- compatible with recipient woman 6.Biologically and genetically similar to the recipient couple, 7.But should not be related to the couple 4/8/2015 8

9. Procedural precautions- Full consent of recipient couple should be taken Full consent of the donor couple should be taken Semen should be collected by the process of masturbation Identity of the recipient and donor couple is not to be disclosed to each other. The donor should not know the result of the procedure The insemination should always be carried out in presence of a female attendant. To succeed it should be carried out at the time of ovulation period 4/8/2015 9

10. GUIDING PRINCIPLES Consent Confidentiality Regarding Donor: Potent & fertile Free from STD’s 21 to 40-45 years No relation with recipient couple Should have its own children 4/8/2015 10

11. Socio legal aspects of A.I. It is against many religions It has no legal sanction in India, except in Delhi. Following legal problems may come up- Adultery Legitimacy of the child thus born It could be ground for nullity of marriage and divorce Incest 4/8/2015 11

12. Donor may be made liable to pay the maintenance Doctor advising and taking part in the operation, can be charged with negligence, assault or battery, conspiracy in suits of inheritance, support and custody of child etc, 4/8/2015 12

13. INDIAN SCENARIO- Usually the donor is unmarried No formal consent of the donor is taken In metropolitan cities semen is available on sell (Semen Bank) No medical examination of donor is done Semen is procured from the pathologist No consent of the recipient couple is taken in writing No record is maintained and preserved Sometime ‘family’ semen is used 4/8/2015 13

14. SURROGACY Also called as Surrogate Motherhood . An arrangement in which a woman agrees to carry a pregnancy that is genetically unrelated to her & her husband. Intention: to carry the pregnancy to term & hand over the product of conception to the original genetic parents. (Ovum & sperm of a couple is used & fertilized in vitro & the embryo is implanted into the uterus of surrogate mother. ) 4/8/2015 14

15. Surrogacy with Oocyte: Woman allows insemination by sperm of male partner of a couple with a view to carry the pregnancy to term & hand over the child to couple In this type the sperms of husband is utilized & oocyte is from the surrogate mother herself. 4/8/2015 15

16. MEDICOLEGAL ISSUES Legitimacy of the child Name of the mother Revoking the contract Commercial transaction: no specific law in India; however in general law prohibits the use of human body for commercial purpose. 4/8/2015 16

17. Whatever happens to married couple naturally can now be done artificially Now we know that semen is available Ovum can also be extracted from the woman Fertilization is done in laboratory Fertilized ovum is then implanted in uterus These create multiple situations   4/8/2015 17

18. See some combinations- Semen Ovum uterus Husband Wife wife Donor Wife wife Donor Wife donor Husband Donor wife Husband Donor donor Donor Donor Wife Donor Donor Donor Laboratory ! Laboratory ? Laboratory? 4/8/2015 18

19. Ham Sath Sath Hai Woman carrying five fetuses. The circumference of waist is 70”. Her height is 167 cm. from the ‘Republic of China’ 4/8/2015 19