oral The Annual Scientific Meeting of the Endocrine Society of Australia and the Society for Reproductive Biology 2013

IVF and abortion: Incongruous faces of sex in the 21th century (#1)

John Aitken 1
  1. University of Newcastle, CALLAGHAN, NSW, Australia

We live at a time when 1 in 30 Australian children are the product of ART (Assisted Reproduction Technologies) while 1 in 4 pregnancies is electively terminated by abortion. Extensive uptake of ART is the product of 2 major factors – advanced maternal age and male infertility. The age at which Australian women have their first child (30) is on the edge of a precipitous age–dependent decline in fertility, which begins around the age of 35 and nears completion by the age of 40.  Within this 5 year window, female fertility is brought to an abrupt halt and, contrary to public perception, cannot be rescued by ART. This is because it is not the fertilization of the oocyte that declines with reproductive age but rather, the developmental potential of the embryo. In order to remedy this situation something has to change – and it cannot be the biology. Male infertility, on the other hand, is highly amenable to treatment by ART. In such cases, it is usually the fertilizing capacity of the spermatozoa that is at fault and any such defects can be readily remedied by assisted conception techniques such as intra-cytoplasmic sperm injection (ICSI). The reasons behind the high rate of male infertility are unknown but probably involve a complex interplay of environmental and genetic factors.  The latter’s involvement may mean that the more we use assisted conception in one generation, the more we are going to need it in the next.    On the other side of the reproductive coin, we have an extremely high rate of elective abortion in this country, particularly at the extremities of reproductive life when pregnancy can come as an unwelcome surprise. This situation highlights the paucity of contraceptive technologies available for women in these situations and the sad fact that funding agencies do not prioritise contraceptive research even though nationally, the number of lives terminated by abortion is twice the death rate from cancer.