IVF Case Study
A 30 year old Saudi couple engages the help of a U.S. clinic after three years of infertility. Neither individual has any children from previous partners. They are a Muslim couple who wish to have children, but are unable to seek reproductive counseling in their native country because the husband’s father is a Minister in the Saudi Government. They are the only couple in both of their families who have not yet had children. The wife’s reproductive history is as follows: Height 5’7”, weight 165 pounds. Menarche at age 13, with regular cycles until age 24; intermittent dysmenorrhea for the past 6 years. The patient reports that she has had only her husband as a sexual partner and indicates that there is no history of genetic disorders in the family, but some history of premature ovarian failure. Her mid-luteal progesterone level was 17ng/mL, with normal TSH levels. Her LH and FSH levels are in the low/normal range. Tests reveal a Chlamydia infection. The husband’s reproductive history is as follows: Height 5’8”, weight 225lbs. Semen analysis indicates a volume of 2mL, with 20 X 106 sperm/mL. Sperm are of poor quality, with low forward motility. Testosterone levels are low, with low levels of inhibin and high levels of estradiol present. The patient reports multiple sexual partners prior to marriage and indicates that there is a genetic history of Cystic Fibrosis in his family of which his wife is unaware. Normal male secondary sexual characteristics are present. Tests reveal a Chlamydia infection. Accompanying the husband and the wife is their maid, a normal female of approximately 24 years of age who has offered to be a surrogate for the couple, should this be necessary. The maid speaks no English. What are the Clinical, Legal, Ethical and Societal issues facing this couple’s desire to achieve pregnancy?