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This chapter demonstrates how major divergences have occurred in the fatwas being issued by Sunni and Shia religious authorities regarding the permissibility of third-party reproductive assistance. In recent years, new fatwas emerging from the Shia world have condoned third-party gamete donation, whereas gamete donation continues to be banned across the Sunni Muslim countries. These divergent Sunni and Shia Islamic approaches toward gamete donation have affected the moral decision making of infertile Muslim couples in ways that are only beginning to be realized. The degree of consensus across the Sunni Muslim countries is quite striking, as are the ways in which these fatwas have guided the clinical practices of the Middle Eastern IVF community.

This chapter presents Eyad's story about double forms of emergence—both technological and masculine. On the one hand, new forms of reproductive technology are continuously emerging, and once they reach the reproductive marketplace, they are being rapidly discussed, debated, and, in most cases, deployed in Middle Eastern IVF settings. Egg donation is a case in point: after entering Iran in 1999, it spread within a year to Lebanon, where Shia Muslim couples were the first to access this reproductive technology. The willingness of Middle Eastern husbands such as Eyad to accommodate egg donation is a powerful marker of their emerging masculinities. These men have effectively prioritized their wives' own motherhood desires and their conjugal happiness over religious orthodoxies and various practical obstacles and apprehensions.

This introductory chapter outlines the role and function of the HFEA, the UK's regulatory body. It highlights the practical, legal, economic, and ethical challenges of this area, suggesting that it is rarely possible to pursue abstract ethical ideals in this context.

This chapter explores the history of reproductive technology. It goes back to the first attempts at artificial insemination and traces the trajectory of technological developments since then. The biology of reproduction is explained, and the current technological means of addressing infertility are listed. The social impact of reproductive technology and the associated need for regulation are considered. Future developments in reproductive technology are considered, and the impact of controversial breakthroughs, such as the cloning of Dolly the sheep, are discussed.

Sperm donation was originally introduced in the name of a medical relief of infertility, and it was understood that it would ordinarily take place anonymously. The donor is in effect allowed to forgo the usual moral responsibility of parenthood, that of being a father with duties to his children. This chapter argues that was a mistake: a donor of sperm remains the biological father of the procreated child, even if society relieves him of that obligation. It should not do so. One reason for that judgment is that too often historically men have abandoned their procreated children, and this is simply another way of allowing them to do so. It is particularly strange that many feminists ignore that commonplace male reality and officially seem to bless it in this case. It is often argued that the essence of parenthood lies in the love of and commitment to a child, not in the biological relationship. Yet, the desire of a woman to use a sperm donor so that she can have a biologically related child assumes that the woman’s desire for the biological relationship is enough to ignore the relationship with the donor. There is a fundamental contradiction here about parenthood.

This chapter closely analyses C. S. Lewis's The Abolition of Man, especially its crucial third chapter. It compares its thought with the line of argument which shows the moral wrong involved in generating human offspring by artificial means divorced from marital intercourse: the inequality involved in the producer–product relationship is inherent, and is manifested in non-intrinsic but virtually universal conditions of IVF, namely destructive experimentation, observation, and selection. The concern in Lewis's third chapter with contraception is usually overlooked.

Although focused on cloning, this chapter considers the reality and nature of the early human conceptus however conceived, and considers the moral significance of arranging conception otherwise than as supervening on sexual (particularly marital) intercourse (whether by ‘ordinary’ IVF or by cloning). R. G. Edwards's witnessing to the reality and human individuality of the one-cell zygote/embryo is quoted. Terminological expedients such as ‘therapeutic’ as distinct from ‘reproductive’ cloning are shown to be unacceptable. IVF and cloning involve production, and this makes the act a kind of enslaving, even when otherwise well intentioned.

This chapter states that women and men equate new reproductive technologies with hope. Hope is closely associated with American notions of individualism and responsibility for health. Both lay and medical literature attests to the importance of maintaining a hopeful attitude in taking charge of one's illness, and the propensity for optimism is reflected in medical practice. Hope escalates as couples wait to see if they have qualified for an IVF (in vitro fertilization) program. Assessments of the odds escalate as well. In the field of reproductive technology, hope has become part of the process of commodification, a marketing tool. Persistence too is appropriated in this way. It is emphasized by the biomedical science establishment and the medical technology industry. Persistence, the means by which people attempt to control their environment, is demonstrated by those seeking medical solutions for a wide range of conditions. This chapter also explains the effects of marketing on consumer's attitudes.

In assisted reproduction treatments, consent in writing concerning licensed treatments, i.e. the techniques covered by the Human Fertilisation and Embryology Act 1990, is mandatory. This involves gametes donation, either of sperm or oocyte (and hence embryo) donation and in vitro fertilization (IVF). By contrast treatment with thawed cryo-preserved sperm is not covered by the Act unless it is also used in vitro, whilst the storing of the sperm in licensed units categorically is. Infertility specialists practise in one of the few fields where specific legislation has been deemed to be necessary by society, through a vote in Parliament and the enactment of legislation, binding patients and practitioners in a common endeavour. Not all assisted treatment for reproduction is covered by the Act if one takes the word ‘assistance’ in the largest sense, although the term has come specifically to indicate treatments which are indeed licensed.

With the possible exception of the post-menopausal pregnant woman, the surrogate mother has been the most controversial figure among the several new types of biological mother and father who came into being with the new reproductive technologies (the others are egg and sperm donors). This chapter explores the uncertainties evoked by surrogacy and more broadly by the notion of the division or doubling of maternal functions (egg provision and pregnancy) that IVF makes practically feasible (but that surrogacy does not, in fact, entail). Two elaborate surrogacy stories from Genesis are analysed (Abraham, Sarah, and Hagar; Jacob, Leah, and Rachel), and an early eighteenth-century Spectator essay by Richard Steele against wet-nursing—in effect, another form of surrogacy

This chapter looks at some articulations of the distinctive forces and passion of parental feelings, including those that come from the loss or absence of children. It notes the relative absence of the subject of parental wishes (or fears) from Freud's writings, in spite of his drawing on Greek tragedy, where children and childlessness are common themes. Parental issues are prominent in Sophocles’ Oedipus the King, for instance, where Freud saw only the history of a child. The chapter's main focus is on how parenthood and infertility appear in Euripides’ Medea. Medea is both a murdering mother whose parental feelings are unhinged in the face of her jealousy of her husband's new woman, and—at the same time—an infallible fertility consultant.

I introduce the general phenomenon of reproductive travel and survey the existing literature about this type of medical tourism. I apply feminist and globalization theories to this phenomenon as I claim these holidays are political economies of hope (Rose and Novas 2005). I sketch the primary actors of this global care chain: IVF brokers who promise lower middle class North Americans they can have blonde-haired, blue-eyed babies, a European vacation, and excellent health care at affordable prices as well as the North Americans who travel to the Czech Republic for IVF using egg donation. I end the first chapter with a brief discussion of my ethnographic methodology and a layout of the rest of the chapters of the book.

This chapter follows North Americans who turn to the Internet where they learn of reproductive travel to the Czech Republic, and become diligent consumers. This chapter follows largely female patients as they enter virtual biosocial communities, where they join on-line gendered support groups and engage in bio-medical global citizenship. We encounter, with the North American patients, IVF brokers who are packaging fertility holidays that promise a stress-free IVF cycle in a relaxing European setting. The marketing of fertility holidays online speaks to North American hopes, both for a child that resembles them but also for a particular kind of healthcare.

This chapter deconstructs the fundamental contradictions embedded within this global care chain. Czech fertility clinics are global checkout lanes for North American global bio-citizens opting to purchase IVF with egg donation. Yet the economic nature of these transactions are minimized by affective discourse and the intimate labor provided by Czech clinics and accommodations. This chapter considers the ways in which women’s bodies are implicated in the contradictory aspects of “fertility holiday” abroad.

This chapter traces the emergence of the human embryo as an object of ethical controversy from 1968 through the early 1990s. This trajectory can be divided into three phases. The first phase, roughly the decade following from the first fertilization of an egg outside the womb in Cambridge, England, in 1968, centered on concerns about eugenics, safety, and human sexuality. The focus was on the development of IVF as an infertility treatment and the race to produce the first “test-tube” baby. The moral status of the embryo was a subordinate issue. During a second phase, as IVF was gradually established as an infertility treatment, from 1978 to 1986, national ethics committees took up the problem of the respect due to the embryo, on the one hand, and the imperative of biomedical research, on the other. During a third phase, from 1987 to 1994, which coincided with the onset of political and policy struggles, the ethical debate became more polarized. The Catholic Church and its pro-life allies fused the embryo research and abortion issues, and scientists and their allies in the bioethics community increasingly emphasized the healing power of research for infertility and other conditions.

This chapter focuses on the national embryo research regimes in the United States, the United Kingdom, Germany, and France. In all four countries, contrasting national terms of debate combined with electoral shifts and new patterns of interest group politics to generate very different embryo research regimes over the period 1990 to 1995. In the United States, a ban on federal funds for embryo research went hand in hand with a laissez-faire approach in the private sector. Britain instituted a comprehensive policy that was also the most permissive, allowing embryo research—and the creation of embryos for experiments—under careful regulatory oversight. After extended policy debates about the possibility of allowing some research with surplus IVF embryos, both France and Germany imposed restrictive regimes that criminalized all destructive embryo research within their borders.