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Reproductive technology
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==Ethics== {{Main|Bioethics|Human enhancement}} Recent technological advances in fertility treatments introduce ethical problems, such as the affordability of the various procedures. The exorbitant prices can limit who has access.<ref name="Kissin_2019" /> The cost of performing ART per live birth varies among countries.<ref>{{Cite journal |last=Chambers |first=Georgina M. |last2=Sullivan |first2=Elizabeth A. |last3=Ishihara |first3=Osamu |last4=Chapman |first4=Michael G. |last5=Adamson |first5=G. David |date=June 2009 |title=The economic impact of assisted reproductive technology: a review of selected developed countries |url=http://dx.doi.org/10.1016/j.fertnstert.2009.04.029 |journal=Fertility and Sterility |volume=91 |issue=6 |pages=2281β2294 |doi=10.1016/j.fertnstert.2009.04.029 |issn=0015-0282|doi-access=free }}</ref> The average cost per IVF cycle in the United States is USD 9,266.<ref>{{Cite journal |last=Peipert |first=Benjamin J. |last2=Montoya |first2=Melissa N. |last3=Bedrick |first3=Bronwyn S. |last4=Seifer |first4=David B. |last5=Jain |first5=Tarun |date=2022-08-04 |title=Impact of in vitro fertilization state mandates for third party insurance coverage in the United States: a review and critical assessment |url=http://dx.doi.org/10.1186/s12958-022-00984-5 |journal=Reproductive Biology and Endocrinology |volume=20 |issue=1 |doi=10.1186/s12958-022-00984-5 |issn=1477-7827|doi-access=free |pmc=9351254 }}</ref> However, the cost per live birth for autologous ART treatment cycles in the United States, Canada, and the United Kingdom ranged from approximately USD 33,000 to 41,000 compared to USD 24,000 to 25,000 in Scandinavia, Japan, and Australia<ref>{{Cite journal |last=Reindollar |first=Richard H. |last2=Regan |first2=Meredith M. |last3=Neumann |first3=Peter J. |last4=Levine |first4=Bat-Sheva |last5=Thornton |first5=Kim L. |last6=Alper |first6=Michael M. |last7=Goldman |first7=Marlene B. |date=August 2010 |title=A randomized clinical trial to evaluate optimal treatment for unexplained infertility: the fast track and standard treatment (FASTT) trial |url=http://dx.doi.org/10.1016/j.fertnstert.2009.04.022 |journal=Fertility and Sterility |volume=94 |issue=3 |pages=888β899 |doi=10.1016/j.fertnstert.2009.04.022 |issn=0015-0282|doi-access=free |url-access=subscription }}</ref> The funding structure for IVF/ART is highly variable among different nations. For example, no federal government reimbursement exists for IVF in the United States, although certain states have insurance mandates for ART<ref>{{Cite journal |last=Mladovsky |first=Philipa |last2=Sorenson |first2=Corinna |date=2009-04-03 |title=Public Financing of IVF: A Review of Policy Rationales |url=http://dx.doi.org/10.1007/s10728-009-0114-3 |journal=Health Care Analysis |volume=18 |issue=2 |pages=113β128 |doi=10.1007/s10728-009-0114-3 |issn=1065-3058|url-access=subscription }}</ref> Many issues of reproductive technology have given rise to [[bioethics|bioethical]] issues, since technology often alters the assumptions that lie behind existing systems of sexual and reproductive [[morality]]. Other ethical considerations arise with the application of ART to women of advanced maternal age, who have higher changes of medical complications (including [[pre-eclampsia]]), and possibly in the future its application to post-[[Menopause|menopausal]] women.<ref>{{cite journal | vauthors = Harrison BJ, Hilton TN, RiviΓ¨re RN, Ferraro ZM, Deonandan R, Walker MC | title = Advanced maternal age: ethical and medical considerations for assisted reproductive technology | journal = International Journal of Women's Health | volume = 9 | pages = 561β570 | date = 16 August 2017 | pmid = 28860865 | pmc = 5566409 | doi = 10.2147/IJWH.S139578 | url = | doi-access = free }}</ref><ref>{{cite journal | vauthors = Lung FW, Chiang TL, Lin SJ, Lee MC, Shu BC | title = Assisted reproductive technology has no association with autism spectrum disorders: The Taiwan Birth Cohort Study | journal = Autism | volume = 22 | issue = 3 | pages = 377β384 | date = April 2018 | pmid = 29153004 | doi = 10.1177/1362361317690492 | s2cid = 4921280 }}</ref><ref>{{cite book | first1 = Eli Y. | last1 = Adashi | first2 = John A. | last2 = Rock | first3 = Zev | last3 = Rosenwaks | name-list-style = vanc |title=Reproductive endocrinology, surgery, and technology |location = Philadelphia | publisher = Lippincott-Raven |date=1996 |pages= 1394β1410}}</ref> Also, ethical issues of [[human enhancement]] arise when reproductive technology has evolved to be a potential technology for not only reproductively inhibited people but even for otherwise re-productively healthy people.<ref>{{cite journal | vauthors = Sunderam S, Kissin DM, Zhang Y, Folger SG, Boulet SL, Warner L, Callaghan WM, Barfield WD | display-authors = 6 | title = Assisted Reproductive Technology Surveillance - United States, 2016 | journal = MMWR. Surveillance Summaries | volume = 68 | issue = 4 | pages = 1β23 | date = April 2019 | pmid = 31022165 | pmc = 6493873 | doi = 10.15585/mmwr.ss6804a1 }}</ref>
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