by Janet Llewllyn

Nursing

In vitro fertilization has been an answer for many couples who are unable to conceive. The procedure involves retrieval of the woman's ovum at the time of ovulation. After conception occurs, using the husband's sperm, the fertilized ovum is replaced in the woman's uterus. The chance of success in increased when more than one ovum is removed and fertilized. Although in vitro fertilization has been viewed as a tremendous new development by many childless couples, some groups have raised questions about the procedure. Some of the issues include the following:

* If more than one fertilized ovum is returned to the uterus, it may be possible for the woman to have a multiple pregnancy of two to eight fetuses. This multiple pregnancy creates problems when birth occurs long before the estimated date of birth. The financial and emotional costs are great when the parents have more than one baby in an intensive care setting.

* If more than one ovum is fertilized and they are not returned to the uterus, what should be done with them? If they are kept, are the embryos entitled to inheritance from their family? If the embryos are destroyed, is it murder?

* Should "extra" embryos be made available for implantation into another woman's uterus?

* Should research be allowed on the extra embryos? If so, under what conditions and for what purposes? Who should approve the research that is done? Is approval needed?

* If extra embryos are frozen and kept, how long should the facility be required to keep them? Does prolonged freezing harm the embryo?

* If sperm other than the husband's is used to fertilize the ovum, does it create special problems? Who does the child belong to? Does the husband need to adopt the child?

* With a success rate of approximately 10 to 20 percent, does in vitro fertilization take advantage of childless couples rather than helping them?

* Does the procedure move conception out of the human range entirely?