§ 3.1 The in vitro Fertilization procedure
In vitro fertilization (IVF) is a procedure by which an egg is fertilized outside the womb by sperm, with the intent that the resulting zygote will later be transplanted into the reproductive system of either the intended mother or another woman who is serving as a surrogate. The American Bar Association Model Act Governing Assisted Reproductive Technology (ABA Model Act on ART) expressly recognizes "[i]n vitro fertilization and transfer of embryos" as a form of assisted reproduction that should be governed by law.1 While the cases involving children of IVF usually relate to such traditional family law disputes as parental responsibility, care and custody, and child support2 or divorce,3 IVF also comes into play in other areas such as probate4 and tort.5
In women under the age of 35, the natural cycle of egg production is often employed to retrieve eggs, avoiding the need for medication and reducing the potential for multiple births. However, in many cases and especially in older women, medication is used to increase egg production. The eggs are normally retrieved by ultrasound and sometimes by laparoscopy. A retrieved egg is fertilized in vitro and kept in a culture dish (sometimes called a "petri dish") until cell division begins and fluid starts to develop between the cells, an indication that the cells have developed into an embryo and a placenta and can be transferred into the uterus or can be cryopreserved for future use.
The Supreme Court of New Jersey described the procedure as follows:
The in vitro fertilization procedure requires a woman to undergo a series of hormonal injections to stimulate the production of mature oocytes (egg cells or ova). The medication causes the ovaries to release multiple egg cells during a menstrual cycle rather than the single egg normally produced. The egg cells are retrieved from the woman's body and examined by a physician who evaluates their quality for fertilization. Egg cells ready for insemination are then combined with a sperm sample and allowed to incubate for approximately twelve to eighteen hours. Successful fertilization results in a zygote that develops into a four- to eight-cell preembryo. At that stage preembryos are either returned to the woman's uterus for implantation or cryopreserved at a temperature of -196 C° and stored for future possible use.6
One court called the procedure used for IVF "a complicated, expensive, and somewhat dangerous process."7 The hormonal drugs (sometimes called fertility drugs) are administered to stimulate the woman's ovaries to produce multiple mature eggs8 rather than a single egg, which would normally be produced. The process of egg retrieval has been more specifically described as follows:
Before fertilization can take place, eggs must be harvested from a woman's ovaries. To prepare for this process, a woman undergoes approximately two weeks of intensive drug therapy intended to stimulate ovulation, as well as tests and ultrasounds to confirm that the drugs are having their intended effects. To harvest the egg, the woman undergoes an outpatient procedure during which the eggs are aspirated from the ovary by either placing a needle, guided by ultrasound through the vaginal wall, by laparoscopic surgery or by Trans-Abdominal Oocyte Retrieval. Typically only one local anesthesia is required for this...
