Speech topics of Dr. Peter E.Hermann, GENIPLET - in NESA International Surgicial Conference, - Palma de Mallorca

OUT OF MAINSTREAM ART. HOW TO DECIDE ABOUT MEDICAL, LEGAL AND ETHIC BORDERLINE CASES.

Dr. Peter Hermann MD

While the world is becoming complex, new groups that were not accepted and that were facing suppression before are gaining their rights. Following this process we are confronted with the resulting questions concerning reproduction.

There are countries where even basic treatment modalities such as egg donation are no issue. This includes the German-speaking countries. We at Geniplet Group have been confronted for many years with many additional requirements. Besides classical egg donation, the issues we confront are:

• How do we treat women without a uterus who desire pregnancy through surrogacy?
• How should we respond to requests of singles without a partner who are "running out of time"?
• How can we help couples over 40 and 50 in second and third relationships that consult us for infertility and are in good health (a typical problem in Switzerland)?
• Same-gender couples and their constitutionally guaranteed rights for equal treatment 
• Should we help transsexuals?
• What do we do with sex-linked abnormalities at the time when we can offer an ethically acceptable pre-conception sperm selection?

New diagnostic methods make it possible to preserve fertility even with diminished ovarian reserve when diagnosed at young age. Identical the situation of the men knowing that the older than 40 will have an increasing number of mutations with psychological and psychiatric risks to the child as a consequence. Decisions are made which influence future profession and career. But these procedures also allow to preserve healthy gametes for a further use. This means at the end a desynchronization of chronologic age and gamete quality which helps to prolong the fertile phase.

We will try to answer these questions while functioning in the context of a substantial loss of tension between ethical and sectarian beliefs in the Western world and aggressively roaring archaic rule claim on our doorstep.