Lifestyle, fertility and the Assisted Reproductive Technologies (ARTs)

Modern developments in assisted conception and contraception have reinforced the idea that reproduction is largely a matter of choice. We are able to decide whether or not we wish to have children and, if so, under what circumstances. In many instances, having children is not necessarily the result of a conscious decision-making process. Social pressure, ambivalence, conflicting needs and simple socioeconomic disadvantage interfere with or confuse reproductive choice. Importantly, however, modern developments in technical control over the reproductive processes have increased reproductive options. These options have led to a new and unique therapeutic relationship in which important reproductive decisions are transferred to the medical scientists. Consequently, these physicians are called upon to assume a greater share of the responsibilities regarding reproductive matters. In turn, our own increased expectations have fuelled an escalating reliance on medical manipulations, which impact on ethical and social concerns. Reproductive choice should not be taken casually, as the main themes of Chapters 3 to 6 have tried to justify.

The origin of certain aspects of human fertility, development and offspring wellbeing centres on parental lifestyle and behavioural factors, while others are unexplained or attributable to changing environmental conditions. What is certain, however, is that ‘bearing a child’ means a lot more than just generating a child, and requires many skills.