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Assembling Viability: The Art of Mundane Embryo Selection in IVF

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Abstract

One of the mundane everyday practices of IVF is observing and classifying embryos. After the fertilisation, embryos are graded according to their quality which is an estimation of whether the embryogenesis—the embryo’s development—seems normal or deviant. This practice is called embryo selection and it is based on assessing the ‘good quality’ embryos as viable and ‘poor quality’ ones as inviable. Viability refers to the capacity of embryos to develop into foetuses and eventually become babies. However, the question of what kinds of embryos ultimately are viable is a complex issue, which also hinges upon several other factors than the quality estimation. This paper shows that the idea of embryo viability is an assemblage of multiple kinds of things. The paper is based on multi-sited ethnography and expert and patient interviews conducted in the private fertility service sector of Finland. I argue that embryo viability is a practical achievement that requires the successful combination of several factors: the scientific facts on embryo quality, the expert knowledge and laboratory practices and the patients’ engagements in the process. None of these factors alone is enough to explain the precarious embryo viability which nevertheless is the central issue in IVF.

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Notes

  1. IVF has been a routine treatment in Finland since the end of the 1980s (Malin and Hemminki 1996, p. 975). Finland has been a late legislator in the area of reproduction and, thus, a rather liberal country, when it comes to ART and the implementation of new techniques (Eriksson 2017; Meskus 2015, p. 73). Since 2006, however, the Finnish act on assisted fertility treatments has directed the ways ART services are organised in Finland. Treatments are available for male–female couples, female–female couples and single women. However, the law bans surrogacy that was previously unofficially permitted in Finland (Act on Assisted Fertility Treatments 2006). Concerning ARTs, the Finnish economy of healthcare is driven by both the public and the private sectors. The role of the private sector is relatively large (see National Institute for Health and welfare 2017). Concerning embryo selection, Finland provides a good case for analysing the mundane aspect of it in a context where multiple embryo transfers are avoided, in order to overcome the medical risk of zygotic twins. The one embryo policy, which is applied widely also in other Nordic countries (TemaNord 2006), is based on transferring a single embryo at a time to the woman’s uterus. However, it is argued that since the embryo is carefully chosen, the probability for pregnancy will not decrease (Martikainen et al. 2001).

  2. Existing discussions focusing on the everyday part of selection have nevertheless elaborated, especially, on how embryos become ‘extra’ or ‘spare’ in terms of IVF and are therefore donated to, for example, stem cell research (Franklin 2006; Ehrich et al. 2010; Svendsen and Koch 2008).

  3. Lock and Nguyen (2010, p. 93) argue that “the biological sciences produce real but partial pictures of what is under examination”, and that “these ‘snapshots’ are usually understood by involved scientists as different representations of the same ontological reality”. In line with Lock and Nguyen, and following Sarah Franklin’s (2013) idea of “biological relativity”, however, in this paper, these snapshots are “understood as lenses onto a shifting and contingent reality” (Lock and Nguyen 2010, p. 93).

  4. In clinics 1 and 2, the experts involved in selecting embryos are physicians and biologists/geneticist/ laboratory technicians. I will refer to all of the experts working in the lab as IVF-biologists.

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Acknowledgements

I am grateful for the valuable comments provided by the two anonymous reviewers. I am indebted to Mianna Meskus for her support and numerous discussions on this work. I also want to thank Ilpo Helén for insightful feedback on the earlier versions of this article, as well as the participants of the TOTEMI (Knowledge, Technology and Environment) and SKY (Gender, Culture and Society) seminars for comments and peer support. Finally, thank you to all the clinics, experts and the ones experiencing involuntary childlessness themselves for taking part in my study.

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  1. Department of Social Research, University of Helsinki, P.O.Box 18 (Unioninkatu 35), 00014, Helsinki, Finland

    Elina Helosvuori

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Correspondence to Elina Helosvuori.

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Ethical Approval

Ethical approvals have not been sought for the PhD study from which the original empirical data come from. None of the funders (the Kone Foundation and the Doctoral Programme in Gender, Culture and Society, University of Helsinki) required ethical approvals for the study. The subject matter of, especially, the interviews and the peer-support groups touches issues of health and personal experience. All the participants of the study were informed of the purposes of the research and how the data will be used. All the interviewees gave a written informed consent. All the other participants gave an oral informed consent. According to the instructions of the University of Helsinki and the Finnish Advisory Board on Research Integrity, an ethics approval should be sought only in the following cases: (1) research is physically invasive; (2) a consent is not asked; (3) research is conducted among children or people aged under 15 years; (4) research participants are subjected to intense stimulus (for example, violence or pornography); (5) there is a risk of long-term mental harm (trauma, depression, insomnia) or; (6) the research can cause danger to participants’ safety.

As my research setting does not meet any of these criteria for the need of an ethics approval, the usual, careful process of providing enough information of the research and its purposes as well as careful handling of data and data anonymisation were deemed sufficient.

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Helosvuori, E. Assembling Viability: The Art of Mundane Embryo Selection in IVF. BioSocieties 14, 1–22 (2019). https://doi.org/10.1057/s41292-018-0114-3

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