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Research

Assisted Reproduction

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Women with disabilities have the right to access and use Assistive Reproductive Technology (ART).1 Infertility, same-sex parenting, and single parenthood are typical reasons for using ART. There are several types of ART available, including:

  • In vitro fertilization (IVF), that is fertilization outside of the body; the most effective and most common form of ART.
  • Artificial insemination is a type of IVF that is often used for couples in which a single sperm is injected into a mature egg, or alternatively the egg and many sperm are placed in a petri dish together and the sperm fertilizes an egg on its own.

There are also options for a woman to have a baby without necessarily going through the physical process of pregnancy, which may be an alternative for women whose disabilities place them at risk for complicated pregnancies and deliveries. These include:

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Surrogacy

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Surrogacy is a process in which a woman gives birth to a child for an intended parent with the intention to hand over the child after the birth to the intended parent. There are two types of surrogacy — traditional surrogacy and gestational surrogacy. In traditional surrogacy, a surrogate mother is artificially inseminated, either by the intended father or an anonymous donor, and carries the baby to term. The child is thereby genetically related to both the surrogate mother, who provides the egg, and the intended father or anonymous donor. Traditional surrogacy is permitted in only a few states in the United States. In gestational surrogacy, an egg is removed from the intended mother or an anonymous donor and fertilized with the sperm of the intended father or anonymous donor. The fertilized egg, or embryo, is then transferred to a surrogate who carries the baby to term. The child is thereby genetically related to the woman who donated the egg and the intended father or sperm donor, but not the surrogate. Surrogacy can be expensive. The overall cost varies on the types and numbers of medical procedures and services used, the intended parent’s insurance situations, legal costs,  compensation for the surrogate, the type of surrogacy, and whether a sperm, egg, or uterus is needed.

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Adoption

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Adoption is a process in which children become full and permanent legal members of another family while maintaining genetic and psychological connections to their birth family. Adoption costs vary widely depending on the type of adoption and the specific adoption services. For example, adopting a child from foster care is generally much less expensive than adopting from a private agency or other sources. The Child Welfare Information Gateway2 provides detailed information on adoption costs, types of adoption, adoption agencies, and other resources for people planning to adopt a child.

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Foster Care

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Foster care is the temporary placement of children and youth with families outside of their own home due to child abuse or neglect.  The goal is to provide a safe, stable, nurturing environment.

Assisted reproductive technologies have advanced to the point that scientists can select embryos that have certain desirable qualities. They are also able to identify defective genes in an embryo that can cause disabling conditions at birth or later in life.3 In some cases, they can repair the genetic defect. If the genetic defect cannot be repaired, scientists often destroy the embryo. Disability rights activists have been strong critics of assisted reproductive technologies that use these processes for selecting embryo characteristics. Their criticism is based on the position that selection based on certain genes discriminates against people with disabilities and devalues their lives.4

Physicians, adoption agencies, and foster care agencies have also been known to discriminate against people with disabilities,4-7 The Americans with Disabilities Act,8 and the Rehabilitation Act9 make it illegal to deny fertility or parenting services to a person with a disability for reasons based on stereotypes or doubts (without proof) about their ability to take care of a child.7 If you believe you have been wrongfully denied parenting access based on the presence of a disability, see Legal Resources below. 

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Reference List

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  1. Asch, A. (1989). Reproductive Technology and Disability, in Sherrill Cohen and Nadine Taube (Eds.), Reproductive Laws for the 1990s: A Briefing Handbook, Clifton, NJ: Humana Press.
  2. Child Welfare Information Gateway. (2016). Planning for adoption: Knowing the costs and resources. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau.
  3. Holland S. Selecting against difference: Assisted reproduction, disability and regulation. Fla. St. U. L. Rev. 2003;30(2):401-409. Accessed September 21, 2020.
  4. Mitcherson KM, Disabling dreams of parenthood: The fertility industry, anti-discrimination, and parents with disabilities. Law & Inequality. 2009;27(2):311-364.
  5. American Society for Reproductive Medicine. Fertility rights and responsibilities. Updated 2014. Accessed August 31, 2020.
  6. Coleman CH. Conceiving harm: Disability discrimination in assisted reproductive technologies. UCLA Law Review. 2002;50(1):17-68.
  7. U. S. Department of Health and Human Services [HHS], & U. S. Department of Justice [DOJ]. (2015). Protecting the rights of parents and prospective parents with disabilities: Technical assistance for state and local child welfare agencies and courts under Title II of the Americans with Disabilities Act and section 504
  8. Americans with Disabilities Act of 1990. (Title II). 42 U.S.C. §§ 12131-12134.
  9. Rehabilitation Act of 1973. (Section 504). 29 U.S.C. § 794.

Funded by the National Institutes of Health, National Library of Medicine (Grant #G08 LM012702) and Paralyzed Veterans of America Educational Foundation (Grant #848).

Page updated October 2020