PATERNITY AND FILIATION ON

NON-CONVENTIONAL METHODS OF PROCREATION

CHAPTER XXVIII

The standard method of reproduction is the introduction of the male sperm into the
generative organ of a female through sexual intercourse followed by fertilization, growth
and development of the conceptus and its subsequent delivery. No technical
manipulation or medication is employed as it is a physiologic process. However, modern
advancement of medicine modified the conventional method as a solution to some
specific problems of reproduction such as Artificial Insemination and In Vitro
Fertilization.

A. ARTIFICIAL INSEMINATION
Artificial insemination is a medical procedure by which the semen is introduced into the
vagina by means other than copulation for the purpose of procreation. Some physicians
consider its as "therapeutic insemination.

Artificial Insemination Classified According to the Source of Semen:

1. A.I.H. (Artificial Insemination Homologous, Artificial Insemination Husband) When
the sperm comes from the husband.
2. A.I.D. (Artificial Insemination Donor, Artificial Insemination Heterologous) When
the sperm comes from a donor other than the husband.
3. A.I.H.D. (Artificial Insemination Husband Donor, Polled Donor Semen) When the
donor semen comes from the husband and a third party donor.

Medical Indications for Artificial Insemination :

1. For A.I.H.:
a. When the deposition of the husband's semen within the vagina is by coitus, this is
prevented because of anatomic or psychologic difficulties on the part of either husband
or wife;
b. When the infertility is due to poor motility, paucity or otherwise defective sperm cells
or too small a volume of ejaculant.

2. For A.I.D. or A.I.H.D.:

a. Absolute male sterility (Azoospermia);
b. Oligospermia Less than 10 to 15 million sperm per cc. of semen with infertility of
long duration;
c. Hereditary disease in the husband making propagation inadvisable for eugenic
reason; or
d. An Rh blood incompatibility is expected to cause an abnormal baby in situations
where other techniques to overcome such incompatibility are not applicable.

Selection of Donor of Semen:

In A.I.D. the selection of the appropriate donor of semen resides in the physician so he
may be held liable if the child born becomes defective from his negligence or
carelessness in choosing the donor.
The following are the obligations imposed on a physician in the selection of donors:
1. Proper screening must be made of the donor including chromosomes for genetic
defects.
2. The donor must have the racial characteristic and physical proportion as those of the
husband and wife and the blood type must be compatible with A.B.O. and Rh genotype
of the wife.
3. The physician must ensure that the identity of the donor is not known to the parents
and vice versa.
4. Complete physical examination with standard test for syphilis and gonorrhea is
obtained not more than one week before the seminal fluid is collected.
Precautions to be Observed by the Physician in Performing Artificial
Insemination:
1. The physician should make certain by reasonable testing that the procedure is
medically indicated for the couple who has requested conception by this method. The
husband is infertile and such condition is permanent.
2. The physician should establish by proper evaluation that the couple requesting
artificial insemination is emotionally stable and psychologically suited for this type of
parenthood, which carries with it the responsibilities of the very presence of the child.
3. The physician must use all reasonable precautions in selecting the donor; with
thorough medical, psychologic and social screening to exclude donor with potential
transmissible undesirable traits, features and details.
4. The physician must, under no circumstances except by court order, reveal the fact
of artificial insemination or 'the identity of the donor or of the couple to each other or to
other persons.
5. The physician must use freshly donated sperm or frozen semen that has been
prepared and stored according to currently accepted methods with the source properly
identified.
6. The insemination procedure must be performed by the physician in accordance with
the currently accepted techniques.
7. Full and valid consents and releases should be obtained in writing from all parties
involved, and each consent must be an "informed consent," particularly on the part of
the prospective parents, who should be fully appraised of the psychologic and legal
complication and the possibility of the birth of a defective child.

Status of the Child Born by Artificial Insemination:

1. In A.I.H., there is no doubt that the child is a legitimate child of the husband because
the semen came from him. No foreign blood is introduced into the family.
2. In A.I.D., with the consent of the husband, the child born must also be considered
legitimate although the fertilization semen is not from the husband. His consent to the
artificial insemination may be considered as a waiver to the illegitimate status of the
child. Even if the child is considered illegitimate, the child can be adopted by him
making the child's status legitimate.
3. In A.I.D., without the consent or if it is against the will of the husband, the child must
be considered illegitimate, specifically a child born because of adultery. This is an
intrusion into the
conjugal home of a foreign element against the will of the husband.

Consent on A. L D.:
In A.I.D. the consent and release for any future claim must be obtained by the
physician from all parties in writing. The consent of the wife is necessary to avoid
being held liable for an assault.
The consent of the husband is necessary to avoid the wife being charged with
adultery, or to avoid the question of legitimacy of the child, issues of divorce,
separation or inheritance.
The consent and release of the donor should be obtained for the unrestricted use
of the semen supplied and he should also certify in writing that he will make no
effort to ascertain the identity of the couple involved. If the donor is married, the
consent of the wife must also be obtained to the giving of semen because her
marital interest may be affected by the donation.

Foreign Court's Decisions:

Child born by artificial insemination without the consent of the husband

constitutes adultery:

A woman attempted to obtain alimony from her divorced husband. The latter contended
that his former wife committed adultery because the child born is not his biological child.
The former wife claimed the child to be a product of artificial insemination. The court
held that the artificial insemination without the husband's consent constitutes moral
turpitude and adultery with the latter being defined as "the voluntary submission to
another person of the reproductive powers or faculties of guilty person" (Osford v.
Osford,68Dom Law Reports, 251 Ont. Sup. Ct. 1921).

The British House of Lords concurred with a ruling that the conception of a child by a
man other than the husband constituted adultery and that, therefore, the resulting
offspring was illegitimate (Russel v. Russel, A.C. 687 (1924) at 148).

Child born by artificial insemination is legitimate:

In a decree to a separation previously granted by the court, the husband was granted to
have a weekend custody of the child born during the marriage. The wife petitioned for
an amendment of the decree arguing that because the child has resulted from A.I.D.,
the husband is not the father of the child and therefore he is not entitled to visitation
right. The court, however, predicted on the assumption that the procedure had been
performed with the consent of the
husband, rules that "the child has been potentially adopted or semi adopted
by the defendant and with the particular reference to visitation, he is entitled to the same
right as those to which a natural parent under the circumstances would be entitled
(Strand v. Strand
78N.Y.S. 2d 390(1918).
Child born by artificial insemination is entitled for support:
The husband consented in writing for artificial insemination of the wife. A male child was
conceived and born. The spouse later had a divorce and the wife was given custody of
the child. The wife later became ill and disabled so she applied for a state support of the
child. The District Attorney brought a criminal action against the husband to force him to
provide for the child's support. The court ruled that "reasonable man who, because of
his inability to procreate, actively participates and consents to his wife's artificial
insemination, knows that such behavior carries with it legal responsibilities of fatherhood
and criminal responsibility of non-support (People v. Sorenson, 66 Cal. Rptr. 7, 437 P.
2d 499 (1968).
B. IN VITRO FERTILIZATION
In Vitro Fertilization (test tube baby) is the fertilization of the egg cell by the sperm cell
extracted from the respective donors placed in an artificial medium and after reaching a
certain stage of cellular division and development:
1. Implanted into a woman's uterus, or
2. Gestation (development of the embryo to a child) in an artificial womb.
Whenever the embryo is allowed to develop in an artificial womb, it is known as
ectogenesis (extra corporeal gestation). The first recorded child born by In Vitro
Fertilization was Louise Brown who was born in England on July 24, 1978 (London
Daily Mail).

Basis of Legality of In Vitro Fertilization:

a. Right of procreation Procreation is fundamental to the very existence and survival
of a race. A ban on the use of in vitro fertilization would prevent an individual from using
means to fulfill his or her procreative mission. Inability to procreate is a malady and it is
the duty of medicine to alleviate or cure the condition so as to make him enjoy life and
realize his
desire.
b. Right of marital privacy Prohibition of in vitro fertilization as a way to have children
will mean government intrusion into the marital bedroom in search of evidence for
violating the law. The freedom of personal choice in matters of marriage and family life
is one of the basic liberties protected by the due process of law clause.

Surrogate Mother:
A surrogate mother is a woman who is not the source of the ovum and in whose uterus
the in vitro fertilized egg is implanted to develop up to full term and delivered child. The
term also applies when fertilized egg is removed from the uterus of a woman and
implanted to the surrogate mother. The surrogate becomes the gestational mother of
the child.
Reasons why the services of a surrogate mother may be necessary:
a. Necessity:
The genetic mother is unable to carry the child to term because of disease or
injury.
The genetic mother may believe either that she is too old to safely carry a child to
term, or that the child may be born with abnormalities.
The genetic mother may possess deleterious genetic traits which may be passed
on to the child.
Couple is unable to adopt a child.

b. Convenience:
A woman may not want to interrupt her career during the gestational period and
therefore seek a more convenient method of having one without changing her
actual way of life.

Motivation of a woman to become a surrogate mother:

a. Altruistic motive A woman may be willing to be a surrogate mother for the sake of
humanity.
b. Material consideration If the surrogate mother merely receives all expenses
incurred in carrying the fetus to term and then delivered then the motive is altruistic. On
the other hand, if the payment agreed upon is beyond the reasonable cost of pregnancy
then it is tantamount to "rental" for the use of the uterus.

Problems that may arise in the agreement in the use of surrogate mother for gestational
purpose:
a. If the surrogate mother decided to abort the child contrary to the wish of the genetic
parents;
b. The surrogate mother may decide to keep the child after birth rather than surrender
him to the genetic parents;
c. The parents may decide to abort the child because of the fear that abnormality may
be present but the surrogate mother refuses to do so; and
d. If the child was born with abnormality and the parents refused to take the child from
the surrogate mother

Potential solution to the problems of surrogate mother:

a. By contract There must be a contract specifically mentioning the rights and duties
of each party. But the mere facts that the rights and duties are specified do not
guarantee that the specifications will judicially be recognized.
b. By legislation The court is bound to enforce the legislation unless found to be
unconstitutional. This method provides a better solution to the problem.

C. OTHER NON-CONVENTIONAL METHODS OF PROCREATION

1. Artificial Inovulation The removal of an unfertilized egg from a woman and placing
it on the reproductive tract of another woman.

2. Embryo Transplantation The removal of a fertilized egg from a woman's uterus to

transfer to that of another woman's uterus.

3. Parthenogenesis ("Virgin Birth") A type of sexual reproduction whereby the

unfertilized egg with 23 chromosome compliment doubled its content to become a
diploid cell that starts dividing as if it is a fertilized egg without the intervention of a male
sperm cell, the resulting offspring is thus a female. It has been speculated that virgin
birth occurs naturally in human being at the rate of one per three billion pregnancies.

4. Cloning A type of a sexual reproduction whereby the nucleus of a female egg is

removed (enucleation) which contains the genetic material and replaced with the
nucleus of a body (somatic) cell of the same or another woman (renucleation). The
renucleated egg is then placed in a uterus for gestation and normal development. The
resulting offspring is genetically identical to the parent.

Prepared by:
NATHANAEL M. DOMINGUEZ LLB3
 LEGAL MEDICINE

CHAPTER XXVIII

Instructions: Encircle the letter of the correct answer. No erasures allowed.

1. A medical procedure by which the semen is introduced into the vagina by means
other than copulation for the purpose of procreation.
a. Artificial Insemination
b. Medical Insemination
c. Standard Method of Reproduction
d. Physiological Insemination

2. Kinds of Artificial Insemination according to source of semen:

a. Artificial Insemination Homologous
b. Artificial Insemination Donor
c. Artificial Insemination Husband Donor
d. All of the above

3. In A.I.D., the selection of the appropriate donor of semen resides from?

a. Physician
b. Husband
c. Wife
d. Both husband and wife

4. The following are the precautions to be observed by physician in performing Artificial

Insemination, except?
a. He should make certain by reasonable testing that the procedure is medically
indicated for the couple who has requested conception by this method.
b. He should establish by proper evaluation that the couple requesting artificial
insemination is emotionally stable and psychologically suited for this type of
parenthood.
c. He should reveal the fact of artificial insemination or the identity of the donor or of
the couple to each other or to other person.
d. He must use all reasonable precautions in selecting the donor; with thorough
medical, psychologic and social screening.

5. The following are correct about A.I.D. except:

a. Consent and release for any future claim must be obtained by the physician from
all parties in writing.
b. Consent of the wife is necessary to avoid being liable for an assault.
c. Consent of the husband is necessary to avoid questioning the legitimacy of the
child.
d. The donor of the semen is free to ascertain the identity of the couple.
6. This is the fertilization of the egg cell by the sperm cell extracted from the respective
donors placed in an artificial medium and implanted into womans uterus after reaching
a certain stage of cellular division and development.
a. Artificial Fertilization
b. In vitro Fertilization
c. Ovum Artificial Insemination
d. Laparoscopy

7. The closure of the fallopian tube in In Vitro Fertilization may be due to:
a. Complication of pelvic inflammatory disease
b. Bilateral salpingectomy due to repeated caesarian section or ectopic pregnancy
c. Tuboplasty failure or unsuccessful tubal anastomosis
d. All of the above

8. The country where the first recorded child born by In vitro Fertilization:
a. England
b. India
c. Scotland
d. Australia

9. The following are the rights of an individual that became the basis for the legality of In
Vitro Fertilization:
a. Right of procreation
b. Right of marital privacy
c. Right of self determination
d. All of the above

10. A woman who is not a source of the ovum and in whose uterus the in vitro fertilized
egg is implanted to develop up to full term and delivered child.
a. Genetic mother
b. Contracted mother
c. Surrogate mother
d. Ingestational mother

11. The ovum removed from the wife is fertilized by the sperm coming from a third party
(sperm donor) and is implanted into the wifes uterus. This situation may arise when?
a. The husband is sterile
b. The wife is sterile
c. Both the husband and wife are sterile
d. None of the husband and wife is sterile

12. What is true about the status of child born through Artificial Insemination?
a. In A.I.H, there is no doubt that the child is a legitimate child because the semen
came from husband
 b. In A.I.D., with the consent of the husband, the child born is legitimate although
the fertilization semen is not from husband
c. In A.I.D., without the consent or if it is against the will of the husband, the child is
considered illegitimate, specifically that the child is born out of adultery.
d. All of the above

13. The following must be considered by the physician in the selection of donors of
semen, except.
a. Proper screening must be made of the donor including chromosome for genetic
defects.
b. The donor must have the racial characteristic and physical proportion as those of
the husband and wife.
c. The blood type must be compatible with the A.B.O. and Rh genotype of the wife.
d. The physician must ensure that the identity of the donor is known to the parents
and vice versa.

14. The removal of an unfertilized egg from a woman and placing it on the reproductive
tract of another woman.
a. Artificial Inovulation
b. Embryo Transplantation
c. Parthenogenesis
d. Cloning

15. The removal of a fertilized egg from a womans uterus to transfer to that of another
womans uterus.
a. Embryo Transplantation
b. Parthenogenesis
c. Cloning
d. Artificial Inovulation

16. A type of sexual reproduction whereby the nucleus of a female egg is removed
which contains the genetic material and replaced with the nucleus of a body cell of the
same or another woman.
a. Artificial Inovulation
b. Embryo Transplantation
c. Parthenogenesis
d. Cloning

17. A type of sexual reproduction whereby the unfertilized egg with 23 chromosome
compliment doubled its content to become a diploid cell that starts dividing as if it is a
fertilized egg without the intervention of a male sperm cell, the resulting offspring is thus
a female.
a. Embryo Transplantation
b. Parthenogenesis
c. Cloning
d. Artificial Inovulation
18. The following are the medical indications for Artificial Insemination for A.I.D or
A.I.H.D., except:
a. Absolute female sterility
b. Less than 10-25 million sperm per cc. of semen with infertility of long duration
c. Hereditary disease in the husband
d. An Rh blood incompatibility is expected to cause an abnormal baby

19. It is administered to induce more production of oocytes to give physician the

privilege of selecting the best for fertilization.
a. gonadotropic hormone
b. ovum
c. zygote
d. embryo

20. When an embryo in In Vitro Fertilization is allowed to develop in an artificial womb,

this is known as?
a. Exogenesis
b. Oocyte
c. Tubal Anastomosis
d. Congenital Aplasia

Prepared by:
NATHANAEL M. DOMINGUEZ LLB3