Contested Reproduction: Ethical Dilemmas in Assisted Reproductive Technologies—A Literature Review

Assisted reproductive technologies (ART) have expanded reproductive possibilities while generating significant ethical controversy. Their rapid development has consistently outpaced social, regulatory, and ethical consensus, producing clashes of values, moral conflict, and periodic moral panics. While some technologies have become broadly normalized, others remain deeply contested. This literature review maps the major fault lines of debate across five issues: access to ART and discrimination; the moral and legal status of the embryo; preimplantation genetic testing; anonymous and commercial gamete donation; and posthumous reproduction. Drawing on empirical research from multiple national contexts, the review considers the perspectives of patients, clinicians, donors, and donor-conceived persons alongside those of professional bioethicists. Three dilemmas recur throughout: the tension between reproductive autonomy and child welfare; the persistent gap between technological possibility and ethical or regulatory consensus; and the risk of commodifying reproductive material and relationships. The review concludes that ART ethics resists resolution within any single national or cultural framework, and that meeting its challenges requires sustained, inclusive, and internationally informed public deliberation.