Browse By Topic

Assisted Reproductive Technologies

Articles

Blogging Infertility

Cheryl Miller on the lively and fractious community of “infertiles”

Why Not Artificial Wombs?

Christine Rosen on the meaning of being born, not incubated

Eugenics—Sacred and Profane

Christine Rosen on Orthodox matchmakers, IVF clinics, and genetic testing

My Mother, the Embryo

IVF's Latest: She-Males, Fetal Eggs, and Children of the Unborn

Fertility Gone Mad

Pregnancy After Menopause, IVF Birth defects, & More

Hollywood’s Fertile Imagination

Baby-Making Goes Prime Time

‘An Unknowable Atom of Human Flesh’

Henry Hyde and Joe Barton on the Ethics of Stem Cell Research

The Embryo Wars

The U.N., Mitt Romney, and California Corruption

The Bioethics Agenda and the Bush Second Term

Acorns and Embryos

Robert P. George and Patrick Lee on moral standing and bad metaphors

Next 

 

Blog Posts

Which Baby Do You Want?

Nature says don't worry about "designer babies." Not so fast, says Daniel MacArthur, a blogger at the excellent site Genetic Future:

[I]t's safe to say that there will be no perfect baby. Instead, the prospective parents will face a tough choice between embryo A, who will likely be tall, slim, smart and cancer-free but have a higher-than-average chance of bipolar, early-onset dementia, and infertility; embryo B, who will be a little shorter, dark-haired, probably fairly gregarious, resistant to coronary artery disease, susceptible to bowel cancer, hypertension and early deafness; embryo C, who will be of average intelligence, unlikely to suffer premature baldness, prone to mild obesity and diabetes, but not at a high risk of any of the other major common diseases; and embryos D-N, who present a similar panel of competing probabilities.

...The parents-to-be will sit down together with dossiers listing a huge set of statistical predictions for each of their potential children, and make a decision as to which (if any) of these abstract collections of traits and risks they wish to bring into this world. Decisions don't get much more emotionally traumatic than this: not only will they be making a decision that will shape their own lives and that of their future offspring, parents will carry a new, extra burden of responsibility for the fate of their children. If they decide on embryo A, and their child goes on to develop severe bipolar disease, they will carry the guilt of that decision in addition to the trauma of the disease itself.

That's not to say that embryo selection is unworkable — in fact, I think it's inevitable — but rather that this process is likely to require a degree of agonising trade-offs on the part of parents-to-be that is seldom fully appreciated. While I have no moral problem with the notion of embryo selection, part of me is glad that my child-bearing years are likely to be over before I have the chance to face this particular dilemma...

ART in the News

Jennifer Lahl speaks at Google about the dangers of egg-harvesting. Watch the video.

Mary Eberstadt says Humanae Vitae got it right on sexuality and technology. 

A baby boomlet? A record number of babies were born in the U.S. last year. 

"Choice Mom" Mikki Morrisette asks what donor-conceived children want.

A British bioethicist says parents should do what they're told.

Still More on 30 Years of IVF (And Britain's Donor Shortage)

The London Telegraph has a series of articles on ART today, including a number of first-hand accounts from patients and donors. There are some great stories, but since I'm working on a piece about donor registries, I was most interested in the ones about the effect of the anonymity ban on donor recruitment. 

The answer is not good — as this U.K. government report recently attested.

Sophie Turner and her partner Karen Harvey have spent two years trying to conceive a child. After learning about the waiting list for sperm donors, the couple turned to a Danish cryobank. The trips did not result in a baby, so the couple returned to the U.K. where they are still waiting for a donor:

After two failed attempts, she's being treated at Barts, where there's a three-month waiting list for British sperm. Any child we have will be able to contact the sperm donor when he or she is 18; I think it's a good thing that children know where they come from, but I'm not sure of the effect it will have on us as a family.

Sue Adlam is a school teacher. She waited a year for an egg donor to conceive her first child, and is now searching for another donor to conceive a sibling:

I feel as if I've spent half my life waiting, but as anyone who's ever suffered from infertility knows, what keeps you going through all the sadness is the prospect of the amazing miracle of a baby at the end of it all. Many women are faced with the prospect of a wait of at least two years, but my hope is that things will begin to improve in the long term.

In Vitro We Trust

Nature is not the only one looking back on the birth of Louise Brown. In the New York Times, Peggy Orenstein reflects on the history of IVF and the challenges ahead:

Louise Brown turns 30 on Friday. These days, her name elicits little more than a mystified head shake. Who was she again? Let me refresh your memory: Little Louise was the world’s first “test-tube baby,” what we now refer to as an I.V.F. kid, or simply “the twins down the block.”

Brown’s life today is as unremarkable as the circumstances of her conception have become: she’s worked as an administrative assistant in Bristol, England, and is married with a naturally conceived toddler of her own. It’s hard to imagine that she begat one of the major revolutions of the 20th century: since her debut, more than three million babies have been born worldwide using I.V.F. or other reproductive technologies.

[I]t’s easy to forget the disturbing questions about I.V.F. — its practices, ethics and impact on public health — that do remain and are left largely subject to a physician’s conscience and a patient’s desires. The trouble is, doctors who do I.V.F. are selling a product and their patients are so vulnerable, their experience with infertility so fraught, that they’re not always willing or even able to act in what seems like their own best interest.

IVF: The Next 30 Years

Nature magazine's July issue has a special feature on the 30th anniversary of IVF. After discussing the legacy of IVF (subscrip. req'd), Nature asked a group of scientists what the next 30 years of IVF research will look like. Among the predictions:

• Scientists will be able to create sperm and egg cells for anyone. Using sperm and egg cells derived from induced pluripotent stem cells, scientists will end infertility. Newborns and hundred-year-olds could become parents.

• Embryo research will become a "fact of life": "They would become objects and would be used as objects...Maybe 20–30 years from now we'll read in newspapers that someone made 20,000 embryos and studied their development, and we'll decide it's OK."

• IVF for less than $100: Cheap IVF will soon be made available in developing countries.

• Healthy babies will be assured with the use of "genetic cassettes." Scientists will insert the cassettes into embryos to correct for diseases like Huntington's.

• But people will still have sex: "IVF is expensive and uncomfortable. The old-fashioned way is cheaper and more fun and that won't change in 30 years."

• Artificial wombs will change the abortion debate: "If an artificial womb were developed, the government could pass a law that requires people who have a termination of pregnancy to put the fetus into one of these wombs."

• Alert the trial lawyers: There will be litigation over the health of IVF babies. "With the increasing availability of IVF, there will be more emphasis on safety. Not enough is known about the long-term health of the Louise Browns of this world — if there is a problem, it will be unexpected."

Women Who Have Sold Their Eggs

If you are in New York, you might want to stop by Lolita Bar next Tuesday, July 22nd. They'll be hosting a panel, "Women Who Have Sold Their Eggs," at 8 p.m. Panelists include graduate students Valerie Bronte and Diana Fleischman, Reason senior editor Kerry Howley, and "finance whiz" Marie Huber. The event is free. More details can be found at organizer Todd Seavey's website.

Can't make it to the Big Apple? Check out Kerry Howley's Reason article on selling your eggs.

Two Takes on Living With Infertility

Melissa at Stirrup Queens has two great posts up. The first is about Jenna Nadeau Currier's infertility memoir, The Empty Picture Frame. (Read more about Jenna in my article, "Blogging Infertility.") Here's Melissa discussing Jenna's idea of  parenthood as a "calling":

I felt strongly drawn to the idea of parenthood and I wanted to experience it very badly. I was willing to try multiple paths to get there. I made life choices/career choices based on the idea of motherhood and what type of mother I wanted to be. I'm lucky that this worked out for me because I made a lot of choices that I probably would have regretted since I gambled making them.

The second post is an interview with Kim Hahn, CEO of Conceive magazine:

Melissa: You are the founder and CEO of Conceive magazine. What gave you the idea to start the magazine?

Kim: While my husband and I were trying to start our family, I was frustrated by the lack of positive, consumer-friendly information about fertility. Specifically, I longed for a magazine as beautiful, upbeat, and informative as the many pregnancy and parenting magazines on the market. I saw a hole in the market for women trying to conceive. There are magazines for brides, pregnancy, and parenting, but there was a gap between the bridal and pregnancy magazines.
 

ART in the News

Affordable IVF, Older Dads, and The World's Oldest Mother

• A new IVF technique gives hope to infertile men.
   
• Frozen embryo babies are just as healthy as fresh ones. 
   
• Affordable IVF comes to Africa.
   
• "The little boy with three mums (and they're all sisters)." 
   
• Men have a biological clock too. But who cares? They'll just hit the snooze button anyway.
   
• Help! My biological clock isn't loud enough!
   
• Are children with Down Syndrome being "exterminated" in the womb? Or do we have an "obligation" to select the best children we can have?
   
• A 70-year-old Indian woman becomes the world's oldest mother. 
   
• The pregnant man gives birth. 
   
• Uterus size can predict some premature deliveries.  

Eugenics Watch: I, For One, Welcome Our New Genetic Overlords

What happens, if after pre-genetic screening, no unaffected embryos are found? Should they be transferred? And if so, who gets to decide?

That's the subject of a talk by Dr. Wybo Dondorp, a senior research fellow at the Department of Health, Ethics and Society at Maastricht University (The Netherlands), at the 24th annual meeting of the European Society of Human Reproduction and Embryology in Barcelona. If you read this Reuters article, you might think that the patients get to decide about the disposition of their affected embryos. You'd also be wrong.

According to Dr. Dondorp, decision-making about affected embryos must be "shared" between parents and doctor--except, that is, when the doctor disagrees with the parents. Then, the doctor gets to decide that it's not in the interest of the future child to be born:

"The present consensus is that where the classical indications for PGD are concerned, doctors should, as a general rule, not transfer affected embryos where no non-affected ones are available.

[...] The welfare of the child is closely connected to the classical indication for PGD: a serious disease caused by a single gene mutation for which there are no, or limited, treatments, and, in most cases, presenting early in life. An example is an embryo that is homozygous for cystic fibrosis, where the child will definitely have the disease. In such cases it is inconceivable that doctors would agree to transfer these embryos as it would be at odds with their professional responsibilities.

[...] It must be made clear that there may be, with conditions, room for shared decision-making about transferring affected embryos. But that does not amount to leaving it to the parents, as doctors cannot avoid their professional responsibility for the welfare of the future child."

Just to be clear, people with cystic fibrosis can live into "their 30s, 40s, and beyond." But no, their lives aren't worth living! For now, Dr. Dondorp hasn't yet ruled on the fates of people with genes for hereditary cancers or other chronic conditions. Those will be decided by a "case-sensitive evaluation of aspects relevant to the 'high risk of serious harm' criterion." Again, not by you, the potential parent!

So what if your doctor decides you shouldn't transfer your embryos? Dr. Dondorp has some helpful advice: 

In pre-test counselling it should be explained that if no non-affected embryos are available, the only options are trying a new cycle or being advised to reconsider one's reproductive plans such as refraining from reproduction, using donor eggs or sperm, or adoption.

But don't worry, the doctors won't immediately dismiss your views about the fate of your embryos. They'll pretend to listen first, and then do whatever they've already decided on. 

"Parental requests for transferring affected embryos should not be dismissed beforehand as a sign of irresponsible capriciousness. As the couple's primary wish may be for a child, they may reason that if a non-affected, healthy child is not what they can get, they will also be happy with, and good parents for, a child with a condition they at first intended to avoid. Respect for autonomy at least requires taking such requests seriously, even if, in view of all other considerations, doctors decide not agree to the requests."

Two Studies About Donor-Conceived Offspring

Much ado about nothing? A study by scientists at Cambridge University found that children conceived by a surrogate mother or by donor conception are as "psychologically well" as their naturally-conceived counterparts. The children were only seven years old at the time so I'm skeptical as to how much this survey really tells us. What's more, most of them don't know they are donor-conceived:

In a press release, Casey added that she found a majority of parents of children born through assisted reproduction delayed telling the child about how he or she was conceived.

"At the time of the child's seventh birthday, only 39% of egg-donation parents, 29% of donor-insemination parents and 89% of surrogacy parents had told their children about the nature of their conception."

These figures contrast markedly with what the parents said they would do when they were questioned at the child's first birthday.

Another Cambridge study suggests that these seven-year-olds might not be so "psychologically well" in the future:

The children of sperm donors should be told of their origins as young as four, a new study suggests.

[...] 

Scientists at Cambridge University found that those who were told as adults were three times more likely to feel angry than children.

In total 38 per cent of adults characterised their feelings as anger, compared to 12 per cent of four to 11-year-olds.

Three times as many adults also said that when they found out they were shocked, compared to 27 per cent of children.

Next