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Single Mothers by Choice


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ART in the News

Cheap IVF, medical tourism, and more

October 3, 2008

ART in the News

An Artist's Journey, Sperm Donor Roots, Aussie Clones, and More

September 23, 2008

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

July 7, 2008

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 More Takes on the Fertility Film

May 19, 2008

Yale blogger Helen Rittelmeyer says the rise of the "fertility film" is "a good thing":

I’m not sure why Quart is unhappy about the move towards seeing mother- and fatherhood as redemptive, given that it moves us away from trying to charge romantic relationships with the burden of making overgrown adolescents man up (which was always a bad bet on our part). Movies are full of men who start out juvenile, sullen, self-absorbed, or humorless, only to fall into relationships with women who offer a promise of salvation. I’m not sure why; confrontation with the responsibilities of fatherhood seems to have more raw valence than “love of a good woman.”

Louise Sloan, single mother by choice and author of Knock Yourself Up, thinks there's plenty funny about being a single mom, but that Baby Mama doesn't get it:

The critiques of Baby Mama find it to be superficial and predictable, lacking fully drawn characters and the kind of emotional depth that takes a funny sketch and makes it a great movie. And that's where I start to lose my sense of humor. Because this material is both hilarious and highly emotional--there was no reason for Baby Mama to be shallow.

I found plenty to laugh about as I encountered exploding semen vials and was twice mistaken for an animal breeder ("I swear, it's always you semen people who get the late deliveries!" one FedEx clerk loudly exclaimed).

My Two Cents on Baby Mama

Beware: Spoilers galore!
April 27, 2008

  

I didn't write too much about the movie Baby Mama in my recent WSJ article as I didn't want to step on their film critic's toes. Now with no such worries, I thought I'd give my two cents on the film. If you haven't seen it yet, beware as there are spoilers galore below.

One thing I found interesting while researching the WSJ piece was that no one in the industry or the infertility and bioethics communities was excited about the movie. Surrogates worried it would perpetuate negative stereotypes of surrogates as "ignorant white trash" just in it for the money. Attorney Theresa Erickson, who handles surrogacy and egg donation cases, feared the movie with its surrogacy-scam subplot would make surrogacy seem unsafe even though the majority of cases pass without incident. Anne Adams of the American Fertility Association agreed: Most surrogate situations are "utterly uninteresting and banal.... Is this what happens most of the time? No. But you obviously wouldn’t make a movie about what happens most of the time."

On the other side, Jennifer Lahl, director of the Center for Bioethics and Culture, was concerned that Baby Mama made surrogacy look too appealing, and left its dark underside unexplored: "In reality, it's not a light-hearted situation.... Americans will watch this movie, and go, 'How sweet!' But wait a minute, let's have a reality check here." Slate critic Dana Stevens had a similar take: The movie, she wrote,

could have been the springboard to investigating (or wickedly satirizing) some of the issues surrounding surrogacy, which, as this excellent Newsweek piece reported, can be a minefield for class, race, and gender tensions. But the conflict between Kate and Angie rarely rises above Odd Couple level: Organic pea soup or Tastykakes? Touchy-feely birthing videos or American Idol karaoke?

Like Stevens, I found the movie rather tame in its approach to the politics of modern parenthood. Naturally, the "mommy wars" make an appearance with laid-back mom Caroline (Maura Tierney) explaining to her sister Kate (Tina Fey), a driven career woman, that motherhood is "not like opening one of your stores. It's not an executive decision." Later, Kate recalls an old flame who wanted to marry her, but she was too focused on her career. "Other women got pregnant. I got promotions," she says ruefully.

Yet the entire career vs. family debate is rendered moot by Kate's diagnosis: a "sucky" T-shaped uterus. Kate's "advanced maternal age" notwithstanding, her eggs are fine, and it's her mother's exposure to DES — not Kate's decision to put family on the backburner — that causes her fertility woes.

To judge from the script, the writers didn't think too hard about this incongruity. Kate's diagnosis is mostly a means of explaining her need for a surrogate (and a source of mostly lame jokes about her mother's liver spot medication). The career vs. family debate is there because...well, that's what movies about career women and infertility are about.

This wouldn't have been hard to work around — Kate could have used an egg donor as well as a sperm donor, for instance — but it's clear the writers wanted Kate to have her own biological child. The press materials for the movie talk of "two kinds of family: the one you're born to and the one you make," yet Baby Mama is very timid when it comes to alternative families.

The movie's conservatism reminded me of two other infertility-related films I recently watched: the truly awful sperm-donor comedy And Then Came Love and Hannah and Her Sisters (which features a DI subplot). In all three movies, the importance of blood ties is reaffirmed. Love might be an important ingredient, but it's biology that really makes a family in these films. In And Then Came Love, Vanessa Williams leaves her successful, long-time boyfriend for her son's donor dad. In Hannah and Her Sisters, Woody Allen finds himself unable to bond with his wife Hannah or their children who are the product of donor insemination. They divorce, but he soon finds romantic bliss with his wife's sister, who despite his extremely low sperm count, becomes miraculously pregnant.

Baby Mama has a similar twist to Hannah and Her Sisters. After a series of plot turns in which Angie may be faking her pregnancy, Kate gets pregnant the old-fashioned way as does her surrogate Angie. Like Woody Allen's character, Kate's pregnancy only comes about after she finds her true love: Greg Kinnear, who plays a sweet single dad. There's an element of wish-fulfillment here, of course, as with all romantic comedies — which makes a strange ending for a movie that seemed to promise an edgy, provocative take on surrogacy and family.