The Economist has a new issue on fertility, which examines the current state of technologies such as in vitro fertilization (IVF), and the work to develop in vitro gametogenesis (IVG) — a process that involves manipulating adult stem cells to become sperm and egg cells so that embryos can be grown in a lab, and children (theoretically) can have two genetic fathers or mothers.
There are glaring ethical objections to both IVF and IVG — not least how they involve the destruction, experimentation, and indefinite freezing of human embryos. But another problem is that by making these technologies research priorities, little is being done to better understand and treat the underlying causes of infertility.
The report notes: “By providing a reasonable rate of success ivf seems to obviate the need for better understanding. Fertility researchers interviewed for this report consistently reported that basic questions about human reproduction remain a surprisingly low research priority.”
Moreover, the report’s authors conclude:
Attempts to gain control over human biology in such ways should set a whole peal of alarm bells ringing; the technical barriers are immense, those in the realm of ethics, public morality and safety probably larger still. They suggest a level of control over human life with which many will be very uncomfortable — and which might well be illusory. After all, ivf is commonly understood, and sold, as a way to take control of errant biology, and for many it proves anything but. Studies have consistently found that a majority of ivf patients drop out before completing all the cycles which their insurers or governments will cover. The main reason they cite is psychological strain. They are experiencing the opposite of the “empowerment” often advertised. They feel wildly out of control.
The authors of this report can empathise. We have, between us, undertaken 14 cycles of ivf, over 550 hormonal injections and countless scans and blood tests to collect around 120 eggs. Our partners have made 23 visits to awkward “sperm sample” rooms. Just 34 of the eggs that were fertilised made embryos that could be transferred into our wombs. Thirty did not implant. Three did but failed further down the road (one ectopic pregnancy and two miscarriages, one referred to by a doctor as “tripping before the finish line”). After five years each, only one of us is pregnant.