It seems that the more desperate an infertile couple is to have children, the more willing they may be to take risks, and the more willing they may be to jump at any new promised technological fix. This is of course understandable. The desire to have children is perfectly normal and healthy, and it is a genuine grief when couples cannot conceive naturally.
It is said that 12-15 per cent of couples are medically infertile (although that figure has been disputed for being too high). People finding themselves in this position are often willing to go to great lengths to have a child. In the past, one could not do too much about childlessness. But with the advent of Assisted Reproductive Technologies (ART), there are now a number of ways that children can be produced.
In vitro fertilisation (IVF) is perhaps the most famous, and the technique has been practiced now for around thirty years. Of course couples who experience a successful outcome with these techniques will be glowing in their praise for them – after all, they have finally obtained what they have so long desired.
While we might celebrate with these couples in their happy outcomes, this does not mean that we should minimise the numerous risks and downsides to such procedures. Indeed, there are many aspects of ART that we should be concerned about.
Before examining some of these problems, let me mention one glowing report about IVF as found in today’s paper (Herald Sun, 30 August, 2007). The author said the “results are miraculous,” and that IVF is a godsend for all who want kids, even “gay couples and single women”. She was so chuffed by the result that she has written a book, describing her experience and that of others.
She is a true believer, and shrugs off the concerns of critics. She says, “To the IVF critics, I ask this: ‘Isn’t it better to be born against all odds to people who truly want a baby, than to be conceived naturally by those who aren’t ready or prepared for the onslaught of parenthood?’”
Of course this response manages to commit two logical fallacies for the price of one. She is making a category mistake here (comparing apples with oranges), and creating a false dilemma (if not A, then B). As to the first, she needs to compare like with like. Sure, a wanted child is to be prefered to an unwanted child. But that is not the real issue here. A fair comparison would be to compare wanted IVF children with wanted natural-born children, or compare unwanted IVF children with unwanted natural-born children.
And concerning the second mistake, the issue is not choosing between either a wanted child or an unwanted child. The real point is to both have a wanted child, and to do what is in the best interests of the child. There are a number of aspects about ART and IVF that may not be in the best interests of the child.
So what are some of the concerns about IVF? Let me briefly mention a few. Elsewhere I have written more extensively on this issue, including a full set of references. This will just be a skeletal outline of that more detailed examination of the issue.
A first set of concerns has to do with financial considerations. Simply put, IVF and the other ART procedures are quite expensive. It is not uncommon for a couple to spend tens of thousands – sometimes even hundreds of thousands – of dollars on numerous IVF cycles.
And bear in mind that the fertility industry is just that: an industry. It is a business, and concerns for profit drive them as with any other business. So they are in the business of selling fertility treatment, whether or not it is always advisable or even needed.
But more important are the medical concerns. First and foremost, IVF is not a panacea. Success rates are still very low indeed. Perhaps only 15 to 20 per cent of couples actually end up with a baby. Thus the great majority will go away without a child, and without a lot of their money.
But health risks abound. The death rate of newborn IVF babies is around 11 per thousand, which is much higher than the national average. And around two in five IVF births are multiple births, which is problematic in itself. Studies have found that the high prevalence of twin and triplet pregnancies associated with IVF is linked to developmental problems and neurological complications in the IVF babies.
Also, IVF results in a higher rate of premature births, which are often associated with mental and physical retardation, and sometimes death.
There are also risks for the mothers. One study found that women who had been treated for infertility were three times more likely to develop ovarian cancer than women who were not.
Moral problems also arise. Consider the large loss of human embryos in the IVF process. Far more embryos are lost in the process than result in pregnancies. Indeed, multiple embryos are deliberately created to increase the success rate of the procedure. But what happens to all the spare embryos? Often they are simply destroyed; flushed down the sink. In seeking to create human life, these procedures end up taking perhaps even more human life.
Social problems and identity issues also come into play here. We are now just getting to discover how children feel about the whole IVF and ART process. As they reach adulthood, many have complained of a sense of alienation, insecurity and root-lessness.
And what of those conceived with, say, anonymous donor sperm? Many children conceived by IVF have spoken of the loss and/or confusion of identity. In an age that emphasises knowing one’s roots and searching one’s genealogy, the dilemma of IVF children is greatly heightened. As one young woman put it, “I’ve always felt like a social guinea pig, an experimental guinea pig. . . . I am absolutely adamant from my experience and from the experience of other people like me that any form of anonymous donation is a violation of our human rights and our identities.”
Family issues also arise. The mother-father-child family unit is being stretched and reconfigured almost out of recognition in these new biotechnologies. Consider these examples. A number of fertility clinics have admitted that fathers are donating sperm to their infertile sons to help them have children. Just how will the child feel as a result of such a union?
In England a woman has given birth to her own grandchildren. Her daughter had IVF treatment, and used her mother as a surrogate, by having the embryos implanted in her, ending up with twins. Talk about strained relations! And in another bizarre IVF case in Britain, a set of twins born via IVF have three mothers and two fathers. One of the three mothers is their grandmother, who has delivered her own grandchildren.
As much as possible, children deserve their own biological mother and father, not a set of various “parents” or a committee.
Finally, there are philosophical problems. Do we have a right to children? What is the relation between parent and child? Does a parent own a child? The difficulties of such questions are highlighted with issues like surrogacy. Who is the parent? Who is the owner? Who does the child belong to?
As one bioethicist notes, we have “a right to try for a baby whenever we want, but that is not the same as claiming the right to a baby. Slavery was abolished because we recognised that one person could not use another to fulfil their needs, and we need to be cautious before responding to the heart-rending pleas of couples who say that they need to have a child to fulfil their aspirations.”
In sum, we perhaps need to be a bit more cautious before throwing our arms wide open to IVF and ART. While infertility is a genuine source of heartache and grief, it is questionable whether these procedures are always the proper answer.
Perhaps we should put more money into the causes of infertility. Our research dollars should be aimed at solving or relieving these problems, instead of pouring money into treating the symptoms. And perhaps other options, such as adoption, need to be more fully explored.
Infertility is a very real nightmare for many, and we can all sympathise with those experiencing it. But we should think more carefully about the various shortcomings of the new reproductive technologies before we further head down this path.