Bionic parents and techno-children

Author Liza Mundy talks about "designer babies," the "epidemic" of twins, and why assisted reproduction is the world's biggest social experiment.

By Lynn Harris

Read more: Genetics, Pregnancy, Infertility, Life

May 9, 2007 | Fertility technology giveth, and fertility technology taketh away. In a custody case for the new millennium, a U.K. woman named Natallie Evans recently lost a much-publicized legal battle for the right to try to get pregnant using embryos fertilized by her former partner. The pair had created the embryos via in vitro fertilization before Evans underwent treatment for ovarian cancer, which left her infertile. Following their breakup, her ex withdrew his consent for their implantation, which would be required by U.K. law; the European Court ruled that her desire to be a mother did not override his desire not to be a father, and ordered Evans to destroy the embryos, which represented her last chance for biological children of her own.

The controversial case engendered much public soul-searching about what it means, today, to be a mother, a father, a partner, an embryo -- along with discussion of what options technology might have offered, or could still offer, Evans and her putative offspring. If only she'd frozen eggs, not embryos! If she used a donor egg and donor sperm, perhaps she could still experience pregnancy! If she offered the embryos for "adoption," they wouldn't be destroyed!

Here in the U.S., fertility is estimated to be a $3 billion industry. Nearly 50,000 U.S. children were born via IVF in 2003, a 128 percent increase since 1996; 30,000 had donor sperm for dads. Donor eggs or embryos, gestational carriers (surrogates), screening of embryos for serious disease: Taken all together, the techniques of advanced reproductive technology (ART) add up to more than private discussions between doctors and would-be parents, more than individual stories of heartbreak and bliss. And according to journalist and author Liza Mundy, ART is not just changing "how we think" about parenting and procreation. In her exhaustively reported and tenaciously argued new book, "Everything Conceivable: How Assisted Reproduction Is Changing Men, Women and the World," Mundy observes that virtually every trend documented in the most recent National Vital Statistics Report is related to fertility technology. ART is changing us all: our very society, our very cells.

But maybe you're done having children, or are pretty good at it, fertility-wise, or not interested in the first place. How does ART have anything to do with you? For one thing, private decisions have public health implications. Your children could be exposed to chemicals today that will affect their fertility tomorrow. (According to Mundy, some researchers suggest that sinking teen pregnancy and birth rates may be due in part to environmentally induced reduced sperm count in teen boys.) Or, thanks to the prevalence of fertility treatments, the "epidemic" of multiple births -- now, one out of every 33 U.S. children born is a twin -- could, given the common medical challenges of multiples, contribute to steadily increasing healthcare costs. ART has sent such tremors through the political terrain that even (some) feminists are speechless and some super-conservatives -- like the director of "embryo adoption" agency Snowflakes, interviewed by Mundy -- are saying things like, "Family is not just that little nuclear genetic family it was in the 1950s." Writes Mundy: "Assisted reproduction is having a social impact as profound as the widespread availability of the birth control pill in the 1960s, and the passage of Roe vs. Wade ... in 1973. Now, the same sort of impact is being created by newer technologies that permit people to create children rather than avoid them."

Salon recently interviewed Mundy about the results of what she calls a vast, "radical" -- and ongoing -- "social experiment."

Your idea for this book came, in part, from an article you wrote for the Washington Post about poor people and infertility -- in response to which you received some very scathing letters. Why do you think assisted reproduction arouses such judgment and hostility?

I think all issues having to do with children and how we raise them attract hostility and judgment. Anybody who writes about work and family issues -- you know you're going to experience a torrent of opinions about the choices that you've made. People are just very opinionated about how other people form families. The technology and the science probably exacerbate that. I also think there is a fear that with these technologies people are going to be able to "design" their babies and choose what sort of child they want to have. That obviously raises the level of alarm, and in some cases it should. But I hope with my book to broaden the picture by providing a lot of real reporting about the choices people are making.

One thing you say in your book, though, is that we're actually a long way from "designing" our own babies.

It's true that the science of genetics and genetic diagnosis is moving forward, but people have the sense that science is rocketing forward, and I think when discussion happens around these technologies the assumption is that "designer babies" are either happening now or are about to happen. But people are completely unaware that the problems now have to do with aspects of technology that have not rocketed ahead -- for example, doctors and scientists not being able to diagnose in advance which embryos will "take" [in an IVF cycle] and the resulting problem of multiple births. While the general public often thinks of IVF patients as picky parents poring over donor profiles, in truth, so many IVF parents I interviewed are all too happy to do whatever they need to to care for twins and triplets born under challenging circumstances: hovering in the NICU unit over premature babies, driving three sick kids to three different pediatric appointments, taking care of, say, a triplet set in which two children are fine and the other is born with a touch of scoliosis, or vision issues, or hearing problems. In the here and now, IVF science is driving up rates of infant mortality and prematurity, and all the complications that ensue.

In fact, it's important to keep in mind that in some ways, IVF science is driving evolution backward rather than forward. While assisted reproduction may someday lead to a master race of genetically designed humans -- the future always looks like Uma Thurman, doesn't it? -- in the here and now what it's doing, often, is creating babies who are at a disadvantage, rather than unfairly enhanced. This is true of techniques that allow men with very low sperm counts to procreate, creating, in some cases, infertile sons. Through the procedure called ICSI [intracytoplasmic sperm injection, for men with low sperm counts], widely done now, where you can inject a sperm directly into an egg, infertile men could have sons likely to inherit the same genetic issue and to need the same treatment. Scientists and doctors recognize that there may be other genetic issues with some infertile men that are now being introduced into the gene line of their sons and possibly exacerbated. Doctors even joke about creating the next generation of infertility patients. There's even one doctor who's done a mathematical calculus showing that thanks to ICSI someday every man will be infertile.

Next page: Reproductive "choice" has been co-opted by the fertility industry