5 Myths of Fertility Treatments
A host of misconceptions about test tube babies are fueled by inaccurate media reports, unethical clinic practices, and euphemistic terms like "egg donors."
Just as the invention of contraceptives freed sex from the concerns of baby-making, new reproductive technologies have freed baby-making from sex.
Yet despite 5 million such technology-assisted births, plus the recent eight by Nadya Suleman, there remain common misperceptions about "test-tube" and "designer" babies.
Myth 1: Designer babies are coming soon
Reports that we will someday be able to artificially choose a child's traits, "from a scientific point of view, are totally totally made up," said Sarah Franklin, researcher, author and keynote speaker at The Politics of Reproduction conference held Saturday at Barnard College.
Genetic selection, or pre-implantation genetic diagnosis (PGD), is not like thumbing through a catalogue and picking favorite genes. In fact, individual genes are not really chosen at all. Embryos are.
"The only thing you can reliably design is the sex of your baby — if you are willing to discard embryos of the wrong sex," said Bonnie Steinbock, a biomedical ethics professor at the University of Albany who specializes in reproduction.
PGD was developed to screen for the few diseases that are identifiable by a single gene, said Franklin. "But no one wants to do PGD," she said, detailing the possible complications, such as contamination, misdiagnosis and risk to the embryo.
As for selecting complex multi-gene traits, like height or intelligence, "even in principle it isn't possible," she said, pointing out it is antithetical to recent findings in biology.
One hindrance is the mechanisms behind gene expression, which are affected by even minute aspects of the environment. "They have cloned all these dogs and cats and even the clones do not come out the same… Even their eye color doesn't come out the same," Franklin said.
Myth 2: In Vitro Fertilization (IVF) is easy
"The media tends to report the success cases," said Debora Spar, president of Barnard and author of "The Baby Business," but failures are the norm.
According to the American Fertility Association, the effectiveness of fertility treatments declines after the age of 32 and a woman in her early 40s, using her own eggs, has only a five percent chance of achieving a healthy pregnancy through IVF. Which is why doctors hedge their bets and, if they get viable embryos, they insert several into a woman's uterus.
"But no one would recommend shoving in six," Steinbock said. In the United Kingdom, where reproductive technologies are more tightly regulated than in the United States, no more than two embryos may be transferred from dish to uterus, she said.
Myth 3: Egg donation is common
"It is egg sales," Spar corrected. Because no one wants to think about money in relation to their child, the baby business talks about "delivering hope" not "profit," she said, but it is a market like any other.
Open any college newspaper and there are ads placed by couples looking for eggs, some willing to pay up to $50,000, Spar said. Unfortunately, Franklin said, the process is less regulated than most clinical trials.
Egg "sellers," usually women in their early 20s, risk their health, fertility and, in rare cases, their lives. The primary risk is over-stimulation of the ovaries, causing them to suddenly swell and leak into the stomach and chest. According to the National Institute of Health, the complication affects 10 percent of women undergoing IVF and women under 35 are particularly vulnerable. While the symptoms, such as abdominal bloating and shortness of breath, range from mild to severe, "when women die of IVF, this is what they die from," Franklin said.
Myth 4: IVF increases fertility
Actually, a woman undergoing IVF must first take hormones to shut down her fertility cycle, Franklin explained. The prospective mother is then injected with synthetic hormones to amplify her egg production or synchronize her cycle to that of a donor's. Hormone treatment is continued throughout implantation and the early stages of pregnancy. This technique, which was first developed in agriculture, results in side effects that range from "mild to incredibly uncomfortable," Steinbock said.
Myth 5: The children will be fine
"The voice that gets lost in all these debates is that of the child," Spar said. No one knows the long-term effects of spending, as an embryo, a few days in cultured media or exposed to surges of synthetic hormones, she said.
The psychological consequences of discovering one's Petri-dish beginnings are also under-explored. And because donors are rarely tracked, questions about genetic identity are often impossible to answer. "We are making the same mistakes that we did with adoption," she said.
As for the octuplets, "for the rest of their lives they will probably have pretty serious health compromises as a result of being a multiple birth," Franklin said, adding that because of fertility treatments multiple births are on the rise.
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