What does it mean for members of our society to practice technology-assisted reproduction, like in vitro fertilization, asked a Stanford panel Saturday afternoon in Cubberley Auditorium.
For example, “It is now technologically possible, in principal, for a brother and sister to be born 80 years apart,” said panel moderator Bruce Goldman, a science writer at Stanford. What with the increasing use of egg donors, gestation carriers and sperm donors, the concept of “normal” in reproduction and sexuality has been altered.
The panel, which discussed the ramifications and benefits of such technology, followed a performance of, “Taboos: When Harriet Met Sally,” a progressive play written by Carl Djerassi, Ph.D., the inventor of the birth control pill and a professor emeritus of chemistry at Stanford.
When Harriet and Sally, a lesbian couple living in San Francisco, use the sperm of their respective brother-in-laws to become pregnant, things go haywire. The meaning of “family” changes. Gender roles and religious beliefs are questioned.
But the audience at Stanford was generally approving of the play—and, as one panelist noted, it's probably because of where we live.
The panel discussion that followed, however, turned into a heated debate about the societal implications and risks of reproductive technologies and the right to use them.
Since 1978, with the birth of the first baby who was created using in vitro fertilization (IVF)—once called a “test tube baby”—the IVF method has been largely commended and largely condemned.
“This new and mysterious form of laboratory reproduction, the mark of ethics is that it is coherent,” said panelist Dr. William Hurlbut, MD, a physician and consulting professor of neurology and neurological sciences at Stanford.
“We need to ask ourselves, is what we're doing medically sound, is it sound for our species ... or society ... individual relations ... for the offspring?” asked Hurlbut.
But for some, the question isn't about changing nature—it's about assisting nature. “If you get a cut on your arm, and you have a doctor sew it up, your arm still has to heal itself. The doctor's stitches don't heal it. That's what we do—we're a helping hand,” said panelist Dr. Valerie Baker, MD, a specialist in IVF technology.
“More what we try to do is help where nature had a problem, rather than try to make something,” said Baker, medical director of the Stanford Fertility and Reproductive Medicine Center.
But even Baker warns to be weary with the technology. “Just because we can do it doesn't mean we should do it,” she said.
“I don't think anyone chooses to have children through reproductive technology if they don't have to,” said Melanie Thernstrom, who underwent several unsuccessful rounds of IVF and then decided to use an egg donor and two gestational carriers to create her “twiblings,” which she wrote about in a recent New York Times Magazine article.
After all, the costs of IVF are rather steep— including medications, embryologists, ultrasounds—adding up to around $12,000 for one round.
But some families are willing go that far, and spend that much, for a child to call their own.
“I've never seen someone suffer as much, including cancer, as in infertility,” said Hurlbut. "When you watch a couple going through the pain of infertility, it just wrenches your heart. You realize how fundamental to our nature—physical, psychological—having children is.”
And as far as societal implications, panelist Hank Greely, JD, said it doesn't matter. “There is no assured path of a happy family. I don't think there is a natural, single, one-size-fits-all family structure out there,” said Greely, director of the Stanford Center for Law and the Biosciences.
In fact, 1.5 percent of babies in the United States were created by IVF, and that number is growing, said Greely.
As the discussion rounded to a close, a man in a suit with a white beard hobbled up to the microphone set in the audience for questions and caught everyone off-guard.
“I was disappointed in the direction this conversation went, because this is not at all what the play intended,” Djerassi himself spoke into the microphone. “Your focus is on old hat—IVF—there's nothing new about this.”
The real problem is, said Djerassi, “within the next 30 to 50 years, increasingly fertile people will use IVF. The issue is why would fertile people use methods of assisted reproduction?”
Shouldn't we be worried about the potential for future IVF procedures to allow us to select specific genes that we want in our children? Though it has not yet been discovered how to do so, what if we could choose our child's intelligence, or gender identity, Goldman had asked earlier in the discussion. The question hung on the audience like thick fog—no one had answered.
Djerassi continued. “If you can increase the biological clock of the well-educated, ambitious woman by five years, that will have an enormous impact on a certain group of women. If you can tell a woman, 'Store your eggs at age 20, for insurance'—the same for a man and his sperm—you could get sterilized at age 20 and then birth control [Djerassi's very invention, which set the stage for IVF] would really not become the future.”