An article just published in the highly respected journal Fertility and Sterility ought to give anyone thinking about using “test tube” baby technology pause. A review of 124,000 children born through two very common infertility treatments -- in vitro fertilization, creating embryos in a dish and transferring them to a womb and ICSI, in which a single sperm is injected directly into an egg -- showed large increase in the risk of having a child with a birth defect. The risk was 37 percent higher than that seen in children made the old fashioned way. That is a huge number. ...

I am not anti-technology when it comes to making babies. The position of the Catholic Church and some social conservatives in opposing the creation of life with a technological assist when infertility prevents a married couple from reproduction strikes me as cruel and anti-life. And those who worry about turning baby-making into manufacturing when it is done in a clinic seem to me to have a very optimistic view about the circumstances that accompany the creation of a huge number of kids when sex is used.

That said, the large risk factor now on the table needs to be a key part of how everyone thinks about making babies in medical settings. The authors of the study say they do not know why the risk is so large. And it has taken far too long for this question to get asked. We need to be sure that long-term monitoring of children born by means of infertility treatment is routine and that more research is done into the causes of health problems for kids who cannot make choices about facing risk.

Labels: Artificial Reproductive Technology, IVF

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It has triggered a boom in risky multiple births, created a generation of children with anonymous sperm-donor parents and spawned an underground trade in semen, eggs and surrogates.

Canada’s thriving fertility industry, however, will soon be left with virtually no official oversight, after the federal government decided this week to close down the oft-criticized regulatory agency for the field.

The government indicated in Thursday’s budget there is no point keeping Assisted Human Reproduction Canada (AHRC) open after a 2010 Supreme Court of Canada decision struck down much of the law it was supposed to enforce. The agency is slated to be shuttered by next March, its remaining functions taken over by Health Canada.

And though the court said large parts of the federal legislation fell under provincial jurisdiction, the provinces have shown little inclination to step into the breach.

Meanwhile, the issues that a Royal Commission argued almost 20 years ago urgently required regulation continue to percolate: the commercial trade in sperm, eggs and surrogates; the multiple births generated by in-vitro fertilization; the effect on children of having unidentified donor parents; and the long-term health impacts of fertility treatment on women and their offspring. ...

On top of all that, the RCMP now appears interested for the first time in investigating violations of the still-active sections of the law – a criminal ban on the purchase of eggs, sperm and surrogate-mother services – despite confusion about what the sections mean.

“It’s a mess,” said Sherry Levitan, a Toronto lawyer who specializes in the area. “The industry is just tied up in knots. Everybody is worried abut the next phone call. People are very nervous because nobody knows where the line is.”

Labels: Canada, donor conception, fertility treatment, IVF, surrogate motherhood

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The biological mother of twins born in a surrogacy procedure does not have to formally adopt her babies, the Tel Aviv District Family Court decided in a precedent-setting ruling published Wednesday.

The twin babies were born last month to Jewish Israeli parents following a surrogacy procedure carried out in Tbilisi, Georgia. The case came to court after the Interior Ministry opposed the couple’s request for an injunction formally naming them as the parents.

The parents said they had decided to use the surrogacy procedure after attempts to conceive naturally failed. The twins were born following an in vitro fertilization (IVF) procedure, in which an embryo was created using the father’s sperm and the mother’s eggs and successfully implanted into a surrogate mother’s uterus.

After the births, the couple requested to be listed as parents on the babies’ birth certificates, so that the children could be entered into the Population Registry and issued passports to bring them to Israel.

Labels: adoption, Georgia (country), Israel, IVF, surrogate motherhood

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More research is needed into a controversial fertility treatment, known as three-parent IVF, before it can be considered safe for clinical use, a review has concluded.

Mitochondrial transfer aims to replace a faulty part of a mother's egg with healthy material from a donor.

This means a baby would have a small amount of the donor's genetic material, and therefore three biological parents.

The Human Fertilisation and Embryology Authority (HFEA) carried out the study.

The HFEA is the UK's independent fertility treatment regulator and its conclusions are published in a scientific review of the technique commissioned by the Department for Health.

Inherited disorders

The proposed treatment is designed to help families with rare inherited disorders.

These disorders are due to faulty energy-generating components of cells called mitochondria. Mothers carrying these faulty mitochondria in their eggs are at risk of having children with the inherited disorder.

Under the transfer treatment, the idea is to replace the faulty mitochondria in the eggs or fertilised embryos with those from eggs or early embryos from a healthy, unaffected donor.

The hope is these methods will enable couples to have healthy children and eliminate the disease for subsequent generations, but the technique is controversial because mitochondria carry their own genetic material (DNA).

Labels: abortion, Artificial Reproductive Technology, IVF, more than two parents

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As an informal guide to having children after fertility problems, Precious Babies has much to recommend it. There is, however, an omission which, as a donor conceived (DC) person, I found particularly troublesome – the book is entirely devoid of DC voices.

Quotes from parents and 'experts' are scattered throughout but the words of DC people are nowhere to be found. This lack of representation is even reflected in the title, with its emphasis squarely on babies.

Babies cannot speak. They rely on their parents to make decisions for them. However, early infancy is only a fraction of our lives. Babies will grow to become adults with their own independent thoughts and feelings about the method of their conception. ...

The section of Precious Babies that concerns DC people – the chapter on donor families – is irrepressibly upbeat. Donor families are, we are told, closer than most other families. There are DC adults who are angry and find the method of their conception difficult to accept, but that is because they found out about their origins, often by accident, later in life. The author is clearly keen to present a positive picture of life after donor conception but her argument is disingenuous – the academic literature actually suggests a far more complex reality. ...

For an alternative take on Precious Babies: Pregnancy, Birth and Parenting after Infertility from a counsellor's point of view, read Jenny Dunlop's review.

Labels: culture, donor conception, infertility, IVF

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The Michigan Court of Appeals has released for publication its September opinion in Moon v. Michigan Reproductive and IVF Center [pdf]. In that case, Allison Moon sued a fertility clinic because it would not provide services to her as a single woman. Reversing the trial court, the Court of Appeals ruled that the clinic was subject to the state's anti-discrimination law and could not avoid litigation on the basis of a doctor's alleged right to choose his patients. ...

A place of public accommodation includes a "health facility" whose services are "available to the public." Such a facility cannot discriminate on the basis of marital status.

The defendant did not dispute that it was a public accommodation, but it did argue that the law requires a doctor-patient relationship to be consensual and that therefore the doctor could decline to treat anyone. The court ruled that the doctor can decline to treat a patient, but not on one of the grounds identified in the anti-discrimination statute. "A contrary interpretation," the court held, "would allow a doctor to follow his personal prejudices or biases and deny treatment to a patient merely because he is African-American, Jewish, or Italian."

Labels: Artificial Reproductive Technology, discrimination law, IVF, single parenting

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The New York Times Magazine explores the "stigma" (undeserved? archaic? regrettable?) surrounding the emerging trend of eliminating one fetus when IVF results in twins. This is a very sad paragraph, among many:

Jenny’s decision to reduce twins to a single fetus was never really in doubt. The idea of managing two infants at this point in her life terrified her. She and her husband already had grade-school-age children, and she took pride in being a good mother. She felt that twins would soak up everything she had to give, leaving nothing for her older children. Even the twins would be robbed, because, at best, she could give each one only half of her attention and, she feared, only half of her love. Jenny desperately wanted another child, but not at the risk of becoming a second-rate parent. “This is bad, but it’s not anywhere as bad as neglecting your child or not giving everything you can to the children you have,” she told me, referring to the reduction.

I don't mean to minimize the hardship that can accompany multiple births, but this excerpt reflects an unfortunate (though increasingly common) view of parental love: a limited commodity that, when extended to one child, necessarily reduces its availability to another child. Not to mention the underlying premise that non-existence is preferable to existence in a household with "too many" kids.

Labels: abortion, Artificial Reproductive Technology, culture, family size, IVF, motherhood, parenting

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...When it is complete you screw on the forest-green lid, write your name and your wife’s name on the label, put it all in a biohazard bag, and ring the buzzer. Along comes a woman, another nurse. She takes the bag and holds it up to the light. If you read the paperwork there is a request that you don’t make any jokes during this moment.

The worst thing that can happen in that room is “failure to produce.” They warn you about it. Men go in and hours later have not come out. They’re sobbing and their arms are sore. Their wives or partners are out in the waiting room, surly from hormone treatments. No one has sympathy for a man who can’t produce. They should have sympathy but they don’t. You do not want to be that guy. And so far I have not failed. Just in case, I have special videos on my phone.

The nurse will take the biohazard bag to a room filled with machines. They will run the sample through a centrifuge. I will join my wife, who is filled with chemicals that encourage ovulation, in a treatment room. A doctor will use a plastic syringe to inject my purified and enhanced semen into my wife. Then we will wait.

Three years of waiting. Everywhere around us there are waves of bouncing sons, bounties of daughters, stroller wheels creaking under the cheerful load. Facebook updates, email messages, and Christmas cards arrive with pictures of tots, their faces smeared with avocado or cake frosting. Babies on rugs, babies in hats. Invitations to baby showers with cursive script and cartoon storks. Over a beer an expectant father—another expectant father—gives me the news, tells me that his wife will soon have her second or third. Am I happy for him? What else can I be? Once again I put out my hand, close my eyes, and wish them joy.

Every day at least once our cat Desdemona, a pretty green-eyed cat, carries a pair of clean socks in her mouth as if the pair of socks was a kitten. Then she drops them to the floor and yowls in anguish, as if she is dying. She looks at me and yowls some more. I go to her and stroke her ears and say, “I know, sweetie.” Sometimes we come home and find three or four pairs, three or four sock babies, scattered around the house.

Labels: Artificial Reproductive Technology, culture, infertility, IVF

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In October 2007 a son was born to Yigal Amir, the assassin of Yitzhak Rabin, and Larisa Trembovler, the divorcée and mother of four whom he had married by proxy while behind bars. The birth followed a series of controversial conjugal visits at the Ayalon Prison, where Amir was then incarcerated. These were in turn preceded by a lengthy court battle involving, at various times, the Israel Prison Service, the internal security service known as Shin Bet, various members of the Knesset, and the Amirs. ...

In the end, the Israeli Supreme Court ruled for Amir, determining that, like all prisoners, he was entitled to certain basic human rights, including the right to bring children into the world and to have a family. ...

In the pre-state period of the Yishuv, or Jewish community in British Mandatory Palestine, a Committee on Birthrate Problems was attached to the National Committee. It called upon David Ben-Gurion, later Israel’s first prime minister, to use both his moral and financial influence to increase the Jewish birthrate. It also asked for the establishment of a “childbirth regime” as “a cornerstone of our Zionist policy and as one of the main functions of our social and local offices; not less important than recruitment to the army, spreading the Hebrew language, purchasing land or maintaining the right for immigration.”

After the establishment of the state in May 1948, in an attempt to encourage an increase in the birth rate, Ben-Gurion introduced a birth prize awarding 100 lira, then the Israeli currency, and a signed letter to every woman on the birth of her 10th child. Though the amount itself was largely symbolic, the program received significant media attention and even became the subject of a popular dictum: “In honor of the motherland/ Ten boys to be born/ With grandeur we receive/ Ben-Gurion’s prize.”

In 1967 the Israeli demographic center was established to act systematically to realize a state policy directed at raising the Jewish birth rate. In 1968 the Fund for Encouraging Fertility was set up to offer subsidized housing loans for families with three or more children and in which one member had served in the Israel Defense Forces. The 1970 Veteran’s Child Allowance Scheme similarly provided child allowances to large families in which at least one member had served in the IDF or another national security service. Given that Jews are required to do military service—and Arabs exempt from it— some have argued these policies had a de facto discriminatory effect, supporting and encouraging an increase in specifically Jewish fertility.

Today, there are more fertility clinics per capita in Israel than in any other country in the world. Every Israeli, regardless of religion or marital status, is entitled to unlimited rounds of in-vitro fertilization treatment free of charge up to the birth of two live children (or even three, under some health insurance policies). In 1996 Israel passed the Embryo Carrying Agreements Law, making Israel the first country in the world to legalize surrogate mother agreements. According to a 2006 paper prepared for the Knesset, 1,800 IVF treatment cycles are performed each year per million people in Israel, compared to 240 in the United States. A 2010 article in Haaretz stated that Israel performs the highest ratio of fertility treatments among developed Western nations.

Labels: abortion, Artificial Reproductive Technology, contraception, demographics, Israel, IVF, natalism

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A man who had his sperm frozen in case he became infertile was astonished to learn that his ex-wife had tricked an IVF clinic into twice making her pregnant.

He then had to pay £100,000 towards the upbringing of the son and daughter he had known nothing about.

The father, a 57-year-old retired haulier, is now demanding a change in the law to ensure no other parents go through his torment.

The astonishing story begins in 1999 when the man was about to have drug treatment for crippling arthritis.

He stored sperm at the Bourn Hall Clinic in Cambridge to ensure that he and his wife, who married in 1979, could have a child if the treatment left him infertile.

In June 2000 the couple decided to divorce and weeks later she visited the clinic and forged his signature, allowing doctors to create embryos from his frozen sperm and her egg.

She gave birth to a girl in June 2001, claiming it was the result of a one-night stand, and a boy in September 2003.

When the boy needed hospital treatment for a hole in the heart, his mother’s sister phoned the haulier to reveal that both children were his.

Labels: child support, children, divorce, Fathers, IVF, United Kingdom

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Roger Abdelmassih is on the run from police after being convicted of sexually assaulting or raping 39 female patients at his clinic.

New evidence gathered by police and public prosecutors suggests that many of the 8,000 babies born after IVF treatment by him and his team may not be the biological children of the couples raising them. There is no suggestion this is the case with Pele.

Labels: Artificial Reproductive Technology, biological parenthood, Brazil, IVF, parenting

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That mature lady sitting on the playground bench beaming at her toddler may have some gray hair, but don’t call her “grandma.” She may well be a member of America’s fastest-growing fertility group: mothers 40 and older.

And if she is one of these “midlife moms,” she would appreciate a little more respect.

No observer, for instance, can know what Kelli Suchy and her husband went through to become parents.

“It wasn’t a choice on my part” to marry at 39, endure six in vitro fertilization (IVF) procedures, lose two pregnancies, and then finally adopt at age 45, said Mrs. Suchy, founder of parentingbyadoption.com.

Angel La Liberte, who entered “babyland” when she was 41 and again at age 44, created FlowerPowerMom.com to “tell the truth about motherhood after 40.”

This Mother's Day, Mrs. La Liberte and others are launching an online campaign to build support for older mothers and jettison phrases such as “advanced maternal age” and “geriatric pregnancy.” ...

These women are not selfish or absent-minded. “No woman forgets to have a baby,” Ms. La Liberte said.

Instead, she said, women born in the 1960s, like herself, became part of an American social experiment that told them to pursue education and careers first.

“When I was in my 20s,” everyone thought “the idea of getting married and settling down right away was basically foolish,” said Mrs. La Liberte, who married in her late 30s.

There was a new social script for us, and “I think we are the ‘test generation’ for that,” she said.

Female fertility, alas, has not always cooperated, and no one knows this more than midlife moms.

“I met my husband at age 39 and married at 40,” and immediately began trying to have a baby, said Sharon Simons, founder of momatlast.com. ...

But hundreds of thousands of women have late-in-life childbirths that do not make the tabloids. In 2009, more than 105,000 babies were born to women ages 40 to 44, and almost 8,000 more were born to women ages 45 to 54. More than half of these children were first- or second-borns.

Labels: adoption, aging, culture, demographics, donor conception, economics, infertility, IVF, Marriage, motherhood

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Family Minister Kristina Schröder said on Monday she would try to make life easier for German couples who cannot have children naturally, with stronger financial backing for IVF treatment and easier adoptions. ...

The Family Ministry estimates that nearly one in 10 couples aged between 25 and 59 were involuntarily childless and reliant on medical help.

Schröder said there needed to be more financial help for treatments such as in vitro fertilisation (IVF) and more opportunities for adoption.

“I find it intolerable if the hope for children is dashed because of money,” she said. “I get many letters from couples who tell me how they painstakingly scrape together the money, then despair when it doesn’t work, and start saving again – all that with the pressure of the biological clock ticking.”

In any case, Germany urgently need to help such couples because of its sinking birth rate and looming demographic challenges, she said.

Labels: adoption, Germany, infertility, IVF

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ALMOST 500 single women and lesbians have used IVF and other fertility treatments in the past year in Victoria.

Taxpayers are subsidising the women who plan to raise children without biological dads, the Herald Sun reported.

The law was changed in January 2010 to allow Medicare rebates for women who are not infertile to access assisted reproduction.

IVF clinics are reporting a significant number of women accessing their services for the first time in Victoria. ...

Dr McBain said donors had no obligations, no responsibility and no rights - but once a child turns 18 he or she has access to identifying information about their donor.

Melbourne IVF has just launched a new online campaign to attract more sperm donors.

Labels: Artificial Reproductive Technology, Australia, donor conception, Fathers, gay parenting, IVF, motherhood, single parenting

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Ryleigh Shepherd was conceived in 1998, the same year as her 11-year-old twin sisters, but she wasn't born until 2010.

The three girls from Walsall, in Great Britain, who were born more than a decade apart in two different centuries, are actually fraternal triplets born through in vitro fertilization (IVF).

Ryleigh came from the same batch of embryos that had allowed her parents -- Lisa and Adrian Shepherd -- to give birth to twins Megan and Bethany.

British experts say they know of no other case in their country in which three siblings from the same round of fertility treatment have been born with such an age gap.

The longest interval between freezing and conception was in the case of a woman from New York City whose embryo had been stored for 20 years, according to a report in the journal Fertility and Sterility.

"It seemed strange to think that we were using embryos that we had stored all those years ago, that were conceived at the same time as the girls," Lisa Shepherd, 37, told Britain's Daily Mail newspaper.

"We knew that if we had another baby it would in effect be the girls' triplet as they were all conceived at the same time," she said. The girls look exactly alike, according to their mother. "It was uncanny."

Labels: Artificial Reproductive Technology, IVF, siblings, United Kingdom

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The government today delivered its promised "bonfire of the quangos", abolishing 192 government agencies, merging another 118 and substantially reforming a further 171.

Thousands of jobs will go and as many will be transferred into new departments. It amounts to the biggest shakeup of government the coalition has made to date.

Health bodies are dealt a particularly heavy blow with the Health Protection Agency being scrapped and its functions brought into the Department of Health. The Human Fertilisation and Embryology Authority, the Human Genetics Commission and the Human Tissue Authority will all be scrapped.

The BBC World Service and the British Council have both won reprieves and the Equality and Human Rights Commission will be retained, though its regulatory functions will be substantially changed and its budget is expected to be dramatically reduced.

Labels: donor conception, IVF, United Kingdom

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Angela Carter once said that "paternal parentage is often clouded in a way that maternity is not." She was talking about Wise Children, her novel concerned with the slippery, unknowable nature of paternity.

The essential mechanics of reproduction have always put women at an advantage in any question over parentage. We know the truth, whatever it may be, about our offspring; men just have to take our word for it. But in the time since Wise Children was published, this imbalance has shifted. For some women, the idea of maternity is suddenly not so assured.

Last month, Carolyn Savage from Ohio handed over her baby to its biological parents. She had been implanted with the wrong embryo after a mix-up at a fertility clinic. This came after a number of other IVF errors. In June, a couple from Cardiff were told that their last remaining frozen embryo had been mistakenly implanted in another woman, who had since had it aborted. In the same month, it was revealed that a white Northern Irish couple had given birth to a mixed-race baby, after being given the wrong sperm. And the instances go on. A Californian woman was awarded $1m in 2004 after a fertility specialist gave her the wrong embryo and hid the mistake until the baby was 10 months old. A white New Yorker gave birth to a black baby in 1998, sparking a complex, two-year legal wrangle between the two couples for visitation rights.

In vitro fertilisation is a booming industry. Around 12,500 babies a year are born in the UK as a result of IVF. More than 36,000 women a year attend the UK's 136 clinics for treatment. That's a lot of embryos in a lot of petri dishes in a lot of freezers. You can see how the occasional mistake happens: all it would take is a technician's moment of inattention, the phone ringing, a colleague asking a question, and – just like that – the wrong petri dish is plucked from the shelf and a terrible, private tragedy is set in motion.

The number of cases which come to light is small but it begs the question: just how many of these slip-ups go undetected? ...

One fertility counsellor – who does not want to be named – says that she deals with an increasing number of people who fear that the clinic may have made a mistake. "It's an issue for a lot of couples, particularly the women. Mothers need to be sure of that bond and it's not uncommon to experience doubt."

Labels: Artificial Reproductive Technology, gender differences, IVF, motherhood, parenting

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The British government's embryo research authority has warned potential parents that children conceived artificially through in vitro fertilization have a thirty percent higher risk of genetic abnormalities.

Reports of higher levels of birth defects among IVF children have been making headlines since at least 2003, but the Human Fertilisation and Embryology Authority (HFEA) has only this week issued a warning on the matter. The HFEA said that parents should be told of the risks associated with IVF, but emphasized that not all the risks are fully understood and more research is needed.

...The risk of birth defects in the general population is low. Two per cent of children in Europe are born with birth defects. Some research suggests there might be an increased risk of 30 percent for babies born as a result of ART. This would mean that the risk rises to 2.6 percent, which is still low. There is not enough data to be more precise but this is the best estimate currently available.

Research to date cannot say with absolute certainty that this increased risk is due to ART. Other causes including the original cause of infertility, the age of the patient or other unexplored factors cannot be discounted.

In order to make sure patients understand the risks of ART as well as they can we keep research of this kind under review. And where it suggests there may be a greater risk we share this information with patients in a clear way to help them understand the risks associated with the choices they are making.

However, we still do not know the complete picture. All we can say with confidence is that there is a small risk associated with ART in general.

Labels: Artificial Reproductive Technology, IVF

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