Welcome to the brave new world of technology-enhanced human reproduction with its promise of alleviating the heartache of infertility, and its dangers of crossing ethical and moral lines. At a time when more options are available for women to conceive on their own timetable, perhaps hone their embryos to be free of disease and defects, and postpone childbirth until it fits their schedule, human reproduction is veering into a future that doctors, scientists, and philosophers aren’t entirely prepared for.
The New America Foundation, a Washington-based think tank, assembled a series of panels last Thursday to explore the frontiers of reproductive technology from the routine-though-still-expensive IVF (in vitro fertilization) to PGD (pre-implantation genetic diagnosis) where parents can screen embryos for potential defects, and mitochondrial intervention that produces sensational headlines like “Meet the Three-Parent Baby.”
A panel titled “Where Babies Come From” explored the three-parent dilemma created when a second woman donates an egg to provide the future baby’s mitochondrial DNA. Even though there are then three genetic parents, Dieter Egli, a senior research fellow with the New York Stem Cell Foundation, hastened to assure people there are still just two parents, that the additional DNA is “not a necessary nor sufficient to claim parenthood.”
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Other panelists rallied to the cause of “the invisible woman”—the second and generally anonymous egg donor. Charis Thompson, Chair of Gender and Women’s Studies at the University of California, Berkeley, declared herself “a huge fan of multi parenthood. Let’s acknowledge the repertoire of people making a child. Let’s celebrate the whole damn lot so that everybody has a good life.”
Mitochondrial intervention is the practice of replacing DNA that carries a genetic disease. It is intended to prevent serious diseases like muscular dystrophy, but it is hugely controversial because it could open the door to people manipulating genetic material. It’s currently banned in the United States, but the FDA is studying its safety and its efficacy. The U..K. is further along in bringing the procedure to market. “It’s a social benefit to a very small number of people, ten people a year maybe in the U.K. Is it worth crossing this very bright line that could put us into the world of eugenics?” asked Marcy Darnovsky, executive director at the Center for Genetics and Society.
Eugenics is a word that made everyone at the event uncomfortable. The moderator of the panel titled “How Far is Too Far,” said she doubted that any high-school student today would even know what the word eugenics meant, or could believe that any government could be that heavy-handed in controlling reproduction. Reproductive technologies are lightly regulated, and scientific advances fueled by financial incentives could overtake ethical and moral considerations.
The mood was lightened considerably by the co-hosts of the podcast “Mom and Dad Are Fighting.” They described themselves as the opposite of experts, and they parried about such burning issues as when is it too old to start having kids, how many biological parents are too many, and in the year 2100, if there was a pill you could take to have a baby in three months, instead of nine, should everyone in the world have a right to that?
Dan Kois, the dad in the duo, cut to the chasse when he observed, “With all these technologies, who decides who has the right to do these things, and who pays for it?” Alison Benedikt, the mom, said she wished she had her children earlier so she could look forward to a “third chapter” without children. “Now we’re all older parents,” she said of her peers.
In the panel on “Whose Business is Reproduction?” Deborah Spar, president of Barnard College, said she tells her students they shouldn’t see freezing eggs as a “magic cure all,” but that it might be an insurance policy. “If you make partner [at a law firm] and unfreeze your eggs at age 42,” you could be a big winner, she said. Still, she cautions women against falling for what is “a very clever marketing operation, but not necessarily a cure all for how to lead the perfect life.”
Asked if the ability to reproduce should be a human right, Spar said she would leave that for the philosophers to think about. “Not being able to become a mother at 65 is not a medical condition, it’s just tough luck,” she said. “With the definition of family changing, technology will always move faster than social norms, and both of them will move faster than the law.”
Spar has a new book titled The Baby Business: How Money, Science and Politics Drive the Commerce of Conception. The word conception could be changed to deception as many entrepreneurs in the world of reproduction are in the business of selling false dreams. It’s an area particularly prone to inequality, Spar noted: “Infertility crosses all economic lines, it’s one area where Mother Nature is fair, for better or worse.” Women without the resources to pay thousands for IVF lose out twice, she said, once because they’re infertile, then because they can’t afford treatment. Unequal access to this brave new world was an ongoing theme, along with questions about emerging legal structures and how to guarantee anonymity for donors in an era of increasing openness and transparency. Panelists polled each other on whether they’d be upset if they learned they had been frozen as an embryo. The answer was no, but one said if her parents lied to her about it, she’d be really upset. On the other hand, said Jane Maienschein, Director of the Center for Biology and Society at Arizona State University, “Would you be upset if you learned someone was paid to gestate you, and we don’t know what happened to her.”
Camille Hammond, CEO of Tinina Q Cade Foundation, said simply that the pathways to parenthood are different. She found hers after five years of infertility when her mother—at age 55—delivered her daughter and son-in-law’s triplets. The foundation, named after her mother, provides financial help to needy families that are infertile. “Nobody wants to stand in the way of people having families,” says Hammond.
