I was going to write something about the award of the Noble Prize in medicine to the developer of IVF. But my friend from Down Under, Carolyn Moynihan of Mercator Net said what I wanted to say:
There is something quite ironic in this week’s award of the Nobel Prize to Robert Edwards for the development of human in vitro fertilisation. During decades in which the whole thrust of reproductive medicine was to render fertile women infertile for 99 per cent of the time, Dr Edwards and later his colleague Patrick Steptoe were perfecting techniques for turning infertile women into mothers.
And yet these two grand projects are only apparently contradictory. Both pushed medicine away from its basic curative function and towards a social engineering role: efficient contraception would suppress bodily rhythms to make every child a wanted child; IVF would make wanted children appear even when the body was not fit to conceive.
In pursuing this path, both contraception and IVF gave birth to a new and arrogant attitude to human beings at the very beginning of their lives and in their dependent years. …
If you could treat a foetus with a heartbeat, fingers and toes as a mis-timed product of conception, how much more the human embryo of only a few days who really did look like a “clump of cells” under the microscope. By the time a live baby was born from IVF in 1978, Dr Edwards had been fertilising human eggs for nearly 10 years, and the wastage of new human lives continues to be a necessary part of the technology. Those that do develop but are flawed are discarded.Before long, embryos who passed muster but were surplus to requirements at the time were being stored in freezers, “waiting to be transferred in utero or, more likely, be used for research or to die, abandoned and forgotten by all,” …
Donor eggs, donor sperm and IVF together have turned the “wanted child” into the “must-have” child wanted by anyone at all: sixty-year-old women, single women, same-sex partners. And, increasingly, it has to be exactly the “product” desired: the right sex, or the right genetic make-up. The rights and welfare of the child are no longer paramount; adult desires trump all other considerations. …
But here we run into another deep irony: the hope IVF held out of a technical solution began to function as a reason to delay childbearing and thus became another cause of infertility.The reproductive revolution unleashed by the contraceptive pill encouraged delayed marriage and child-bearing. Indeed, that was the whole point of it in the minds of those who produced the pill out of concern about the mid-twentieth century “population explosion”. Over the last four decades that delay has steadily increased, so that the median age of mothers giving birth (married or not) has risen from the mid-twenties to around 30 in some developed countries. …
Delay can reduce fertility in other ways as well. The flip side of the reproductive revolution is the sexual revolution — the increase in sexual partners during the uncommitted twenties that raises the risk for sexually transmitted diseases, which in turn can lead to infertility from pelvic inflammatory disease and blocked fallopian tubes. Indirectly, IVF contributes to such lifestyle-related risks in a culture where marriage and child-bearing are delayed.On balance, Dr Edwards’ great invention may have contributed more to infertility than it has appeared to solve. Strictly speaking it has not cured any type of infertility, it has only circumvented it, and in doing so has failed both medically and socially.
His was a clever scientific breakthrough which, however, was fundamentally unethical and a massive distraction from the quest for real solutions to infertility. That the Nobel Prize committee cannot see it devalues the prize and sends a misleading message to young adults, who already have more than enough incentives to squander their fertility in the — largely vain — hope that technology will rescue them.