Problem
More than 35 years ago, Louise Brown captured the world's attention as the first test-tube baby-conceived in a petri dish instead of in her mother-to-be's body. Today, this reproductive technology is no longer experimental; it is used more than 140,000 times annually by American women and produces more than 55,000 babies each year (Centers for Disease Control and Prevention, 2013). Many new techniques are available to couples who cannot conceive a child through sexual intercourse. The best-known technique, in vitro fertilization, involves mixing sperm and eggs together in a petri dish and then placing several fertilized eggs in the woman's uterus, with the hope that they will become implanted in the uterine wall. Other methods include injecting many sperm directly into the Fallopian tubes or a single sperm directly into an egg.
The sperm and eggs usually come from the prospective parents, but sometimes they are provided by donors. Typically, the fertilized eggs are placed in the uterus of the prospective mother, but sometimes they are placed in the uterus of a surrogate mother who carries the baby to term. This means that a baby could have as many as five "parents": the man and woman who provided the sperm and eggs; the surrogate mother who carried the baby; and the mother and father who rear the baby.
New reproductive techniques offer hope for couples who have long wanted a child, and studies of the first generation of children conceived via these techniques indicate that their social and emotional development is normal (Golombok, 2013). But there are difficulties as well. Only about one-third of attempts at in vitro fertilization succeed. What's more, when a woman becomes pregnant, she is more likely to have twins or triplets because multiple eggs are transferred to increase the odds that at least one fertilized egg implants in the woman's uterus. (An extreme example of this would be "Octomom," a woman who had octuplets following in vitro fertilization.) She is also at greater risk for giving birth to a baby with low birth weight or birth defects. Finally, the procedure is expensive-the average cost in the United States of a single cycle of treatment is between $10,000 and $15,000-and often is not covered by health insurance.
These problems emphasize that, although technology has increased the alternatives for infertile couples, pregnancy on demand is still in the realm of science fiction. At the same time, the new technologies have led to much controversy because of some complex ethical issues associated with their use. One concerns the prospective parents' right to select particular egg and sperm cells; another involves who should be able to use this technology.
Pick Your Egg and Sperm Cells from a Catalog
Until recently, prospective parents knew nothing about egg and sperm donors. Today, however, they are sometimes able to select eggs and sperm based on physical and psychological characteristics of the donors, including appearance and race. Some claim that such prospective parents have a right to be fully informed about the person who provides the genetic material for their baby. Others argue that this amounts to eugenics, which is the effort to improve the human species by allowing only certain people to mate and pass along their genes to subsequent generations.
Available to All
Most couples who use in vitro fertilization are in their 30s and 40s, but a number of older women have begun to use the technology. Many of these women cannot conceive naturally because they have gone through menopause and no longer ovulate. Some argue that it is unfair to a child to have parents who may not live until the child reaches adulthood. Others point out that people are living longer and that middle-aged (or older) adults make better parents. (We discuss this issue in more depth in Chapter 13.)
Task
Dan and Caroline are having difficulty getting pregnant. They have been trying regularly for over 2 years, and medical tests have not identified a specific reason why they have been unable to conceive a child. Caroline suggests that they consider using assistive reproductive technology to help them have a child. Dan suggests that they should adopt instead because of all of the drawbacks of such technology. List and briefly discuss three such drawbacks that may explain Dan's reluctance.