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IVF: a miracle of science

This article is over 13 years, 6 months old
Thirty years after the birth of the first "test tube baby", John Parrington looks at ongoing debates around fertility technology and its provision
Issue 2111
 (Pic:» Tim Sanders )
(Pic: » Tim Sanders)

Louise Joy Brown was born on 25 July 1978 at Oldham General Hospital – and the effects of this event still reverberate around the world today.

For Louise’s mother, her new daughter was “truly a gift from god”. But while the birth was indeed a miraculous event, it owed nothing to god and everything to science, for Louise Brown was the world’s first “test tube baby”.

For those who think that scientific progress is inevitable or straightforward, the story of Louise’s birth is instructive.

On the one hand it shows that pioneering discoveries sometimes have to be pursued against bitter opposition.

On the other hand, the fact that reproductive technologies have never been considered entirely “respectable” means that even today the fruits of this medical advance are denied to many ordinary people.

Like many scientific “breakthroughs” Louise Brown’s birth was the culmination of many years of study. In particular, creating the correct chemical environment in which an egg and a sperm could come together to make a new life was far from trivial.

Even when success was achieved with “in vitro fertilisation”, or IVF as it is more commonly known, in animals, many people were opposed to its extension to humans.

Indeed the British pioneers of the IVF revolution, Robert Edwards and Patrick Steptoe, were initially regarded, in Edward’s words, as “immoral, unethical, dehumanising”.

In circumstances that echo those surrounding the development of the contraceptive pill, Edwards and Steptoe were repeatedly denied public funding and could only continue their research because of donations from rich individuals.

Currently in Britain around 8,000 babies are born each year by IVF – around 1 percent of our annual births.

Yet lack of provision on the NHS means that almost 80 percent of women seeking fertility treatment are forced to do so at private clinics, where a single IVF cycle costs around £3,000 and multiple cycles are often required.

Ironically, the country where IVF was pioneered is one of the worst public providers of this medical treatment in Europe.

Researchers at Sheffield University have recently calculated that while it costs £13,000 to create a baby using IVF, each child contributes £147,000 in taxes and insurance to the British economy.

As Britain suffers from a falling birth rate, and with infertility affecting one in nine couples, the researchers argue that if IVF provision were totally free to everyone who needed it, then this would pay for itself in terms of benefits to the British economy.

Of course we should be wary of assessing health needs only according to an accountant’s balance sheet. Surely if the technology exists to help otherwise infertile people to have children then this should be a basic human right?

Worryingly, infertility is on the increase, and it is also worth considering whether there are other solutions to the problem besides purely technological fixes. One issue is that many women are choosing to have children later in life.

This is one benefit of the advances in contraception that have given women more control over their lives. The downside is that fertility decreases with age. In today’s pressurised society, many couples delay having children not out of choice but because of work constraints and high childcare costs.

If we truly wanted to address the problem of increasing infertility, then IVF should be free to all, but so should decent maternity and nursery provision.

This was after all the situation during the Second World War, when it was deemed necessary for the “war effort”.

One consequence of IVF is that embryos can be screened for particular genetic diseases and only those embryos without a defect used to make a baby.

Some disabled rights activists argue that this represents discrimination against people with disabilities – and even a form of genocide akin to that practised by the Nazis.

I understand why some disabled people might hold these views given the discrimination they face in society, but it is surely only possible to equate selection of embryos with the murderous activities of the Nazis if one sees a ball of cells in a culture dish as the same as a living child or adult.

We also shouldn’t underestimate the suffering and shortened lives of people with diseases such as cystic fibrosis or muscular dystrophy. Deciding to select against one’s own child being born with these conditions is quite compatible with the fight for rights and better provision for disabled people.

It is also important to remember that the vast majority of disability is due to accidental causes. A society that was not ruled by profit would devote far more money to understanding and treating genetic diseases, as well as better provision for disabled people and greater safety at work.

John Parrington is a scientist at the University of Oxford. One of his main research interests is the study of fertilisation and embryo development


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