When Does the Pursuit of Pregnancy Go Too Far?
The unregulated and fast-growing ‘fertility’ industry is predicated on a tantalizing promise: ‘We can get you pregnant.’ But at what cost?
I understand, deeply, the primal call to bear a child.
I tried for more than a decade — starting at 29 — to get pregnant feeling at times like little more than a lab rat. Yet, it’s hard not to think we’re crossing into dangerous territory with headlines like ‘The three-parent baby trap — is new IVF technique safe?’ and ‘IVF will mostly be a lifestyle choice by 2050.’
Not surprisingly, the comments about IVF becoming “a normal non-coital method of having children” from Carl Djerassi, the chemist who helped develop the contraceptive pill, sparked outrage. Telegraph columnist Bryony Gordon noted that such ideas “help to perpetuate a myth that leaves many thousands of people in despair every year — the myth that fertility can in some way be controlled, switched on and off or stored up for future use.”
Fertility ignorance is epidemic it seems. Gordon describes a friend who runs a fertility clinic in central London who is:
“…slack-jawed with amazement at all the highly educated, highly paid, highly functioning couples who pass through her doors every day with only the most basic notion of reproduction. ‘People honestly think IVF is a cure-all!’ she squealed the other day. ‘I want to shake them! I want to say, ‘Do you know what it involves? Do you know how heart-in-mouth horrible it is?’ ”
Most people don’t know how ‘heart-in-mouth’ horrible it is because they want to believe science will deliver fairy tale endings. We are helped along in our delusions by glowing reporting on reproductive advances and the seductive marketing of procedures — from the latest product, ‘social egg freezing,’ to the granddaddy profit center, in vitro fertilization (IVF). What isn’t well known is that the majority of those who attempt a $15,000+ round of IVF fail.
Fertility is a funny and fickle thing. We’re counseled to cautiously guard it when we reach sexual maturity and how to actively suppress it, but we rarely if ever think about where we fit on the fertility spectrum. That remains a mystery until we either get pregnant — or don’t. We all assume we will be fertile when we’re ready — or, if not, that it’s readily ‘fix-able.’
There are ways to test for ovarian reserve and quality of sperm, but much is still unknown about why some can reproduce and others cannot. Even when you start trying to conceive in your most fertile years there are no guarantees biology will cooperate, as generations of women and men can attest. Many confront difficult decisions and realities.
My 30s were consumed with my pursuit of pregnancy, fertility-related questions: When am I ovulating? How can I ‘just relax’ when I’m doing everything right but it’s turning out all wrong? Why isn’t my uterus capable of sustaining a pregnancy? How far do I want to go down the reproductive medicine road? And, finally, the deal breaker: How much more IVF heartbreak can I take?
Compounding my difficulty in letting go of my pregnancy dream was society’s glorification of motherhood, the siren song of new treatments, and our ‘don’t give up’ culture. My experience underscored that couples face a rough road when they decide to forgo or end advanced scientific attempts at pregnancy. Those of us who are not parents face judgment (we did not want it badly enough), second-guessing (what’s wrong with them?) and suspicion (they must hate kids) that parents do not.
Now 51, after a bumpy decade coming to terms with an unexplained infertility diagnosis, I watch with concern the lengths to which women (and the industry that profits from them) will go in feeding the obsession to get pregnant.
There’s a lot of money to be made offering fertility-related procedures. The industry is projected to reach $21.6 billion by 2020. Two Australian companies offering IVF have even gone public. The industry focus in the U.S. is shifting from those diagnosed with infertility conditions to those looking for a safety net as their natural fertility window closes. Unregulated, profit-driven clinics and third-party providers are eager to cash in on the latest growth market: single, presumably fertile, women. I can see how women can fall prey to the notion of ‘eggsurance’ and sign on the dotted line to have their eggs frozen.
Frozen eggs, though, are far from a guarantee of a child. Even if eggs are retrieved before a woman turns 35 there are added health concerns for women who become pregnant in their 40s. Moreover, the added risk to women posed by the large doses of hormones required for most fertility procedures has not been well studied.
Many hurtle forward with pregnancy attempts well into their 40s wooed on by third-party brokers willing to sell the eggs or wombs of other women. They proceed focused only on the ‘must deliver a child’ objective, but what of other long-range or unintended consequences?
Once a young bride-to-be swept up in the gauzy haze of romance, I remember someone once asking me about my priorities. Was I focused on the wedding or the marriage? I began to ask myself that question in a different form as I moved further down the reproductive medicine path: Do I want to put my long-term health — mental, physical and financial — at risk on unregulated or unproven procedures or live my life?
As reproductive interventions grow more complex the risks multiply. It is one thing to put your own body on the line, but what of the emotional or physical health risks facing young women recruited to be egg ‘donors,’ or the potential stay for an infant in a neo-natal intensive care unit due to a premature birth.
We are now hearing from the first generation of children born via IVF and or donor gametes. They’re coming of age and beginning to give us a sense of their identity and health issues. From an op-ed piece, ‘What I’m Really Thinking: The IVF Child,’ came this perspective:
“I feel like a lab mouse. Sometimes headlines appear saying that our DNA may have been compromised — accidentally mixed and forever shaped by the DNA of the embryologists who worked on ‘making’ us — but then they’re refuted and it all goes quiet again.”
As much as my heart ached in the turmoil of our unexplained infertility and losses, I knew I could not saddle a child with the responsibility to make it better. Nagging worries about any resulting child’s health and identity issues was one of many reasons we stopped treatment, steering clear of pursuing donor gametes.
“Today, human rights do not apply to the donor-conceived child because her humanity has been deconstructed and she is a product to please adults, a thing to service others and be consumed. She does not have a father like other people, nor a mother. She only has donors and ‘intended’ parents.”
Not everyone will meet their mate in their 20s and start a family right away, which is a major reason the fertility industry has ballooned.
As was pointed out at an event on the future of reproduction, “there is no natural constituency” to advocate for industry oversight. Instead we are left with troubling questions:
• At what point do we cry foul on the never-ending ‘hope’ sale at the heart of fertility clinic profitability?
• How do we better monitor the short and long-term effects of IVF procedures and high-risk labor and delivery?
• What awaits women freezing eggs today, who are, in effect, becoming ‘mentally pregnant’ who don’t succeed in delivering a child in the future?
• Where is the accountability and responsibility for the health of all involved in third-party reproduction?
• How prepared are we to address questions from a generation created by IVF and donor gametes troubled or confused by their genetic creation?
• Should the fertility industry be allowed to grow unabated and broaden its scope without more rigorous certifications, standards or consumer protections?
With people at stake, we are long overdue in reaching some good answers — or at a minimum greater transparency and discussion around the complexity of these issues.
Pamela Mahoney Tsigdinos was recently named a Top Health Blogger by Time, Inc.’s Health magazine. She is the author of the award-winning book Silent Sorority and the ebook Finally Heard: A Silent Sorority Finds Its Voice. More of her writing can be found in FORTUNE, The New York Times, The Huffington Post, WIRED, and on her blog.