Happy 30th, Louise.
As I approach my 30th birthday, having delayed marriage and
children, the social and biological clock of keeping time for childbearing ticks louder.
However, thanks to another 30-year-old woman, it’s possible for me to
feel at ease. That woman is Louise Brown, the first child born via IVF. Last week marked not only her 30th birthday but thirty years of success in
giving many women and men a second chance to have a biologically-related (at least, in
part) child of their own. In fact, over 3 million babies worldwide have been
born using IVF — with over 52,000 infants born in the US, accounting for 1 percent of all
births in the country.
In conversations with my close friends, it’s been comforting to
hear that we share the same concerns about starting a family later in life. We
joke that after years of being on birth control–from condoms to
pills to patches and rings and back to condoms again–diligently trying to
avoid an unplanned pregnancy, we’re fearful that we may, in fact,
Because of assisted reproduction and the tremendous
successes gained in the past three decades, the clock is not ticking as loudly for me as it was for my mother. Instead, my generation has grown accustomed to this $3
billion industry–most of us know at least one friend, family member or
colleague who has been through IVF. But this familiarity brings with it a
whole new set of concerns. What are the ethical, moral, legal and financial
impacts of this field? How do we grapple with these issues as a
women’s community, before others tell us what’s best for our bodies
and for our children? We’ve seen it before, and it will happen again.
It is incumbent upon the women’s reproductive health community,
particularly those who face these issues daily, to foster this debate. We might begin with the following concerns:
Number 1: Why is my generation of women and men more infertile than our
parents? Currently, in the US,
1.2 million (or 2%) of women of reproductive age (defined by the CDC as age 10 to 49) have an infertility-related
medical appointment each year; 10% receive infertility services at some point
in their lives. As I’ve alluded, a big factor is age. To simplify things
greatly, as more women gained equality in education and in the workplace, we
also began to delay childbearing–for many reasons, including lack
of maternity leave and inflexible work schedules.
But to highlight only age would be misleading. With so many individuals experiencing infertility (and
in cases in which the underlying causes are never found), we cannot ignore the tremendous
role that environmental
contaminants are playing in this problem. Exposure to ubiquitous dioxins,
such as cigarette smoke, lead, mercury and some agricultural pesticides are
direct threats to a couple’s ability to conceive or have a healthy
pregnancy. And, more troubling, new research suggests that a broader range of
chemicals–including many that are associated with everyday products
such as household cleansers, flame retardants, personal care and beauty aids,
and even plastic water bottles–could have a complex and far-reaching
impact on fertility.
Number 2: Are these procedures–the hormones, the retrieval of
eggs, the implantation of one or multiple embryos–safe for women and
their children? The answer, for the most part, is that we don’t know.
While IVF has generally been accepted as safe by
the American public, there are in fact very little published data, let alone quality, standardized data, on
the short and long term safety of these procedures on women and
children’s health. As we see an increase in women going through these
procedures for either their own reproduction or to donate their eggs, how can
we fully inform them of the potential risks and benefits?
Number 3: The growth of this industry and the growth in the numbers of
assisted fertility clinics (now at 475 in total) have increased the demand for
women’s eggs. While most clinics offer women an average of $3,000 to $8,000, some
"baby brokers" have offered as much as $50,000-80,000 for specific egg
donors. (The American Society for Reproductive
Medicine’s (ASRM) guidelines allow for women to be compensated for
their time and risk up to $5,000 or $10,000 in some cases, but this is neither mandated
nor regulated by either state or federal law.) This issue poses its own
ethical and moral dilemmas: should a woman be compensated for donating her
eggs? Can payment create a coercive or exploitative situation? What are the
race and class implications of who demands and who gets solicited for their
As with many momentous events in my life, as I approach my 30th birthday, I’m asking myself more questions than I know answers. I have found
that asking questions–and listening to a broad range of voices who have
their own personal and insightful answers–is the first step in the process in
advocating for change. We must grapple with these issues and then propose
solutions that follow our values and morals. So, in that vein, my parting
question: what policies will empower all
women to make their own decisions about having a child and yet protect her
health? The answer to this will be the best 30th birthday present
for me and Louise.