IVF: The Heavy Cost of the Nobel Prize
For the 4 million children conceived through in-vitro-fertilization, the 2010 Nobel Prize for Medicine awarded to Dr. Robert Edwards on October 4th,
is understandably, good news. Congratulatory statements are also
pouring in from advocacy groups, fellow physicians, prominent parenting
How this news plays out in the unfolding story of Assisted Reproduction and its role in shaping our healthcare, medical research, economy, the air we breathe and the soil we count on for food, depends largely on how the rest of us respond to the announcement of this prestigious prize.
Medical technology is a powerful tool that helps or harms depending on how we use it.
In the last decade and a half of my work as a fertility educator, I’ve celebrated the arrival of many IVF-conceived babies, with mothers and fathers who followed this road to parenthood attentive to internal cues, protective of their overall level of health. I have also seen women, propelled by fears of childlessness, reach for the big guns of IVF as a way of tuning out the body’s call for attention. For them, a potentially useful tool became a self-punishing weapon.
What the wave of jubilation has washed away from public view is the $5 billion-and-rising cutthroat industry. An industry competing for customers with discounts, advertising and a lure of the latest breakthrough technique.
Sadly, the sound of cheering is drowning out the voices of the many millions of women for whom IVF became a revolving door of endless egg retrievals and embryo transfers; women, who entered the promised land of Assisted Reproduction, blasted their ovaries with progressively more aggressive protocols, only to return years later, childless, broken and broke.
Motherhood and pregnancy are emotionally charged experiences. Guiding wannabe moms on the baby-making-road I have found that reproductive challenges are often linked with unresolved inner conflicts, memory of sexual abuse, birth trauma or other issues imprinted in our tissues. I have witnessed the resolution of such conflicts lead to natural conception, even for women with a history of failed high-tech treatments.
Anne Harrington, the chair of the History of Science Department at Harvard University, and author of The Cure Within speaks of this link between story and symptom: “...there is more to physical illness than can be seen just in the body; and more to healing than can be found in just pills and shots. Mind matters too: how one thinks, how one feels…And this being so, it follows that there may be other ways than those of physicalist medicine by which to heal the body of the real disorders that ail it.”
Sometimes the missing piece of the puzzle is undiagnosed Celiac disease or a latent nutritional deficiency that allows individuals to function but impedes the more challenging task of implantation, gestation and birth. A thoughtful change in diet and lifestyle can often restore balance creating a more life-friendly inner environment. The attempt to side step such symptoms by revving up our ovaries with synthetic stimulants might not only further disrupt endocrine function, it robs aspiring parents of the opportunity for healing that comes with every health crisis.
A 2002 report in The New England Journal of Medicine examined the incidence of health problems in babies conceived through in-vitro as well as children conceived through introcytoplasmic sperm injection, in which the egg is fertilized by injecting it directly with the sperm. Reviewing data from registries of birth defects, the investigators found that 9 percent of babies conceived through treatments had chromosomal abnormalities, heart, kidney, and urogenital defects—compared to 4.2 percent of babies conceived without treatments.
The investigators, as always, called for further research, stating it was unclear whether the abnormalities were caused by IVF or by the “infertile couples’ medical problems.”
For me, the study raised a different set of questions: If your car begins to break down, chances are you will take it in for repair, rather than force it into higher performance. Doesn't the body deserve similar attention? Wouldn't make more sense to address the underlying medical problems that might've triggered a couple's inability to conceive, rather than force the body into doing what it may not be ready for?
Achieving a full term pregnancy is still one of the challenges where certainty eludes even the best and the brightest. 32 years after Dr. Edwards’ historic birth announcement and millions of dollars spent on research, the chance of a healthy baby after treatment, remains low: 28.2% for women under 35, falling to 10.6% for women 40- 42.
Something about conceiving a child makes it startlingly clear that we are more than a collection of well-designed organs.
At the announcement ceremony, Professor Christer Hoog, the member of the Nobel assembly declared IVF a “safe and effective therapy,” regulated by “strict ethical guidelines.” He must’ve missed the 2009 study--one of many worrisome findings--published in the American Journal of Epidemiology showing a link between ovulation-inducing drugs and increased risk of breast cancer by 42%, 4-6 times higher risk of uterine cancer and 2-6 times greater risk of malignant melanoma.
As for strict ethical guidelines? Perhaps Professor Hoog could arrange for a private viewing of recently released Made in India, a sobering documentary about the exploitation of impoverished Indian women as surrogate mothers. Eggsploitation, a disturbing film featuring young egg-donors-- who suffered brain damage, strokes, or nearly died of complications resulting from the procedure done to retrieve the eggs –might be another useful source of information.
Technopoly -- a term coined by the late cultural critic, Neil Postman -- is a system wherein technology is always viewed as positive and of value, with little consideration of its consequences. “It is the kind of friend,” writes Postman, “that asks for trust and obedience because its gifts are truly bountiful. But, of course, there is a dark side to this friend. Its gifts are not without a heavy cost.”
This has become tragically true in the unregulated field of assisted reproduction. Unless more patients and doctors begin to speak up about the dark side of this friend, the earth-community has yet to see the immense environmental impact and healthcare costs of the rising number of state-of-the-art clinics worldwide. A dubious legacy for the not-yet-born generations of children we so fervently long to bring into the world.
Ultimately, what’s most troubling, is that a stamp of approval from such a prestigious-- albeit in this case-- poorly informed committee, will do more to serve the pecuniary interests of an exploitive industry, than the interests of couples Dr. Edwards once set out to help.