A 40th Birthday for IVF
By Philippa Taylor
Millions of babies have come into the world through IVF. But is the net effect positive?
On July 25 Louise Brown, the world’s first baby born via in vitro fertilisation (IVF), celebrate[d] her 40th birthday.
Forty years after her birth it is estimated that more than seven million babies have been born as a result of IVF and other assisted reproduction treatments. Around 2.4 million assisted reproductive technologies (ART) cycles are estimated to take place each year worldwide, with about 500,000 babies born as a result. If rates stay at current levels, then a million people alive at the end of the century will owe their lives to assisted reproductive technologies (1.4 percent of the global population).
Forty years ago it was generally assumed that IVF would remain rare. However there has since been an explosion of assisted fertility services: intracytoplasmic sperm injection (ICSI), gamete and embryo freezing, gamete and embryo donation, embryo genetic diagnosis and surrogacy, to name some. The most common fertility treatment now is ICSI, accounting for around two-thirds of all treatments worldwide, with conventional IVF around one-third (proportions that vary across countries).
Infertility is deeply distressing and can affect every area of life for those struggling to conceive—as many as one in six couples. The Bible views childlessness as a painful, personal tragedy (Samuel’s mother Hannah’s anguished prayer illustrates the stress of infertility, as does Rachel in Genesis 30) while the Psalmist praises the God who “gives the barren woman a home, making her the joyous mother of children” (Psalm 113:9).
IVF can provide couples with a child they desperately want. And it has brought many precious new lives into being, and real happiness to millions of parents.
Therefore, many now think IVF is the answer to infertility.
But it is not. While the IVF industry and media focus on and market the success stories, the average delivery rate from ART treatments are around just 19 percent per cycle—a global IVF cycle failure rate of around 80 percent. In the UK, the Human Fertilisation and Embryology Authority reports a “success” rate of 26.5 percent. This “success” rate actually means that 73.5 percent of cycles do not lead to a birth.
Success rates for IVF diminish rapidly after 35 years of age for women, largely because of loss of ovarian follicle reserve and oocyte quality with age. Even a woman under 35 years has less than a one in three chance of having a baby per embryo transferred, using her own eggs and partner’s sperm. A woman in her early 40s only has about a one in ten chance of having a baby per embryo transferred. And the success rate drops to a mere two percent for women over 44. This is highly relevant in a time when more and more women are delaying childbirth to concentrate on jobs and careers. When celebrities in their 50s become pregnant, what the media do not tell you is that it is almost always with a donor egg (indeed, 59 percent of women over 44 years used donor eggs in their treatment).
IVF heartbreak is real. IVF is no guarantee of success, despite all too often being touted as such. Added to this is the significant financial, emotional, and physical toll that IVF can have on women.
Yet still, with one in six couples experiencing problems conceiving, the fertility industry is thriving. It is estimated to be worth over £600 million in the UK alone, with one cycle of IVF costing up to £5,000 or more.
There are some very troubling aspects of the fertility industry.
For instance, the number of babies born with health challenges (see here and here too), the use of medically unproven techniques and “add-ons,” poor regulation, the shocking commercialisation and exploitation of women’s wombs and eggs (see here too) and the change to “traditional” notions of family structure and biological parenthood, through gamete donation (which can bring much heartache to the offspring) and surrogacy. A dead or dying person can have their reproductive tissue removed to enable someone else to have a child—even a grandmother.
IVF has also opened what many regard as a Pandora ’s Box of genetic engineering, cloning, pre-implantation genetic diagnosis (screening out of embryos), embryonic stem cell harvesting, research on three-parent babies, and animal-human hybrids. Many IVF programs involve the production of spare embryos, which are then used for research, disposed of, or frozen for future use. Between 1990 and 2013 over two million were allowed to perish, according to a Parliamentary answer. Now, over 170,000 IVF embryos perish every year. Embryos are experimented on, donated to other couples, frozen indefinitely, or even turned into jewelry.
The last 40 years of IVF and ART have given many couples happiness but even more couples, dashed hopes. The next 40 years will undoubtedly bring even more possibilities for the fertility industry, but what is possible is not always right.
A moral vision, especially one shaped by a Christian understanding of the person and family, has to be prepared to say “no” to some exercises of human freedom and to turn away from technology that is possible but unwise. With fertility treatments, while we can and should use our God-given skills to help alleviate infertility, we should also be prepared to acknowledge that there may be suffering we are free to end, but ought not to, that there are children who might be produced through artificial means, but maybe ought not to be.
Philippa Taylor is head of public policy at the Christian Medical Fellowship. She is also a consultant on bioethics and the family for the charity CARE. She has an MA in bioethics from St. Mary’s University College, and, for the past 20 or so years, has been speaking, writing, advising, and working on a wide range of ethical issues.
This article has been reprinted with permission and can be found at mercatornet.com/features/view/a-40th-birthday-for-ivf/21529.