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S. Lochlann Jain Headshot

We Must Regulate Reproductive Technology

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Fifteen years ago this week, news that scientists in the U.K. successfully produced a cloned sheep named Dolly sparked intense concern and debate across the U.S. President Clinton reacted quickly, banning the use of federal funds for human cloning research and called on privately funded researchers to voluntarily implement a similar moratorium.

But while the country feared a dystopic future of rampant human cloning, the unregulated use of another reproductive technology had already slipped under the radar at untold human cost.

Between 1980 and 1998, the rate of multiple births in the U.S. skyrocketed more than 400 percent due in large part to the use of assisted reproductive technologies, like in vitro fertilization. Women over the age of 40, who typically experience the most difficulty conceiving, embraced the new technology along with their doctors.

What's wrong with an increasing number of older moms having twins, triplets, or quadruplets?

Multiple births and pregnancy over the age of 40 are each serious risk factors for premature birth. Over the last 25 years, as the use of IVF became more common, the premature birth rate in the U.S. climbed by 36 percent. This increase should give us all pause. Premature birth is a major cause of mortality, severe physical and cognitive disability, can cost hundreds of thousands of dollars in immediate medical costs, and potentially far more for society as a premature baby with life-long health complications grows into an adult. Despite these serious public health repercussions, the explosive growth of the IVF industry has taken place exclusively as a private contract between a woman and her doctor without government oversight.

To be clear, the government should not be in the business of deciding whether women in their forties should be permitted to use IVF. But with the average cost per live birth through IVF totaling forty-one thousand dollars, patients and their doctors want to maximize their chance of success. As a result, roughly 40 percent of IVFs in the U.S. today involve the transfer of three or more embryos.

This is a flawed and dangerous precedent.

A recent U.K. study demonstrated that transferring three embryos instead of two made no difference in the rate of live births in older women. However, the transfer of three or more embryos in any age group did significantly increase the risk of complications like premature birth and low birth weight. Unfortunately, the IVF industry has a financial interest in downplaying the major health ramifications that result from their practices.

With the U.S. fertility industry worth an estimated three billion dollars, IVF is a major income generator for medical institutions. To generate business, fertility specialists publicize their statistics on live births rather than thriving babies. After the embryos are implanted though, these doctors walk away -- too often from difficult pregnancies, ill babies, and the life-long struggles of the children and parents resulting from prematurity.

This unregulated free-market approach to fertility is nothing short of human experimentation based in financial incentive and medical hubris.

With the ever-rising costs associated with raising children, deferring pregnancy is often times the only viable option for many women. Whether by choice or necessity, as more and more individual women wait to have a child, the collective result is an enormous increase in the creation of expensive premature babies. A week in a neonatal intensive care unit costs upwards of $110,000 per week. My former partner's child, born through IVF at 24 weeks and 1.5 pounds, was in an NICU for three months.

Since the costs are collectively borne, the responsibility should be collectively shared.

The fetuses created by IVF will ideally become healthy people. But the IVF industry needs federal oversight to ensure that the children produced have the maximum chance of growing up to be healthy adults. By looking only to statistics about live births, rather than quality of life, the medical industry has been able to separate itself from its complicity in these too-often tragic situations.

Responding to the cloning debate in 1997, President Clinton said, "Any discovery that touches upon human creation is not simply a matter of scientific inquiry. It is a matter of morality and spirituality as well." Congress must regulate the number of embryos fertility specialists can transfer through IVF. It's not that having a baby isn't worth the tens of thousands of dollars that IVF costs. But the people with the most to lose from its unregulated use are those least able to consent: the potential children produced.