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As a far from liberal or godless infertility specialist, I feel it my duty to address some of the points that George Neumayr attempts to make in his article at The American Prowler entitled “In Vitro Defects.” I want to discuss the specifics of the study that Mr. Neumayr refers to in detail, but will first address some more general points.
Mr. Neumayr states that “[t]he studies support exactly what the dismissed moralists of the 1970s argued: it is not good for children to begin their lives in petri dishes.” I guess that depends on whether you think not beginning a life at all is better than beginning a life in a petri dish. The fact remains that there are literally tens of thousands of babies born each year using these assisted reproductive techniques (ART) such as in vitro fertilization (IVF), the vast majority of which are completely and perfectly healthy. Without these techniques, these children would not be born. The part of my job that is the most satisfying is assisting these couples, who would otherwise remain infertile and childless, in bringing a new life into the world. Think about it. Would you deny these people the right to have children? I have actually had people in my religion tell me that they thought that there must be a reason that God had not allowed them to have children naturally so we ought not intervene. Using that argument, you’d have to abandon all medical treatment since, for example, if God “allowed” someone to get cancer or appendicitis, who are we to intervene?
As for the study that Mr. Neumayr refers to in his article, a few notes of caution. It is always dangerous to take news reports describing medical studies at face value. They are frequently misrepresented or their significance overstated. And that is certainly the case here. The reported incidence of Beckwith-Wiedemann syndrome (BWS) is 1 per 13,700 to 1 per 14,300 live births. This study showed a total of six cases of BWS out of 45,074 IVF births in the UK, giving an incidence of 1 per 7,149 births. Let’s assume that this study is definitive (which it is not). The incidence of BWS is twice as high in this study (which has its methodological flaws — that I won’t go into unless you want me to), but the fact remains that the incidence of BWS is still remarkably low and the chance of having a child born with this malady remote. Is a 1 in 7,149 chance of having this occur worth calling for an end to IVF or decrying it as evidence that the technology is flawed? As a matter of fact, there are numerous studies which have investigated whether there is an increase in birth defects with ART and the vast majority of them have shown there to be absolutely no difference between the naturally conceived pregnancies and IVF groups.
Mr. Neumayr goes on to state that we are “killing” thousands of embryos every year in our labs. I would like to discuss briefly my perspective on embryos. Being an infertility specialist, I do indeed assist in bringing gametes together that results in the creation of an embryo. I watch their development in our petri dishes and it humbles me to be involved in such a miraculous process. The more I learn, the more amazed I am that reproduction ever occurs much less with my help. And in the end, my experience has taught me that God is still in charge. But I have also come to know that not every embryo is created equally, and by that I mean that not all have the potential to become a viable pregnancy that will result 9 months later in the birth of a child. Of the oocytes that fertilize, only about half will grow normally and continue to divide. The ones that don’t divide or grow normally have been studied in the past and the majority of them found to be chromosomally abnormal. In other words, they were destined from the moment of fertilization to never result in the live birth of a child. Am I “killing” these embryos (or by implication a child) by discarding them? Most certainly not; they never had the potential to become a child.
And the fact that there are so many abnormal embryos is not a reflection of the technology but rather a confirmation of what has been observed in spontaneous conceptions (i.e. a high “miscarriage” rate). A study was done in which women took a home pregnancy test every day. A surprisingly high number of women turned up with positive pregnancy test results prior to their expected period. Approximately 40% of these women (with a positive test prior to missing a period) ended up having a normal period at the expected time and thus “lost” the pregnancy without knowing they were ever pregnant (or at least they wouldn’t have know they were pregnant if they hadn’t been in the study). The best information we have says that this is because that embryo created that month did not have the potential under any circumstances to become a child.
While I do think that these things need to be investigated further, it is unnecessarily alarmist to point to this study and say “Aha, I told you IVF was bad.” By far, the most common outcome in those who get pregnant is to have a normal and healthy baby. Let’s not lose sight of that fact. And let’s figure out how we can do things better.p>Respectfully, br> — Frederick W. Larsen, M.D. br> Reproductive Endocrinology and Infertility /p>
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