First off a Happy Thanksgiving to all of you. It’s been a long fall from my point of view and I’ve been less then satisfied with my ability to get posts up here. Things might improve a little with the end of the semester but of course, only time will really tell. In the meantime, I appreciate all of your patience and your participation.
Now, this story from the LA Times caught my eye. It’s about a new frontier in ART marketing.
Generally if someone is going to do IVF they provide the sperm and eggs which are then combined in a lab to create pre-embryos. If people are not using their own gametes they generally obtain sperm and/or eggs from banks or clinics. There’s been lots of discussion here about that process of shopping for gametes and it’s good to keep that in mind. But the key thing to stress right here is that the individual(s) select the gametes and then they are combined specifically for them. In effect, the pre-embryos are custom made based on the elections of the customers.
As a part of this process, more embryos are usually created than are needed. This leads to the extra embryo problem–something else that has been discussed here. The LA Times article says there are over 500,000 extra embryos in storage in the US.
Dr. Ernest Zeringue offers a different approach. Here’s how it works:
Zeringue sharply cuts costs by creating a single batch of embryos from one egg donor and one sperm donor, then divvying it up among several patients. The clinic, not the customer, controls the embryos, typically making babies for three or four patients while paying just once for the donors and the laboratory work.
In other words, he chooses the gametes and creates the pre-embryos and then offers them for sale. The advantage here is that it works out much cheaper for the people using IVF–cheap enough that he can offer a guarantee. It seems to me that it is rather like buying off the rack instead of having items custom made. (I think the economy is generated from being able to use all the embryos created in a batch.) The LA Times article explores the controversy around his practice.
There’s one important concrete thing to note at the outset–all the embryos created from one batch of sperm/eggs are full genetic siblings. They’ll end up in a dozen different families, though. Obviously you have to be willing to accept this if you go this route. And it isn’t clear to me whether there is any thought that eventually these children might meet each other. (It looks to me like this is not contemplated. And there are also all the usual questions about anonymous gamete providers.)
So what to think about this? Most obviously, anyone who objects to the use of third-party gametes will object to this. That’s pretty straightforward.
But that, it seems to me, is the easy route. The harder question is could you be okay with the gamete market and not okay with this? In other words, is there a difference between selling gametes (OK) and selling pre-embryos (not OK). If you say there is, how do you explain where you are drawing your line? What is the difference between selling eggs/sperm and selling pre-embryos.
It’s clear that a number of people think there’s an important difference.
“I am horrified by the thought of this,” said Andrew Vorzimer, a Los Angeles fertility lawyer alarmed that a company — not would-be parents — controls embryos. “It is nothing short of the commodification of children.”
(Vorzimer runs the Spin Doctor blog and discusses this at more length there.) Then there is Dr. Robert Klitzman, a bioethicist at Columbia University, who says
“It gets kind of creepy. There is a yuck factor. We need to proceed very carefully.”
(I’m afraid this doesn’t strike me as very insightful analysis.)
I confess that, for the moment, I am of two minds. If I can go out and buy sperm, buy eggs and then pay someone to put the two together, how is that so very different from just buying the end product? Granted I have more control over the makeup of the final product if I buy each component separately, but if I’m willing to give up that control?
It’s already the case that scores of embryos are created that are not needed and end up in freezers. If anything, the practice here means fewer embryos kept on ice and more transferred to develop into children. I suppose this is a good thing rather than a bad thing, isn’t it?
I know the concern is commodification–that it brings us ever closer to buying/selling children which I (and virtually everyone else) agrees is off the table. But the exact argument seems murky to me. If you can buy all the parts needed and the services to put the parts together, too, is that so very different?
Something to think about while we all digest our lovely meals over the weekend perhaps?