It Just Takes One: ICSI Comes to the Rescue of A Single Sperm

I’ve written about ICSI (that intracytoplasmic sperm injection) in the past.  It’s a technique that allows fertility docs to take sperm and inject them into the egg.  This means they can be immobile, ineffective or (I think) virtually dead.   You basically put them where they need to go.   

While there are some concerns about this technique (some say that the sperm who cannot find their way there on their own are more likely to produce flawed offspring) you can also see the appeal.  ICSI eliminates many instances of male infertility.   This story illustrates the point.     

Jason Schrialdi had but a single sperm to work with.   Remarkably, that one sperm was used to fertilize an egg produced by his wife, Jennifer Schrialdi, and this lead to the birth of their daughter, Kenley.  I guess this is newsworthy because the typical man produces vast numbers of sperm and while it is true that the actual fertilization only takes one, millions fall by the wayside before that one reaches its goal.   With only one sperm to work with, there is no margin for error at all.   

Apart from marvelling at the technical achievement, what’s to say about an accomplishment like this.  No doubt it is wonderful for the individuals involved and I do not mean to cast any cloud over that, nor to trivialize its importance.   But at the same time, it is evidence of the lengths to which people will go in order to have a genetically related child.    

This makes me think about what the source of that craving for genetic connection is.  I am well aware that many will say that it is just natural–the way we are programmed.   But I am actually skeptical about that, as I’m sure you know.   At the very least, I’m persuaded that whatever natural craving there is has been magnified by an array of cultural forces we’ve talked about here in the past.   And I’m not at all sure that this is a good thing.

In other contexts (at least as I recall) people have been critical of the ART industry, and I wonder if some of that critique is applicable here.   Men with low sperm counts are vulnerable in a number of ways.   ICSI offers them a cure for a problem that may well make them feel less masculine.   Of course the cure comes at a price–in terms of money, in terms of physical discomfort, and in terms of potential risk to the offspring.   But it is not hard for me to see why for many men (and for many couples) the price ends up seeming reasonable.

And what should we think about all this?   Is the phenomena illustrated here good, bad or indifferent?   (That’s putting it rather simplistically, I know.)   For those who care, it can be seen to validate the importance of the genetic link and allows people to have “their own” children as opposed to having to adopt or use third-party gametes.   But is it a good use of energy and resources?   Wouldn’t  we be better off if people didn’t feel they had to go to such great lengths to have a genetically related child?

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10 responses to “It Just Takes One: ICSI Comes to the Rescue of A Single Sperm

  1. That conversation we are having on ethics and executive level decision making can be applied here and again without going down that endless rat hole that is the nature vs. nurture-what makes a parent debate.

    A man who is capable of reproduction is not sterile, he just needs expensive medical assistance to place his sperm in the egg of whomever he is trying to reproduce with. Without the help he is as good as sterile and will not be able to reproduce.

    Is it a waste of money for him to pay for that help in order to reproduce himself? Maybe the desire to reproduce and the desire to raise a child to adulthood come from different places in our minds and hearts. Maybe one is vain and the other selfish. Is spending money reproducing any more or less vain than coloring your hair or getting your toes done? Is it any more or less vain than buying a flashy sports car or putting caps on your teeth? I suppose if you want to raise a child to adulthood and you also want to reproduce – its handy if you can achieve both simultaneously in one fell swoop.

    • I have some regrets now about how I couched the original post. To me it isn’t a question of whether it is a waste of money for the people involved and I do not mean to sit in judgment on their actions. It seems it is worth it to them, as the pain/inconvenience of the process was worth it to them. My question is really what should we think/say about this. Should we hail this as a great medical advance as we might herald the discovery of an anti-malaria vaccine? Or should we see this as a regretablle reflection of misplaced priorities?

      It seems to me that if you think the desire for genetically related children is natural (and hence, inalterable, I think), then this is ought to be understood as an advance. But if you don’t think it is a natural and inalterable desires (and you know that I do not) then it doesn’t look so much like a great advance. It does look a bit more like a lot of cosmetic surgery which I’m afraid is something that has been very effectively sold as a cure for a problem (aging skin, say) that doesn’t have to be a problem at all. Rather, the industry that makes money off of sale of cosmetics and surgery has created the perception of the problem in order to sell us the cure.

  2. Oh as to the ethics of opting for donor sperm over this more expensive treatment…
    erring again on the side of caution…if you believe that 1/4 the people on earth believe its important to know their blood relatives and the other 3/4 think genetic relationships are interesting but largely irrelevant – there is a 25% chance you’ll end up making a child who finds not knowing his blood relatives very painful. If you can obtain a child to raise to adulthood without having to take that calculated risk of hurting someone else in the process of achieving your own goals, shouldn’t you? Should you not opt for the method where there is no risk of the child being anguished over the whole blood relative thing? Even if it is only a remote chance and you think its silly to be upset over? Because here comes the executive decision making, you know that not being in contact with genetic relatives is a hotly contended issue you have devoted an entire blog – neigh, a career to exploring the validity of the losses claimed by people over not knowing their genetic relatives. You could not say “whoops I had no idea this might come up!” if you ended up with that odd ball kid who was troubled by it. You’d have to say “I anticipated the possibility you’d be hurt and I decided to move ahead with using the donor sperm anyway, thinking I could convince you that it was not that big of a deal” So if a guy can avoid that situation altogether why not if he has the money and is willing to spend it?

    • You could always elect a sperm provider whose identity could be avaliable to the child. And you could be forthcoming with the child about making that choice, as opposed to spending all the $$ for the genetic relationship. It would, of course, depend on how important the genetic connection was to the people–if they really care about it, then I suppose they’d best spend the money.

      • Yes but the child would still have to grapple with the idea that his or her genetic parent chose to create offspring that they were not interested in raising. That does carry with it the potential for the child to feel unimportant and discarded. It may be a small chance in your mind and it may be contrary to your own personal opinion, but someone would be hard pressed to convince a child that it never occurred to you they might feel unwanted by the bioparent who donated. If its possible to avoid the situation by raising your own offspring and its possible for you to do so physically and you have the financial resources, what exactly would be the reason to create a child who won’t be a member of all the families that they are biologically related to?

  3. Wouldn’t we be better off if people didn’t feel they had to go to such great lengths to have a genetically related child?

    Would we? In an age of (hopefully) increasing access to contraception and family planning, adoption will be less and less of a viable way of building a family. Creating a bigger market for donor sperm, donor eggs, and surrogate carriers, may be more stimulating for the economy, but unless it was available only through private funds you’d still have the same problems of public funding and/or unequal access to reproduction and family building. I’m pretty convinced that depending entirely only on altruistic donations would only lead to international black/gray markets that would exacerbate things further.

    I understand wanting to pass on you own genes, and have the chance to maybe see bits of your parents alive again in all or some or any of you children, and feel that you and your line goes on. I’m in that group.. I also understand not caring a whit about your children’s genetic background. It seems to me that some people care and some people don’t, and you may as well ask why some people prefer swimming to running, or believe in God or don’t, prefer travelling and living in many places or prefer to put down roots and settle in one place. People are different, have different experiences, and that’s a good thing, and one thing doesn’t always have to be better than another.

    Especially in this case when it’s really not clear to me that if we want to support childrearing and childbearing, it’s really less efficient to invest supporting genetic relatedness than not to. Presumably, technological development and investment now would lead to interventions and medical support becoming cheaper and cheaper, whereas human services and organ donation may well just become more and more expensive.

    Curious to hear more about why it seems straightforward to you that the opposite is the case.

    • It’s true that people value the genetic connection different ways and there are doubtless many things that influence that. One of the things, I think, is the culture (or cultures) in which we all live. It seems reasonable to me to assume that the more we read about/hear about the importance of genetic connection, the more likely we are to internalize that message. Not everyone will, of course, and different people will be more or less responsive, but in general, I’d assert the tendancy would hold true.

      Now I know that many people will assert that it isn’t simply a cultural message about the importance of genetic connection–that it is an actual truth. But this is where we disagree. I do not think it is an absolute truth–like the law of gravity, say. I think it is a construct. And I don’t think we do ourselves (as a society, as cultures) big favors when we relate to it as a universal truth or when we deny the extent to which it is culturally constructed.

      This is what lead me to question the value of the technological advances like this one and the one in the next post. I see what they do and it is undeniable that for some people they bring significant relief from suffering. That’s got to be good. But they also come at a cost–perhaps not to the people who use them, but to the rest of us. Partly that’s a cost in terms of the resources consumed in perfecting this project instead of developing something else and partly that’s a cost in terms of reinforcing the message that genetics is so important.

  4. “For those who care, it can be seen to validate the importance of the genetic link and allows people to have “their own” children as opposed to having to adopt or use third-party gametes. But is it a good use of energy and resources? Wouldn’t we be better off if people didn’t feel they had to go to such great lengths to have a genetically related child?”

    I keep thinking about this that you said above, and about our ethics conversation. Erring on the side of caution being a good rule of thumb. Doing no harm being another super rule of thumb. Being wary of self talk about what constitutes harm is another good rule of thumb.

    You pose the question wouldn’t we be better off if people did not feel they needed to go to such great lengths to have a genetically related child?

    Ok. So if someone is about to spend a bunch of money reproducing himself with his spouse and he is questioning whether or not this is an ethical path to take – who is it that would be negatively impacted by the birth of his genetically related child. You say “wouldn’t we be better off if people didn’t feel they had to go to such great lengths to have a genetically related child” Do you mean that society is better off when people are not the offspring of the people who raised them? Do you mean more specifically that people themselves are better off when they are not the offspring of the people who raised them? Do you mean that people are better off not knowing the identity of their genetic relatives?
    Are you talking about the idea that its bad to bring another person into this overpopulated world when there are many children whose parents are unable to care for them? Well that is an ethical quandary but the purchase of donated sperm is not the conservationists choice there either because a new person is still being added to the world.

    • I think what I mean to suggest is that our world would be better off if people didn’t feel that they had to have genetic-related children. That would mean that people who couldn’t have genetically related children wouldn’t feel so bad about that. It would mean that people might think more quickly about adoption, which can be a good thing if it is properly regulated and all that. It would mean that resources currently devoted to producing genetically related children could be redirected to other projects–provision of clean water, say.

      Now I understand that to you this might seem a fanciful riff. You might say that I might as well just say “our world would be better off if people didn’t need to eat so many calories to sustain life.” You can point to lots of benefits that might follow from needing less food, but the amount of food people need (and I do mean need) isn’t something we can decide to change. But remember that I think our attachment to genetic relationships isn’t like our need for food. I think it is something that is socially constructed, in the same way that our need to look young and unwrinkled might be. Thus, just as I can imagine a world where people are content to look their age, I can imagine a world where people accept that some children are genetically related to their parents and some are not.

      I do realize that this isn’t the world we have and that many people do feel like having a genetically related child is important. I see the lenghths that people go to in order to attain that goal. And of course, there’s a substantial industry built up to satisfy that desire. I just think that it doesn’t have to be this way and that we’d be better off if it wasn’t this way.

  5. You think that men who wish to reproduce themselves and raise their resulting offspring themselves are kind of blinded by their egos. You think its egocentric of them to spend all that money reproducing when it would be just as easy for their partner to become pregnant with the sperm of a donor. You think that society suffers because this ego driven, genetic-centric behavior reinforces the misconception that family is constructed around blood relations.

    I’m reading that you believe people spending money trying to reproduce themselves is unethical; not because being raised by genetic parents poses any potential risk to children, but because it reinforces cultural myths that genetic parenthood is more desirable than non-genetic parenthood. I’m interpreting all this to mean you think people should opt instead to raise an unrelated child because people who pursue genetic parenthood make non-genetic parents feel like they are not really parents.

    If you think its vain for folks to want to to raise their own offspring I’ll tell you something, asking that others not pursue genetic parenthood in an effort to bolster public support of non-genetic parenthood is just totally off the vanity charts. Wanting people to refrain from reproducing as part of a PR campaign for non-genetic parenthood takes the cake. Its a full blown narcissistic 10 for overlooking that there is 0 potential for a child raised by his or her genetic parents to feel unfairly denied the opportunity to know them and their other relatives. The child won’t sit and wonder about their who their social parent is if they don’t have a social parent in the first place. They won’t long for their non-existent social parent’s medical history nor will they pine away for a genetically inaccurate birth certificate. Choosing not to create children with donated gametes is the opposite of vain.

    You are suggesting that other people not pursue their goal of genetic parenthood because their genetic parenthood makes you feel like your non-genetic parenthood is less valid than genetic parenthood in the eyes of society. In reality, non-genetic parents are not harmed by the pursuit of genetic parenthood anymore than straight married couples will be harmed by the existence of gay married couples. I don’t think non-genetic parents need to campaign against genetic parenthood to have value in their own right. Frankly I don’t see why the two types of parenthood cannot peacefully exist in tandem without either type of parent feeling like they are less valuable than the other. Its a lot of ego from where I sit and its not terribly child centered.

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