Delivering life with one hand and death with the other


REMEMBER Louise Joy Brown, the pink-cheeked little English girl, proclaimed around the world as the first "test-tube" baby? Baby Louise is growing up -- she's 15 today -- but she has already changed the world.

"Test tube baby" was always a misnomer. It conjured up sci-fi images of tiny hands pressed against a cylindrical glass; like something out of Aldous Huxley's "Brave New World." But Louise didn't gestate in a laboratory. She was born normally. It was her conception that inaugurated a new era. Louise Brown came into the world when Mrs. Brown's egg and Mr. Brown's sperm were united in a petri dish. She was then implanted in her mother's womb for a normal nine-month term. In-vitro fertilization was, as it were, born.

At the time, in-vitro fertilization, or IVF, seemed an unalloyed blessing for infertile couples. Blocked fallopian tubes and other obstacles to normal conception seemed conquered. More than 10,000 petri-dish children were born between 1978 and 1988. But the blessed event is increasingly being seen as a mixed blessing.

Couples who volunteer for IVF are infertile. Almost by definition, they worship at the shrine of "life." But by choosing IVF, they are forced to the agonizing choice of sacrificing some embryos for the sake of others. Experience with IVF has shown that implantation of a single embryo rarely results in a successful pregnancy. Accordingly, doctors who specialize in the procedure have begun to "harvest" larger numbers of eggs from the woman's ovary, and then fertilize as many as possible. The best four or five embryos are implanted in the uterus with the expectation that only one or possibly two will thrive. Since the remaining contents of the petri dish go down the drain, the Roman Catholic Church has opposed IVF since its inception.

Not uncommonly during the first trimester, all of the implanted embryos live. That causes further problems. Multiple pregnancies are dangerous for the mother as well as the children. Even twins run far greater risks of miscarriage and birth defects than single babies. And so, ironically, after years of fertility drugs, thousands of dollars and hours of tears, the woman who has life within her for the first time is asked to choose "pregnancy reduction." With the help of an ultrasound picture of the inside of the womb, the doctor glides a needle into the chest cavity of two or more fetuses and injects them with potassium chloride. Their hearts stop, and they die.

Many doctors who perform "pregnancy reductions" are uncomfortable about it. For some, there seems to be a moral difference between this and ordinary abortion. "These are wanted children," explained George Annas, a professor of health law at Boston University. Dr. Joseph Schulman of Fairfax, Va., claims that he has no ethical problems with abortion but admitted to the New York Times that watching a colleague reduce quadruplets to twins "was not a pretty sight."

In our century, medical science has probably eliminated more human suffering than any other realm of human endeavor (especially including politics). It has liberated us from pain, disease, deformity and despair to an almost miraculous degree. But when medical science delivers life with one hand and death with the other, when human lives become exchangeable parts, it's time to re-evaluate.

The desire for children is a profound and nearly universal longing. The pain of infertility must be devastating to couples hoping to start a family. Medical science rushes in to fill the void because it can. It's up to us to question whether it should.

Are the couples who spend so many years, so much money and so much disappointment (only about 30 percent of IVF procedures result in healthy babies) in pursuit of families forgetting about adoption? As bitter as the sting of infertility must be, is it worse than the pain experienced by a baby with no one to love it? Is an adopted child any less of a blessing than one's own offspring? Just ask the parent of any adopted child. Or ask any child who's been adopted. Love and commitment between people are what define families. And so long as the world teems with babies in need of parents (which is likely to be forever), the tortuous path to in-vitro fertilization comes to seem less like a medical miracle and more like genetic vanity.

My nephew is a blood relation. My niece is genetically Korean. And while it's undeniable that Adam takes after his father, we tend to think Julie is a combination of both parents.

Mona Charen is on maternity leave. She wrote this column in February 1988.

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