One road to motherhood - via science

The Baltimore Sun

Embryo Culture

Making Babies in the Twenty-First Century

By Beth Kohl

Sarah Crichton/Farrar, Straus and Giroux / 288 pages / $24

In 1978, an eternity ago as measured by advances in science and technology, the first test-tube baby, Louise Brown, was born in England. Either a tiny blessing from heaven brought into the world with a little help from a team of miracle workers in white lab coats, or a suspicious "alien life-form" manufactured in the artificial light of a petri dish, Louise was for many a Rorschach test for the rapidly growing arsenal of modern reproductive technologies.

In Embryo Culture, an account of her personal experiences with infertility and assisted reproductive technology, or ART, Beth Kohl is haunted by the specter of Louise Brown:

"I wondered whether kids who result not from ordinary sex (dimmed lights, R&B;, orgasm) but from extraordinary feats of science (hysterosonogram microdose Lupron, intracytoplasmic sperm injection) are completely normal. Are science- babies exactly like the traditional kind?"

As Kohl embarks on her travels through the world of in-vitro fertilization, egg harvesting and embryo freezing, among other things, she worries incessantly about whether her own science-babies will be marked by the somewhat mysterious and possibly even ethically murky technologies that help to bring them into being.

Of course, as Kohl reports with relief, 30-year-old Louise Brown is not a freak of nature or a mutant life form, but actually leads a rather ordinary life as a postal worker in Bristol, England. And, despite the ethical, religious and political debates, high-tech baby-making is hardly a rarity, among those who can afford it. For hopeful parents with a healthy bank account, the utterly irresistible combination of scientific know-how and the desire to make babies has resulted, as of 2005, in the birth of more than 1 million in-vitro fertilization children, Kohl writes. Kohl is comforted by these numbers and also by the thought that, at any one moment, she is "enacting the same drama as approximately 300,000 other women." She confesses:

"I desperately want pregnancy, and the fact that the science is so easily accessible, a mere matter of signing up with one of numerous area fertility clinics, makes it hard to resist even if I'm troubled that we'll spend more money to try to have a child than most people ever have to feed, house, clothe, and educate already-existing ones. And it bothers me that there are children out there who could use a loving home and that I am choosing to expend our resources in pursuit of a future one. ...

"But a force, an inner drive, is pushing me toward [in-vitro fertilization]. And anyway, if it works, we can still adopt. And anyway, there's a good chance it might not work."

Kohl's somewhat scattered and largely unexplored misgivings, here and elsewhere, about the economics of ART and about the deeper implications of the reproductive choices she makes are more a reminder to herself about the larger world that lies outside of her ART-induced psychic bubble than an expression of the issues and problems that actually preoccupy her as she goes about the business of making babies.

This kind of self-centeredness also seems to be par for the ART course, as Kohl makes her way through the punishing emotional gantlet of infertility treatment. One failed in-vitro fertilization cycle leads to the next in-vitro fertilization cycle; after pregnancy No. 1, Kohl moves on to the next ART pregnancy with its own myriad technological problems and physical challenges, each of which inspires an extraordinary degree of physical and mental concentration to manage the "meticulous record-keeping about biological processes" and to ensure all "ebbs and flows" are carefully charted, "tidy as a mathematical equation."

Not particularly fond of mystery or surprise either for herself or for her readers, Kohl puts a color photo of herself with her three daughters on the inside of the book jacket. She also refers by name to her "astonishing children" as early as Chapter 4, simply unable to contain her syrupy mother's pride in the "sweet-as-sugar blonde" with the "staggering memory" and the "quirky and charming personality," the "funny and sensitive brunette" and the "whip-smart redhead." It can hardly be considered a spoiler, then, to reveal that by most standards her tale of two pregnancies (one of which results in twins) would be considered a success story not only for herself, but also for the tanned and dashing fertility doctor who, like most professionals in the business of ART, lives or dies by the strength of his clinic's "take-home baby rate."

Although a little suspense would have been a very good thing in a book that - except for Kohl's awkward leaps forward in time - unfolds slowly, even distractedly at times, Kohl's inquisitive nature and determination to share her story keep her high-tech medical journey moving forward, providing a physical and a psychological road map to motherhood in the age of ART.

Laura Ciolkowski teaches literature at New York University. She wrote a version of this review for the Chicago Tribune.

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