On the Edges of Science and Law

From Rabbits to Humans: Transplanting Wombs

  By Sarah Blenner

In 2000, the first human womb transplant was attempted in Saudi Arabia.  The transplant failed when the 26 year old woman developed a blood clot and the transplanted uterus had to be removed.  But now scientists believe that they are close to perfecting a reproductive technology that could solve some women’s infertility: transplanting a womb into a woman who lacks a functioning uterus. 

Infertility affects one in six women.  Some women are unable to get pregnant because they either do not have a uterus or do not have a properly functioning uterus.  At least 15,000 women in Britain alone are infertile because of a condition associated with uterine function.  A woman may lack a uterus because she has had a hysterectomy or may not have a properly functioning uterus because of a medical condition, such as intrauterine adhesions, also known as Asherman’s syndrome.  Currently, if women without a properly functioning uterus wish to have children, they must either adopt or turn to surrogacy.  Despite the availability of these alternatives, some women want to bear their own children and are willing to undergo surgery to achieve pregnancy. 

Motherhood Divided: What Should Happen When a Clinic Gives a Woman the Wrong Embryo?

By Lori Andrews

When Carolyn Savage learned she was pregnant through in vitro fertilization, she and her husband Sean rejoiced.  A few weeks later, though, they received devastating news.  The clinic had implanted the wrong embryo in her.  Rather than carrying their own genetic child, Carolyn was carrying the embryo of another couple.

While some women might have chosen to terminate a pregnancy, the Savages' own moral beliefs precluded that option.  So instead, they selflessly went forward with the pregnancy, agreeing to turn the baby over after birth to the child’s genetic parents.  The one thing Carolyn Savage requested was a moment for her and Sean to be alone with the baby.  She said, "We want a moment to say hello and goodbye."

In an interview on the Today Show, Carolyn's absolute emotional pain comes through.  Whatever abstract legal ideas currently exist about the weight given to genetic bonds over gestational bonds, Carolyn had already begun a nine-month relationship with this child.  And, to make matters worse, she will not be able to carry another child.  If she and her husband want to procreate further, they will have to hire a surrogate mother to carry their remaining embryos.

"Is That Your Grandmother? No, That's My Mom!"

GUEST BLOGGER Marilyn Boskey

In 2006, Maria del Carmen Bousada received in vitro fertilization (IVF) from the Pacific Fertility Center in Los Angeles, CA.  At age 66, she was well above the 55-year-old age limit.  Bousada claimed that they did not ask her for any identification, and she simply told them she was 55.  With the birth of her twin sons in December 2006, she became the oldest new mom, according to the Guinness Book of World Records (although that record now belongs to a 70-year-old-woman in India).  Whenever she was criticized for being too old to have children, Bousada would cite her own mother's 101-year life span.  Unfortunately, soon after the birth of her sons, she was diagnosed with a tumor.  Bousada died this week at the age of 69--her twin boys are only 2.

This is only the latest in a string of news stories that paint IVF in a negative light in recent months.  The birth of octuplets to Nadya Suleman and the recent divorce proceedings between Jon and Kate Gosselin, who used IVF twice to give birth to twins and sextuplets, have caused many to question the regulation of IVF as well as the psychological and physical effects on children. An article in The New York Times provides data that 70% of survey respondents want tougher standards on IVF, and 50% believe that women over the age of 45 are unfit to become mothers.  Although assisted reproduction has allowed many young families the opportunity to have children when they cannot naturally, it has also lead to questions such as the one Maria Bousada's death creates.  How old is too old to be a new mom?

Sperm Donors, Products Liability, and the Rights of Children

By Lori Andrews

When I first started working in the infertility field 25 years ago, the AIDS crisis had emerged, but doctors still were not screening sperm donors for the virus.  One doctor actually said to me, "I didn't screen my wife before I had children with her, why should I screen a sperm donor?"

The infertile couples didn't see it that way.  There might be lots of reasons to have a child with your spouse, but when couples go to infertility clinics, they are specifically trying to have a healthy baby.  Yet, due to lack of screening, children created through sperm donation have been born with AIDS, hepatitis, cytomegalovirus, and a variety of genetic diseases.  No mechanism exists for sperm banks to learn of the children's problems and stop using the donor for future pregnancies.

Deciding the Fate of Frozen Embryos

By Lori Andrews

What do Nadya Suleman and Barack Obama have in common?  The mother of octuplets and the President whose Executive Order allows funding for embryonic stem cell research have raised questions about the fate of frozen human embryos.

Over half a million human embryos are frozen in in vitro fertilization clinics across the country.  After Glenda and Scott Lyons had a child through in vitro fertilization, they decided to donate their 14 excess embryos to two other couples.  This month's Good Housekeeping contains an in-depth report of the couple’s decision and the unique family tree that resulted, with seven biological siblings being raised in three different families. 

Coerced Korean Egg Donor Loses Case

By Julie Burger

Debate over embryonic stem cells heats up once again, between proponents claiming the technology will be a panacea to cure the world's ills and opponents contesting the hype and raising ethical and legal issues.  One such issue hit the Korean courts on February 18—the coercion of egg donors.  The saga began when Hwang Woo-Suk, a South Korean researcher, was hailed for his groundbreaking research after he reported in Science in 2004 that he had successfully cultivated human embryonic stem cells from cloned embryos.  One year later, he reported the creation of patient-specific stem cells.  Both articles were retracted after reports surfaced that much of Hwang's work had been fabricated.  As the story unraveled, more ethical and scientific violations were revealed.

Hwang submitted duplicative photographic images of cells to Science which he falsely claimed supported his creation of different cell lines in 2005.  He also manipulated the DNA testing of the cell lines to support his desired results.  Allegations abound that Hwang switched samples to cover up the falsification of data and potentially embezzled research funds.

CDC Data Highlights a Need for Regulation of Infertility Docs

  By Jake Meyer and Lori Andrews

The Suleman octuplets have captured Americans' hearts, but the actions of the mother and doctor have raised people's ire.  Blogging here last week, Dr. Bruce Patsner pointed out that self-regulation of the infertility industry is insufficient to protect women and children from harm.

Infertility specialist Richard Paulson told Time that we shouldn't use "this incredibly rare event" to legislate.  But the practice of transferring too many embryos is far from rare and suggests that the billion dollar infertility industry needs stricter oversight.

The Octuplets: A Medical Mistake Needing More Regulation?

GUEST BLOGGER Bruce Patsner

The spotlight and the story line have been shifting continuously since the news of the delivery of octuplets by Nadya Suleman was first announced by Kaiser Permanente Medical Center in California on January 26, 2009.  Staged photo shoots of the smiling faces of dozens of physicians and nursing staff involved in the historic Cesarean delivery of the eight premature infants (only the second known living set of octuplets in the U.S.) were quickly replaced by interviews with family members and efforts to secure multi-million dollar contracts for morning talk show appearances.  However, public amazement quickly turned to consternation and in some cases outrage when it was revealed that the birth mother was divorced, unemployed, disabled, on food stamps and already the mother of six previous children.  Kaiser Permanente is asking California taxpayers to foot the bill for the octuplets' seven-figure hospital bill.

Infertility specialists almost immediately began to question the rationale for implanting all eight embryos, and a noted medical ethicist immediately labeled the conduct of all parties concerned "unethical."  A determined but unsuccessful effort began to keep the identity of the infertility specialist who implanted eight embryos from becoming known in the face of mounting public and medical criticism.  Two weeks after the octuplets' birth, the California Medical Board announced that it would investigate the infertility specialist for potential violations of the standard of care.  Ms. Suleman asserted in an interview with NBC News that "Those [the embryos] are my children, and that's what was available and I used them. So, I took a risk. It's a gamble. It always is."

Octuplets: Medical Miracle or Medical Mistake?

  By Lori Andrews

When octuplets were born at Kaiser Permanente Bellflower Medical Center in California, the doctor overseeing the 46 health care professionals in the delivery room called the event "marvelous" and described the mother as "courageous."  But was the event really marvelous?  Or was it a public health nightmare of fertility treatments gone awry?

Between 1980 and 2003, the number of higher-order multiples (triplets or more) increased four-fold.  The prime culprits responsible for this rise in multiples are fertility drugs and in vitro fertilization (IVF).  While other countries regulate the number of embryos that can be transferred to a woman during an in vitro fertilization treatment, the U.S. does not.  As a consequence, one in three in vitro fertilization births involves multiples. 

Divorce, Bioethics Style: Can a Kidney Donor Get His Organ Back From His Ex?

  By Lori Andrews

New options in medical therapies, including reproductive technologies and organ donation, provoke heated debates among philosophers and physicians.  But these therapies also create disputes in the unlikeliest of places:  divorce courts.

When a man has an infertility problem, his wife can be inseminated with donor sperm to create a child for the couple.  But what if the couple later split?  Initially, some ex-wives tried to deny their ex-husbands visitation rights, saying the men had no biological bond to the children.  And some ex-husbands tried to shirk child support, saying "I'm not that baby's daddy."  Courts initially fumbled (with a 1956 Illinois court decision holding that donor insemination constituted adultery, even if the husband consented).  But ultimately, courts and most state legislatures came to a solution that benefited the child: a man who consented to the insemination of his wife has the rights and responsibilities of a legal father.