IS IVF ON THE WAY TO BECOMING THE NEXT BIG POLITICAL FOOTBALL?

Briefing: A recent op-ed in The New York Times argued that the country was not ready for what was coming after IVF. We disagree and are especially taken aback by this commentary since it came from a self-described classical liberal who we would expect to support the field. The politization of medicine appear increasingly unstoppable and, because reproductive medicine deals with establishing and maintaining human life, this politization puts reproductive medicine at the center of conflict between right and left.


If you believe a recent guest essay in The New York Times by Ari Schulman, editor of The New Atlantis, “a journal of technology & society,”1 the world is not ready for what comes after IVF. What he appears mostly concerned about is in vitro gametogenesis, the production of new eggs and new sperm, most likely from stem cells. Schulman, moreover, expects society to “turn against reproductive technology” in the very near future because he perceives Silicon Valley to represent the focal point of much of today’s criticism and, as everybody knows, Silicon Valley “is getting more involved” in reproductive medicine (boy, is he right on that point!)

 

Presenting himself as a “classical-liberal critic of assisted reproductive technology,” he claims to talk for so-characterized individuals when arguing that it would be “unethical to turn the arrival of a child – which should be considered a gift – into a project in satisfaction of our own ambitions.” In short, infertility treatments are probably unethical and should be abandoned.

 

And we thought that it was the political right the IVF field had to be concerned about; but now it turns out that in our topsy-turvy world that was exactly wrong. What the infertility field really has to worry about are what the author, himself, described as classical liberals on the left. This, however, on second thought should not be too much of a surprise: After all, most of the right loves children; and much of the left, less so!

 

Have we really reached the point on the left when, if pregnancy doesn’t happen on its own, doing something about it is perceived as “unethical?”

 

Schulman presents his article as a demand “to set limits now” to the “designing of children.” We, however, would argue that almost nothing would elicit more moral resistance in the infertility field than attempts at “designing babies.” Some outliers exist in any group and the infertility field, for sure, is no exception. Polygenic risk scoring (PRS) of embryos, unfortunately propagated by some such outliers, indeed, could be misunderstood as “designing babies;” but while by no means an excuse, PRS at the current time is more a business of selling snake-oil than of “designing babies.” 

 

Not being known as defenders of PGT-A, we nevertheless have no choice but to in this instance defend PGT-A since Schulman included PGT-A among procedures used for “designing babies.” While chromosomal analyses of embryos, of course, allow for the determination of sex, to argue that PGT-A is used to select in China an “overclass” of boys and an “underclass” of girls is nonsense because China prohibits PGT-A laboratories from reporting the sex of embryos, exactly to prevent sex selection. And in contrast to many Western countries, in China laboratories follow government advisories to the dot.

 

Moreover, already years ago, CHR investigators demonstrated that, while in the U.S. (where sex selection is legal) certain minority populations (Chinese and other Asians, as well as couples from Middle Eastern countries) for cultural reasons, indeed, preferred selections for male, a large majority of Caucasians and other minorities actually preferred selections for females.2

 

How political this article basically is becomes apparent not only from the fact that it was invited and appeared on the opinion pages of the very liberal New York Times, but also by the author apparently not being able to help himself from bringing Elon Musk into the picture and describing him as having “pronatalist ambitions,” among those, “his desire for ‘smart people’ to have more children, his reported extensive use of IVF and surrogacy” (the author likely cannot differentiate between use of a gestational carrier and a surrogate3), “and his serving as a sperm donor” (we wonder about the sources for all of this information).

 

In short, just another example for the increasing politization of medicine and science in general! With reproductive medicine at the cutting age of producing and maintaining life, this medical specialty may, indeed, have to get better prepared for increasing future controversy.


References and Notes

1.Schulman A. The New York Times. September 9, 2024. https://www.nytimes.com/2024/09/09/opinion/ivf-debate.html

2. Gleicher N, Barad DH. Hum Reprod 2007;22(11):3038-3041

3. A gestational carrier just carries a pregnancy produced with an embryo produces by an unrelated couple. Asurrogate contributes her wone eggs to the pregnancy for an unrelated couple)

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The increasing challenges to publication integrity in medicine and basic sciences