She sees the whole situation demanding these services as very concerning. In the case of an otherwise healthy woman with tubal defects or other reproductive injury, neither of us sees an ethical problem with offering a treatment whereby the patient could have a baby. However, both of us agree that a large fraction of these fertilizations should not be performed both for medical and ethical reasons.
First of all, there are usually good reasons the patients are having trouble conceiving. A lot of them have poor egg or sperm quality with markedly higher percentages of observable defects. Poor sperm with low motility normally wouldn't survive the trip up the uterus and into the tubes to fertilize. Low counts have a lower probability of successful implantation. Poor eggs more often fail to accept a sperm. In-vitro bypasses those deficiencies, but at a price. Babies born by in-vitro fertilization have higher birth defects, more immune system problems, and lower intelligence quotients than children conceived naturally (this in a population of parents able to afford the procedure). It would seem that the process abets undesirable combinations by failing to cull poor sperm and bad eggs. Then we take these (for lack of better words) less optimal combinations and implant them under ideal or even augmented circumstances doing everything possible to make sure they survive where they might otherwise be rejected by the body through a spontaneous abortion.
More disturbing is the ICSI process (Intracytoplasmic Sperm Injection), wherein a sperm is injected directly into the egg. The rate of birth defects and other congenital problems subsequent to this process is very high, in part because the procedure bypasses the usual process wherein an egg selects a compatible sperm. If you ever wanted to see the hand of God in conception, it is there.
Also disturbing (to her) is the number of couples entering the clinic who seem, upon first appearance, to be totally incompatible, just plain bizarro couples. She says half her job is managing frayed emotions of unstable women jacked up with hormones and suffering in rotten relationships. This is to say nothing of the number of lesbians visiting the clinic.
It used to be that the clinic only accepted stable married couples. In recent years with fewer cash patients and lower rates paid by insurance companies, the clinic is now accepting larger numbers of just about anybody in order to remain a profit center for the hospital. If the work wasn't so interesting, I don't think she would be doing it, preferring to take care of babies instead.
Studies are all over the map on this. I've never heard of the immune system problems. The IQ claim is bogus as followup studies have no lasting effect on IQ. You also have to be careful when reading the studies to find out if there were early deliveries, etc.
More disturbing is the ICSI process (Intracytoplasmic Sperm Injection), wherein a sperm is injected directly into the egg. The rate of birth defects and other congenital problems subsequent to this process is very high...
Only if you consider going from 4% to 6% "very high".
I'm with you on wacky couples, although there are plenty of them having kids without IVF and you can question motivations there as well. Society is what it is.
I've seen mixed info on the studies...I will say that the IQ argument seems to be pretty much nonsense because of all of the other factors that impact prior to being able to test.
As far as the spontaneous termination of the pregnancies, that still happens quite a bit in IVF cases, whether from failure to implant or other problems doesn't it? It seems the body knows what it's got once it is there and acts accordingly.
Thanks for the info.