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Motherhood at 40 and the Bioethical Quagmires of Reproductive Technology

Miriam Zoll's new book, "Cracked Open: Liberty, Fertility and the Pursuit of High Tech Babies" explores a transition into womanhood and motherhood.
 
 
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The following are excerpts from Cracked Open: Liberty, Fertility and the Pursuit of High Tech Babies  by Miriam Zoll, including chapter titles. (Interlink, May 2013)

One Egg, Please, and Make It Easy

I am an official member of the Late Boomer Generation. We grew up after the Pill and the Baby Boomers, in the socially transformative 1970s and ‘80s, watching with wide eyes while millions of American women—some with children and some not—infiltrated formerly closed-to-females professions like medicine, law, and politics. This exodus from the kitchen into the boardroom created a thrilling, radical shift in home and office politics, in the economy, and in relations between the sexes.

“Shoot for the stars,” some of the more thoughtful women advised us, “but don’t forget about the kids.”

We are the generation that also came of age at a time of burgeoning reproductive technologies. We grew up with dazzling front-page stories heralding the marvels of test-tube babies, frozen sperm, surrogates and egg donors; stories that helped paint the illusion that we could forget about our biological clocks and have a happy family life after—not necessarily before or during—the workplace promotions.

Each week newsstands brimmed with stories about older celebrities becoming mothers with the help of miraculous fertility treatments. A few years ago, photographer Annie Leibovitz birthed her first child at the age of fifty-two, while actress Geena Davis delivered at forty-eight and supermodel Christy Brinkley at forty-four. More recently we read about singers Mariah Carey and Celine Dion delivering twins at forty-one and forty-two, and actresses Courtney Cox and Marcia Cross became mothers at forty-three and forty-five, respectively. From where we stood, science and technology was the New God, giving women once considered over the hill a chance to start a family in middle age. Whether we knew it or not, we comforted ourselves in a security blanket of medical and media reassurances that age and motherhood no longer mattered.

***

On the morning of our first appointment at the fertility clinic, Michael and I were nervous and excited. The clinic literature cited studies claiming, “Well over two-thirds of all couples seeking treatment for fertility- related problems become parents.” It didn’t occur to us then to ask if this statistic meant that two-thirds of parents birthed their own babies or a donor egg or embryo baby, or if they became parents through adoption or surrogacy. We were as green as could be about what to expect and what to ask, and we were eager to hear how the doctors thought they might help us.

The world’s first test-tube baby had been born in Britain in 1978. Data from the European Society for Human Reproduction and Embryology indicates that globally in 2012, approximately 1.5 million assisted reproductive technology (ART) cycles were performed and roughly 1.1 million failed (77 percent). In the United States, the Fertility Clinic Success Rate and Certification Act of 1992 requires the Centers for Disease Control (CDC) to publish self-reported ART pregnancy “success rates” from almost 500 fertility clinics scattered throughout the country. In 2010, the most recent data available, there was an overall failure rate of 68 percent. With no standardized reporting mechanism, the rates are based on cycles that require manipulation of egg and sperm outside of a woman’s body. They do not take into account success or failure rates of intrauterine insemination (IUI), hormone treatments alone, or donor egg cycles that are c cancelled.

That first day, my husband and I met with two health care professionals, one who examined my female interior and another who walked us through the ins and outs of the medical aspects of fertility treatments. A marble egg sat on a little pedestal on both staff members’ desks, and at one point during our meetings they each held it between their thumb and index fingers. In the spirit of Vanna White, the former Wheel of Fortune hostess, they smiled and said, verbatim: “Like we say here at the clinic, it only takes one good egg to make a baby.” It was obviously the clinic’s mission statement. I immediately thought that, if all we had to do was find one good egg, we were certainly the right candidates for the job. How hard could that be, really? We had the best of modern science and medicine at our fingertips. I was in great mental and physical health. I exercised and practiced yoga regularly. I ate well. What more could a doctor ask from a patient? Little did I know that the process of finding one good egg would be a bit like panning for gold in a mine that had already been stripped of much of its bullion.