PKP Plenaries: Dr Zeynap Gurtin
On 25th July 1978, a baby called Louise Brown was born. She was the first IVF baby, and the start of a revolution in reproductive technologies.
The second plenary lecture of the Pembroke-King’s Summer Programme 2018 was perfectly timed. The day before Louise’s 40th birthday Dr Zeynep Gurtin gave her talk on “New Family Forms and Frozen Eggs: Lessons on Reproduction for Millennials”.
The development of Assisted Reproductive Technologies (ARTs) since has been a long road. In many ways the implications of Louise’s birth are only just becoming clear. The only living member of the team that made Louise’s birth possible – Bob Edwards – didn’t receive a Nobel Prize for their work until 2010. It took that long for the global community to accept that an IVF baby could grow up to be healthy. We’re still learning what the invention and proliferation of ARTs means for modern families.
In the last 40 years we’ve gone beyond IVF to develop more ARTs; sperm donation, egg freezing, surrogacy, and shared motherhood are just a few examples. Scientific advances combined with social change have led to new family forms, and there are now more than 6 million IVF babies throughout the world. Not only that, but research has found that family form – such as the number and gender of parents - has no impact on the happiness and success of children. It’s all about family behaviour, and children born through assistive technologies often actually do better in developmental terms than other children as they grow.
However, Dr Gurtin cautioned that IVF, and other ARTs, are not panaceas. There’s significant inequality in terms of access to IVF as well as disparity between states. Of the 1.5 million ART cycles carried out every year, most are through private healthcare in developed countries. In developing countries concerns about overpopulation have led to a reluctant to offer ARTs despite their widespread use elsewhere. Even within regions the use of ARTs is not uniform. There are different laws between even France, the UK, and Germany. They’re also not a guaranteed fix; IVF only has a 33% success rate. There’s a risk that ARTs, now a profitable global industries, are becoming over-hyped.
The scientific developments are fascinating and important, but equally so is the human element. The development and use of ARTs is connected to the social context of people staying in education longer and marrying later. Over the last forty years people’s attitudes to long-term relationships and parenthood have changed, and there’s been a general move away from settling down early in life, particularly for women.
There’s also ethical questions to consider. ARTs offer important possibilities, including preventing infertility, enabling lifestyle options, preserving fertility, and avoiding passing on genetic diseases. None of this means we should ignore sociological concerns around child welfare, the right to reproduction, cultural differences in regulation, and potential for exploitation. The benefits and the risks deserve equal attention.
Dr Gurtin illustrated some of these complicated questions with examples of ‘first-case’ families, whose use of ARTs placed them at the forefront of scientific and social change. In the first case of posthumous conception, for example, Diane Blood used her husband’s sperm after his death. While she was able to successfully use his sperm posthumously, and had his name put on the children’s birth certificates, the case raised questions about consent that are hard to answer conclusively. Dr Gurtin also talked about the first case of two men appearing on their children’s birth certificates, instead of the biological parents. This started a debate in the UK about the purpose of birth certificates. Her third example was Thomas Beattie, a transgender man who became pregnant using his eggs and donor sperm after his female partner was unable to have children. All of these cases started debates that have no easy conclusion, and invoke strong emotion in supporters and critics alike.
Dr Gurtin’s talk was a clear illustration of how science and society are inextricably tied together. We’ve come a long way since Louise Brown’s birth forty years ago but we still don’t have simple answers to many of the challenges posed by ARTs. Whatever the future of ARTs will be, research like Dr Gurtin’s will be a crucial part of navigating our changing world.
Read about the first PKP Plenary lecture on the blog, and look out for our article on the third lecture by Dr Sarah Nouwen next month.