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Pandora's Baby: How the First Test Tube Babies Sparked the Reproductive Revolution

A Conversation with Robin Marantz Henig about Pandora's Baby

Q) What drew you to this subject of test tube babies, or in vitro fertilization, and its place in our culture?

A) When I listened to the contemporary debate about reproductive technology — which in 2003 means methods like cloning and preimplantation genetic diagnosis — it all sounded so familiar. Concerns about creating genetic monsters, treading on God's territory — a lot of these fears were the same ones I remember hearing thirty years ago, before the first test tube baby was born. I thought it would help enlighten the current debate for people to hear how it played out with IVF.

Q) Was there a predecessor form of medically assisted fertilization that was as controversial as IVF?

A) Yes, but that was basically before my time, though I write about it in the book. The controversy over artificial insemination by donor, which dates back to the early twentieth century, sounded a lot like the subsequent controversy over IVF. In fact, infants born after artificial insemination used to be called test tube babies.

Q) What was the biggest surprise you came across in your research?

A) That in debates over reproductive genetics, we've been arguing the exact same points for thirty years — sometimes even verbatim, sometimes even with the same detractors and defenders making the same pronouncements.

What was also surprising, and sort of gratifying from the writer's point of view, was how quickly things changed in our attitude toward IVF. In 1973, when an attempt was made to create a test tube baby for John and Doris Del-Zio, the procedure was considered so dangerous and scary that Raymond Vande Wiele, the boss of the scientist involved, opened up the test tube and stopped the experiment. But just five years after that, Louise Brown was born — and Vande Wiele lost the case that the Del-Zios had brought against him. And here's the part I find the most interesting: in 1983, just ten years after Vande Wiele saw IVF as a terrible intrusion into the natural order of things, he became codirector of the first IVF clinic in New York City. That's how quickly attitudes changed in a single decade.

Q) How much of in vitro fertilization research was regulated in the early days?

A) In the 1970s the federal government had a hands-off policy toward IVF. The research itself was controversial, with anti-abortion activists complaining that it was toying with God's proper role and that discarding some of the embryos thus created would be as bad as abortion in terms of throwing away a human life. So the government decided not to fund any research that might involve human embryos, human fetuses, or IVF.

The result was that the research continued anyway, but outside the reach of the federal government. It became something of a cowboy science, supported by desperate patients and engaged in by some of the most far-out research entrepreneurs of the day.

Q) Has the regulatory situation changed at all?

A) IVF is still basically unregulated, and it's controlled more by market forces than by government oversight. But the government seems to have learned the wrong lesson from IVF as it considers how to regulate a new generation of reproductive technology. Realizing that it was a mistake to refuse to support IVF research — supporting it would have given the feds some control over how it was done — Congress now is talking about outlawing controversial new research altogether. This is why we have debates these days about banning cloning, not only "reproductive cloning," which is intended to create a cloned baby, but even "research cloning," designed to generate embryonic stem cells that might be useful in the treatment of a range of degenerative diseases. The lesson we've learned, it seems, is not to confront controversial research and figure out how to regulate it, but to clamp down on it altogether, as though it were possible — or even preferable — to keep such science from taking place.

Q) What do you think about some of the biggest controversies in reproductive genetics today?

A) I think these controversies reflect our generally ambivalent attitude toward scientific progress. On the one hand, we are fascinated by what genetics can tell us, and we love the idea of knowing everything there is to know about what our genes look like, which genes are responsible for which disorders, what it means to be normal, how we can eliminate disease and disability, and how genetics can help us create a world — including all living things, from food crops to people — that is as good as it can be.

On the other hand, the very idea of messing with genes is terrifying to many. Even knowing about genes frightens a lot of people, and it frightens me if the result is that we ascribe ultimate importance to genes in a way that reeks of biological determinism. I think our genes help explain a lot of things about us, but they don't explain everything — they don't lock us in to a particular fate.

Q) Can you be more specific about what you think about such issues as genetic engineering, gene therapy, surrogate mothering, preimplantation genetic diagnosis, and human cloning?

A) My attitude can probably be summed up as "proceed with caution, but proceed." Inserting new genes into cells doesn't bother me unless we do it for whimsical reasons, like making sure we won't go bald. It worries me to start messing around with sperm and egg cells, but I don't really see a big ethical difference between doing that and changing the genes in a fetus or a newborn baby — in both cases you're trying to ensure some sort of specific future for a child, but you don't necessarily know what you're doing.

Q) Would you say the same thing about cloning — that it's okay to proceed?

A) I must admit that I'm not as troubled by it as a lot of thinkers seem to be — maybe because I don't believe that genes are an explanation for everything. Yes, the clone will have exactly the same DNA as the donor, but everything else about it will be different, beginning with the egg in which the genome grows, the uterus in which the egg grows, the family in which the baby grows. All those environmental influences will, I think, have an effect on how the particular genome is expressed. I think if you create a baby who has exactly the same genes as, say, Bill Clinton, you're not going to end up with a boy who will grow up to look and act exactly like Bill Clinton — unless the Clinton clone also goes to Yale, is raised by a single mother, and eats too many Big Macs.

Q) How are cloning and in vitro fertilization different? How is that difference crucial in the larger discussion about scientific inquiry and its benefits to human life?

A) I was surprised, as I talked about my book to friends and relatives, at how little people really understand about human cloning. Very few people realize that cloning starts out a lot like IVF — something takes place in a petri dish that will grow into an early embryo that gets implanted back into a uterus and grows into a baby — but everything about the genetics involved is different. In IVF, what's put into the petri dish is an egg and a bunch of sperm, and fertilization takes place the way it always does, the only difference being that it happens in the laboratory instead of in a woman's body. But with cloning, what's put into the petri dish is an egg whose own genetic packet has been removed, and into which is placed the genetic packet, or genome, of a single individual rather than of two individuals, the mother and the father. If cloning were done on a large scale, it would subvert the normal mechanisms of evolution, which depend on the mixing up of male and female genes to keep the species strong.

I like to say that the biggest difference between IVF and cloning is what we're afraid of. With IVF, the biggest fear always was that the technique might fail. With cloning, I think the biggest fear may be that it might succeed.

Q) You use the phrase "slippery slope" a great deal in your book. What exactly does it mean, and what impact do you think it has had on research into IVF and other forms of reproductive genetics?

A) I think of the "slippery slope" argument as being very antiprogress, and it worries me. What it says is that once you take a first step in using a new technology, you're heading down an inevitable slide toward worse and worse applications of that technology. In other words, the first step itself might not be so bad, but since it could lead to other things, it shouldn't be taken in the first place. I use the phrase a lot in Pandora's Baby because it was the argument used most forcefully against IVF in the early days: that in vitro fertilization wasn't necessarily a problem, but that it was the first step down a slippery slope toward surrogate mothers, frozen embryos, genetic engineering of babies, and human cloning. And in a way, there's something to that argument: if we hadn't perfected IVF, we wouldn't even be talking about some of these more problematic methods. But I think that the slope isn't as slippery as some people make it out to be. I think when we notice that a technology is being used in objectionable ways, there is always time to stop it.

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