Racing along in blinkers we are well down the road in modern reproductive technology. The success rate of the treatment of infertility, which affects 10 per cent of the population, is increasing and "has been unequivocally sanctioned by usage," writes Robin Baker. In this fascinating book he goes on to postulate how techniques now used only by the infertile will be the norm for the fertile in 50 years' time, sexual intercourse and reproduction being totally separated except for the poor, who cannot afford the techniques. Fertile men and women will curse their fertility and take measures shortly after puberty to be sterilised - or blocked, as it will be called - and rely on the new technology to reproduce.
All aspects of assisted human reproduction are addressed in a novel manner by Baker, who taught zoology in the School of Biological Sciences at the University of Manchester throughout the 1980s and early 1990s, and is the author of such previous books as Sperm Wars. A tableau is set up to illustrate the practical aspects of each of the techniques discussed. For example, one to illustrate both In Vitro Fertilisation (IVF) and surrogacy involves the eggs of a woman with an abnormal womb being fertilised by her husband and incubated by a friend. The possibility of selective abortion is considered when three eggs implant. The question is which foetus shall be aborted - and this becomes very complicated when it is discovered one foetus is the child of the husband and the surrogate mother!
The clinical conditions, the medical and scientific techniques are described clearly and concisely. Some are a little stomach- churning, for example, the maturation of human sperm in rat testes, and the transplantation of the rat testes into the man's scrotum. This means rat as well as human sperm will be introduced into the woman's body. Baker explains why there is no likelihood of a rat-human evolving. Work on this technique is at animal stage only - but when one remembers this is for men who have lost testes due to cancer, how long before human tissue will be thus transplanted too?
The world's legal systems are lagging behind advances in reproductive technology. In Ireland we have no regulations at all. Dependence on Medical Council guidelines are useless; these guidelines have no legal status, and not all those involved in reproductive medicine need be doctors. The very least we need is an ethical or advisory committee with statutory powers to establish a register of all clinics providing human assisted reproduction. This is the central theme of the Private Member's Bill I have presented to Seanad Eireann. (The recent scandal regarding the screening of cervical smears by clinics with poor quality control shows how dangerous lack of regulation can be in health areas.)
Surrogacy arouses much emotion. The Warnock Committee, which advises on legislation in this field in Great Britain, describes surrogacy for the fertile as "totally ethically unacceptable". But as wet-nursing was condemned in the 18th century and now breast-feeding in public is frowned upon in some societies, so Baker sees surrogacy being available, not just for those who could not gestate, but for those who would prefer not to gestate.
However, there are warning words about surrogacy going wrong. A couple in California commissioned a child, but divorced before the surrogate mother gave birth, the father refusing to support the child! Dreadful legal battles continue about this case. To avoid such difficulties arising here I have suggested in the Bill that surrogacy contracts should be void and unenforceable so that everyone knows what a delicate area it is.
Women will have smaller families because reduction in infant mortality will allow them to have the optimum number of pregnancies to raise their children in the best possible circumstances. They will delay pregnancy until their late 30s, establishing wealth and status before finding a partner.
In this bright new world lone parents will be the norm, poverty, not single parenthood, being described as the problem for children in such families. Men will be obliged to pay a child tax to all their genetic children, no matter with whom the children live. Rich men could be seduced into impregnating avaricious young women who want a good income. Baker recommends paternity testing at birth, this being the time that father, mother and baby are most likely to be together. As one who works in a maternity hospital I am unsure about this - it could lead to serious disharmony in the delivery suite on occasions.
The divorce of sex from reproduction, Baker writes, means we will have more, not less, fun. Concern about contraception will be gone, but I feel he is very optimistic about the demise of sexually transmitted disease. As soon as one is defeated another spoilsport usually pops up.
Mary Henry has recently presented a Private Member's Bill on the regulation of assisted human reproduction to Seanad Eireann