Although difficult to prove, it’s safe to assume that throughout the history of conception, couples have struggled with infertility. However, the technological prowess of our age means that almost any couple can conceive with the tools now available to doctors. Now that it’s possible to produce babies in the laboratory (as opposed to the good old fashioned way - the business of baby-making has almost completely left the (bed) room. So to speak.
The first test tube baby – Louise Brown - was born in 1978 and in vitro fertilisation (IVF) remains one of the most widely known techniques used today. IVF involves retrieving the eggs from the mother and fertilising them in the lab with sperm from the father. The resulting embryo is then re-inserted into the mother's uterus to develop until delivery. IVF is usually the treatment of choice for a woman with blocked or absent fallopian tubes, through which the egg normally travels from the ovary to the uterus
This technique has changed how doctors treated infertility almost overnight. Initially, the procedure offered a 3 to 6 per cent chance of pregnancy but recent advances have increased that to 40 per cent or higher.
These days, even post-menopausal women can conceive, as can the 3.5 per cent of infertile couples who 50 years ago would likely have remained childless for life. Still, every medical advance, no matter how miraculous, comes with possible side effects. With IVF, it is an increase in the rate of multiple births, since multiple embryos are implanted to increase the odds that at least one will result in a pregnancy. While the idea of having twins, triplets, quadruplets or even sextuplets might not seem like a negative, multiple pregnancies risk not just the health of the babies but the mother as well. In addition, several studies have also shown that IVF babies have a higher risk of birth defects and low birth weight, but researchers are still not sure why.
A more recent technique called pre-implantation genetic diagnosis (PGD) was developed two decades ago to allow embryos to be tested for genetic diseases before implantation, so that only embryos free of disorders are transferred to the mother's uterus. This way, parents who carry the genes for disorders such as Downs’ Syndrome, Sickle Cell Anaemia or congenital malformations can ensure they don't pass these defects onto their children. In the Middle East, where historically small, isolated populations and a high degree of inter-marriage have led to elevated levels of genetic disease and infertility, PGD has been a godsend.
Unfortunately, PGD also can also be used to allow couples to select the gender of their embryo. While this use of PGD is banned to varying degrees in a number of countries - though notably, not in the U.S. - its abuse has already begun to create detectable gender imbalance in many developing world countries.
If the technology for gender selection is becoming more widespread, it remains controversial. Some feel that it's tantamount to "playing God" – an argument that is rarely applied to the process of artificial fertilisation, which surely falls into the same category - though others welcome having more choice in family planning.
As Science increasingly allows us to control the things we could not, future advances may allow us to ‘cheat’ Nature even more. Perhaps the day of the designer baby isn’t as far off as we once thought.
