Louise Brown, the world's first test-tube baby, turns 25 today, and it certainly seems like a reason to celebrate. Brown is by all accounts a healthy, normal young woman, and her birth opened the door for a million or so childless couples worldwide to fulfill their dreams of having a family.
But once the final chorus of "Happy Birthday" fades, we should take a hard look at in vitro fertilization and the fertility business it has spawned. It's not just a matter of helping the hopeless, it's also about the dubious claims of a for-profit industry -- that it can ensure healthier babies, that we can do a better job than nature when it comes to engineering life.
For starters, we need to remember that IVF pioneers -- including British researcher Robert Edwards and physician Patrick Steptoe, who crafted the embryo that became Louise Brown -- were essentially running human experiments, with little oversight, on a vulnerable patient population.
Although so far most IVF babies seem normal -- that is, they have medical problems in about the same numbers as the rest of us -- concerns persist about the true effects of having been conceived in the lab.
The population isn't large enough or old enough to have yielded a complete picture. In fact, several recent studies marked increases in birth defects and eye cancers among IVF children, and several studies have indicated that babies conceived by a sperm injection technique known as ICSI may be at higher risk for some genetic ailments.
It remains anyone's guess whether other susceptibilities may begin to show up in IVF offspring in adulthood.
Questions also remain about the long-term cancer risks of the hormones used to stimulate egg production in women undergoing IVF or serving as egg donors. Multiple births -- heavily associated with increased genetic and developmental risks -- have skyrocketed because, to increase the chances of a pregnancy, multiple embryos are transferred from petri dish to womb.
But more worrisome is that IVF clinics now want to convince fertile couples that they should use their services.
The first step is to persuade them that the kinds of genetic screening now done on fetuses should really be done on embryos -- this way, couples can avoid the difficult decision of whether or not to abort when amniocentesis reveals Tay-Sachs, Down syndrome or other "negative" traits.
