A week after the Nobel Prize went to Robert Edwards for his accomplishments in developing in vitro fertilization as a treatment for infertility—and more than thirty years after Edwards’ first successful IVF procedure in 1978—IVF still looks like an amateur lab experiment. The same ethical matters that troubled science when Edwards created his first test-tube baby remain unresolved, even in the wake of winning the world’s most prestigious prize.
Aimed at creating fertilized embryos, IVF destroys many more than it creates. Aimed at producing successful pregnancies, IVF results in twice as many failed attempts as successes. Aimed at healing the traumatic experience of infertility for many women, IVF brings with it a multitude of traumatic experiences for women—including years of failed attempts, miscarriages, and the difficult choice of which baby to abort when a prospective mother finds she has conceived more embryos than she could bring to term.
As the Nobel website itself clearly states: with IVF, “20-30 percent of fertilized eggs lead to the birth of a child.”
Yes, that means that for nearly one in every three couples, IVF can bring a much-wished-for child into the world. No one can deny that babies are priceless, and, for infertile women especially, it means the world just got better, to finally have a baby of one’s own. Studies have shown that the depression many women experience from infertility is similar to that experienced by people with heart disease or cancer. Sure IVF brings a rocky road of hormones and failed attempts, but the relief and joy that comes with the baby can make it all seem worth the costs.
So certainly a discovery that relieves women of the burden of infertility is worthy of a Nobel prize, right? Right.
But that’s not what Edwards’ development of IVF has achieved. IVF hasn’t cured infertility. If it had, all women who undergo IVF would no longer be infertile. Instead, Edwards has developed a procedure that costs more than $10,000 and rarely is covered by insurance, that comes with significant physical suffering, risks, and psychological burdens of its own, and that is marketed as the only option available to thousands of vulnerable, infertile women today—even though it offers no guarantee of success, and comes with a two-to-one risk of failure.
Of course, it has grown increasingly difficult to criticize IVF, because many of us now know a child who was conceived with IVF; and who could suggest that child shouldn’t be alive? To do so would be truly wrong. No other medical innovation has ever led so directly to the creation of human life. This represents a real, seemingly prize-worthy breakthrough in the history of medicine.
But, like most medical breakthroughs, it comes with a host of ethical ramifications. Even if we put aside the issue of what it means to be able to create people for whatever use we’d like—which is indeed ethically worrisome—there are other, equally troubling costs we can measure. For instance, we know IVF destroys many embryos in the process of seeking to bring one embryo to term. Doesn’t this matter just as much to medical practitioners as the creation of life?
Well, let’s consider that while looking at a recent example of scientific research. Last Friday we heard the horrifying report that during the 1940s American researchers in Guatemala willfully infected hundreds of people with STDs in an effort to find out if penicillin could be used to stop the spread of STDs. This is obviously an ethical and scientific disaster on the face of it; just last week President Obama publicly apologized for this decades-old scandal, since the U.S. government is responsible for funding the research.
Imagine if researchers found a cure for AIDS today; what an amazing achievement that would be! But if, in the process of reaching that cure, researchers infected several participants with AIDS, it would be not praiseworthy but abhorrent. Here’s the difference: The ethical scientist who discovered a cure for AIDS would win a Nobel Prize in Medicine; but the other one—who discovered a cure by using unethical procedures—it would be the journalist who blew the whistle on him who would win the Pulitzer Prize.
With science, as with everything, how we do something is just as important as the result we’re hoping to reach. It’s not okay to find cures to diseases by testing on voiceless people in developing countries. And, as Alfred Nobel well knew, it’s not justifiable to create peace in one place by bombing civilians in another. No matter how worthy a goal, it’s not legitimate to try to achieve peace at any cost. As humans, we are bound by reason and ethics to be humane.
With IVF, the worthy desire to help infertile couples conceive a baby can be so great that it can be tempting to overlook the ethical and human costs: the embryos destroyed in the process that are just as human as the ones created alongside them that come to full term and walk among us; the years of pain and struggle that many women undergoing IVF experience with the assurance that it will lead to a child, when often it doesn’t.
And that is why this year’s Nobel Prize for the discovery of IVF represents a failure. It fails humanity because it overlooks the human costs of IVF; it fails women because it overlooks their suffering that, even thirty years later, is still routine in the procedure; it fails science because it does nothing to encourage ingenuity and research for better treatments to the condition of infertility; and, in perhaps its greatest irony, it fails the legacy of the Nobel Prize itself.
Mary Rose Somarriba is managing editor of First Things.