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A Nobel Prize for IVF                                                                                    

Posted at: Oct/14/2010 : Posted by: mel

Related Category: Perspectives,

This month (October 2010), professor emeritus Robert Edwards of the University of Cambridge and Dr. Patrick Steptoe (who died in 1988) won the Nobel Prize in Medicine for developing in vitro fertilization.

In vitro fertilization (IVF) is a process where eggs removed from the female are fertilized by sperm outside the body, “in vitro.” IVF has proven to be a highly successful treatment for infertility. The process involves hormonally controlling the ovulation process, removing (eggs) from the woman's ovaries and letting sperm fertilize them in a fluid medium. The fertilized egg or “zygote” is then transferred to the patient's uterus with the intent to establish a successful pregnancy. At the time of the processes inception many critics warned of birth defects and mass manipulation of the species. The first successful birth of a "test tube baby", Louise Brown, occurred in 1978. Despite all the predicted nightmarish outcomes, the millions of children born since who were conceived by this process have shown normal, if not lower rates of birth defects.

The term “in vitro” is from the Latin root meaning “within the glass”. The term “in vitro” is used, because early biological experiments involving cultivation of tissues outside the female host in a glass container such as a beakers, test tube, or petri-dish.

The technique of IVF has enabled couples to have children when other processes or procedures have failed for them. Since Louise Brown was born in 1978, some four million children have been conceived using the IVF technique. My research indicates that between 1% and 2% of all babies born in the United States and other developed countries each year are conceived through IVF.

An additional benefits to IVF is the technique developed about 10 years ago called Preimplation Genetic Diagnosis (PGD). PGD allows for the screening of the fertilized egg for a number of recessive and dominant diseases which could not previously be diagnosed until many weeks into a conventional pregnancy. This means that a zygote can be tested prior to implanting and destroyed if a very debilitating genetic disease is present as opposed to the possibility of testing and aborting a fetus weeks in a pregnancy. Some of the diseases that can be identified in PGD include cystic fibrosis, sickle cell disease and spinal muscular atrophy, along with Huntington's disease, hemophilia-A and muscular dystrophy.

I should also mention that “embryonic stem cell research” is considered another boon produced by IVF. In stem cell research frozen embryos left over by couples who have used IVF to have children are used by scientists with the hope of producing cures for some of our worst diseases. None of this research has yet yielded anything definitive and the debate about performing research using this “left over” material is quite lively.

The actual reason that I decided to discuss the IVF process and its recent Nobel Prize is because of the uniquely diametric views that Catholics and Jews hold for IVF.

The dispute is not about the medical facts of gestation; rather it is about how to perceive the stages of development. For roughly the last 400 years or so (some would argue longer), Catholics have maintained that as soon as fertilization occurs a full human being has been created. When the process of IVF was invented, Catholics expanded their doctrine to cover even a fertilized egg in a petri-dish. Catholics have therefore been opposed to IVF because some of the embryos will probably be discarded, either because they are not needed by the would-be parent or because genetic testing reveals they carry a genetic disease. Because the zygote is a full human being, in their view, that amounts to murder. Similarly, embryonic stem cell research requires that the embryo be destroyed, and that amounts to murder as well. This is unique to my mind since there is absolutely no chance of this fertilized egg developing into a baby unless it is implanted into a woman’s womb.

For Jews, the Talmud is a primary source of learning, especially with respect to Jewish law, philosophy, ethics and customs. After the destruction of the Temple in 70 CE (Common Era) Jews lost their central place of teaching orally the law and ethics that are considered critical to their faith. With this upheaval the Talmud was created to have a common set of laws to teach to this dispersed Jewish population.

Back to the discussion at hand: The Talmud teaches that during the first 40 days of gestation, the embryo is “merely water.” From the 41st day of gestation until birth, the fetus is “like the thigh of its mother.” Only at birth does the fetus become a full-fledged human being. Thus to use “merely water” to help people procreate, to avoid genetic diseases, or to find cures for devastating diseases is not only permissible, but strongly mandated by Judaism’s demand that we seek to overcome infertility, procreate if we can, and avoid or cure genetic and other diseases.

One of the problems with interpreting religious text literally is that there is little room to accept what modern science can offer us. In this case the truth is that neither tradition is supported fully by modern science. Numerous studies have found that between 75 - 80% of all naturally fertilized eggs are miscarried for no apparent reason in the first 3-7 days after fertilizations. This means that even naturally conceived children beat at least 4 to 1 odds to develop from conception. Taking the strict Catholic interpretation most women would therefore be murders knowingly or unknowingly. For the Jew as well the belief that the fertilized egg is “merely water” for the first 40 days is also naïve by modern standards. We now know that the fertilized egg has the full DNA of the child that may potentially be born and this hopefully means the Jew will give more careful thought to the possibility of an early stage abortion.

The fact is that in countries where IVF is available couples who previously could not enjoy the experience of raising a healthy child now can. Nobel prizes are generally given to recognize science and medicine that has come to a beneficial fruition for man. Maybe someday religious doctrine will recognize science not as a burden, but as a gift from G-d.

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