Everything Conceivable - Book Review
Sunday, April 22, 2007
Everything Conceivable How Assisted Reproduction Is Changing Men, Women and the World By Liza Mundy KNOPF; 416 PAGES; $26.95You might have forgotten this snippet of local news. In 2005, a San Francisco woman gave birth to a baby who as an embryo had been frozen for 13 years. While this may have been perceived as a curiosity, now it can be grasped as a component in a much larger story, one about to swamp us all with sticky choices.
This bigger story is laid out in exquisite and disquieting detail by award-winning science writer Liza Mundy in "Everything Conceivable: How Assisted Reproduction Is Changing Men, Women and the World." The book is the result of an assignment given to Mundy to write about infertility among the poor. What she discovered was that many of her colleagues were also experiencing this heartrending problem. It also became evident to Mundy that the world has undergone a major shift. The almost quaint environment in which she formed her attitudes concerning reproductive choice during the 1980s had been superseded by a more Byzantine landscape. A feature writer for the Washington Post Magazine, Mundy has done her research well. She conducted hundreds of interviews with "mothers, fathers, prospective parents, infertility doctors, lab technicians, social workers, surrogate mothers, egg donors, sperm donors and children (many now adults) conceived through surrogacy and in vitro fertilization," using them to penetrate the high-tech, high-dollar world of making babies. The topic of assisted reproductive technology is complex, yet Mundy keeps the narrative moving forward without dumbing down the story. She leads the reader through oblique concepts, acronyms and statistics, embedding the facts within the human stories, making her book palatable for serious students of the subject as well as the general reader. Endnotes and a fine bibliography offer readers the opportunity to take their interest even deeper. Filled with scenarios and questions not imagined 30 years ago, this remarkable work provokes a spectrum of emotions ranging from alarm to wonder. Consider the concept of fertility tourism, in which patients visit Cyprus, Ukraine and Romania to obtain eggs "donated" by women in those cash-poor countries. Or consider the startling fact that today the rate for having twins is highest for women older than 40. And how reproductive technology could topple Roe vs. Wade, with the emerging theory of civil rights for embryos, in which the fetus could be elevated to "constitutionally protected personhood status." Mundy introduces the reader to the bizarre world of industrial assisted reproduction with a stroll through the aisles of the 2005 American Society for Reproductive Medicine conference. Vendors hawk a patented sperm-sorting technique called Microsort, and a Los Angeles business, Fertility Futures, provides egg donors to gay men. These trade shows are underwritten primarily by the pharmaceutical industry, which does an estimated $3 billion a year, Mundy says, selling the drugs and manufacturing medical devices, such as "microscopes with joysticks that control hollow needles that enable lab technicians to suck a single cell out of a three-day-old, eight-cell human embryo." She applauds the San Francisco company Sperm Bank of California, recounting how by using a simple technique, this nonprofit engineered a breakthrough in technology-assisted alternative families, with lesbians leading the way. Mundy shows that San Francisco is the center of lesbian-pioneered same-sex families and that Los Angeles is "ground zero for gay parenting ... and the world capital of technology-enabled gay parenting." In the most disturbing chapter, "Souls on Ice: America's Frozen Human Embryo Glut," Mundy explores the tortured world of patients burdened with the moral decision of what to do with their frozen fertilized eggs, and how they are usually so conflicted that they decide not to decide and leave them frozen indefinitely. This surplus of nearly half a million eggs has spawned a new industry solely to manage the accumulation of frozen life. One study states "that even in the most progressive regions of the country ... such as the San Francisco Bay Area," few patients were blase. The frozen embryos were variously characterized as "biological tissue, living entities, virtual children having interests that must be considered and protected, siblings of their living children, genetic or psychological insurance policies and symbolic reminders of their past infertility." Mundy states that her goal in writing "Everything Conceivable" was not to sort out right from wrong or advocate for a hold on scientific research. Rather, she wanted to inform readers why these changes are occurring, what the probable consequences will be for our families and our culture, and maybe to help us answer the moral questions of "what life is, and morally what can and should be done with it."