In Without Moral Limits: Women, Reproduction and Medical Technology (2000), health educator Debra Evans discusses how reproductive technologies are changing the meaning of sexuality, women’s roles and family structure.  The book is a primer on the lab methods of the so-called “Assisted Reproductive Technologies” but is grounded in Christian theology, the humanities and a core view that there is an intrinsic wisdom in nature.  


Emblematic of this basis, she quotes, e.g., T.S. Eliot’s The Rock: “The endless cycle of idea and action, endless invention, endless experiment, brings knowledge of motion, but not of stillness; Knowledge of speech but not of silence; All our knowledge brings us nearer to ignorance; All our knowledge brings us nearer to death; But nearness to death, no nearer to God.  Where is the Life we have lost in living?  Where is the wisdom we have lost in knowledge?  Where is the knowledge we have lost in information?  The cycles of Heaven in twenty centuries bring us farther from God and nearer to the Dust.”  In other words, we’re getting better at manipulating life but, instead of making babies, are we making “cleverly designed packages of selective breeding, genetic diagnosis, embryo experimentation and the medical control of life from the earliest moments.”


There are numerous annotations in this relatively brief work, derived from the variety of sources consulted, from the Old Testament to mainstream magazines to medical journals to bioethicists’ writings to Vatican statements to C.S. Lewis’s Abolition of Man. 


The book raises many of the typically-expressed concerns about these technologies, from their health effects on the parents and offspring, to their eugenic roots to effects on family structure.  She’s willing to go beyond these effects to briefly consider some “unmeasurable” effects, namely the effects on self-perception. As do other authors, she observes that softened vocabulary is used to describe activities that would otherwise be troubling and notes the mitigating/facilitating effect these euphemisms have of the acceptance of these practices.


What else is unusual about this book? She describes the research origins of IVF.  In embryological studies from 1938 to 1953, Harvard researchers Rock and Menkin removed naturally fertilized eggs from women research subjects who had reported having intercourse recently.  They studied, and even named, them.  One of the first, in 1946, was named “Dominic,” after Red Sox player Dominic DiMaggio, had just gotten a key hit in the World Series that was then audible on the lab’s radio.  The researchers also waited in the hallway outside  operating rooms where hysterectomies were being performed to take eggs from women’s removed wombs and ovaries; they then and combined these mined eggs with sperm in attempts to perform IVF. 


As this was a relatively low-ovum-yield process, a British researcher, Robert Edwards, began stimulating ovaries to produce eggs and then removed them laparoscopically.  By 1968, he had performed IVF in the lab, which led to the first IVF birth in 1978, and predicted and advocated for the eugenic applications of PGD through the use of gene probes and for the and stem cell transplantation that are being tried today.


As do other authors, Evans also notes that the fertility industry is unregulated.  In both IVF and through the use of fertility drugs, multi-embryo transfers are performed to raise “success rates.”  Then, in the “reduction” process, the hearts of the unwanted, implanted embryos are pierced and potassium chloride is injected into them.  She notes that IVF separates sexuality from reproduction and introduces a third party into the making of life.


Her statistics on IVF use are, by now, outdated and greatly understate the number of IVF births.  Another interesting, though perhaps also dated, stat is that multiple births have increased from less than one percent to over twenty percent since IVF and fertility drugs have become popular.  She notes that over 60,000 women/year-- half of them married-- used purchased sperm to conceive. This number may also be low compared to recent years. Here’s another: at birth, a girl had 500,000 eggs; she has 10,000 at puberty and nearly none at fifty; from menarche to menopause, only 400-500 will be hormonally stimulated to develop within the ovaries.


Evans observes that, by degrees, the separation of sexuality from reproduction is creating more distance between traditional women’s roles and contemporary roles.  Instead of viewing children as blessings from God and celebrating motherhood, we have turned conception into a willful process in which the difficulties and risks-- and the joys-- are being removed, women’s reproductive systems are being bypassed and men and women have more similar roles. 


The perhaps-imminent culmination of this process will entail the gestation of designed-- or at least, selected-- offspring in artificial wombs, which, based on relatively simple artificial placentation machinery for fetal lambs, will allow for the addition of oxygen and the removal of carbon dioxide and for heparin and other fluids to be provided.  While it would seem difficult to get the subtle chemistry right, culturally there seems to be plenty of room for experimental trial and error.


She counsels Christians unable to conceive immediately not to hurry to one of the hundreds of highly profitable, test-intensive, unlimited-method fertility clinics across the United States (or abroad). Generally, she criticizes the medicalization of life creation.  She notes that not only the present practice of IVF, but also its development during research, is based on the destruction of embryos.  Citing studies, she notes that much infertility is induced by conduct, such as STD and abortion scarring, and that billions of dollars in expenditures on high tech treatments could be saved if women had monogamous relationships. 


This book comes from the right place and deserves a wider audience.

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