Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, July 8, 1990 TAG: 9007100424
SECTION: EDITORIAL PAGE: D3 EDITION: METRO
SOURCE: HOWARD W. JONES JR.
DATELINE: LENGTH: Medium
Our center has helped more than 500 couples bear one or more children. Yet an estimated 4.4 million women of childbearing age in the United States experience difficulty conceiving a child, and many of them might become pregnant with better treatment methods. Research to develop these methods is hampered by a moratorium on federal funding for human embryo and fetal research.
About 200 centers in the United States offer in vitro fertilization and embryo transfers to infertile couples. But success rates have been low, as was reported recently by a committee of the Institute of Medicine and the National Research Council on which I served. The procedure is appropriate as initial treatment for 10 to 15 percent of infertile couples and, in 1988, it resulted in a live birth only 12 percent of the time.
Clinics like ours will never be able to help every infertile couple, but we could improve the odds considerably by learning more about the biology of human reproduction. Just as a brain surgeon studies brains, researchers in our field need to study sperm, eggs, pre-embryos, embryos and fetal tissue. Computer modeling, studies of animals and other methods can answer some of our questions. But we must investigate early prenatal development in humans directly if we are to truly understand it and learn why it does not always occur as desired.
Such research raises many difficult ethical and social issues, such as whether embryos are human, how "spare" embryos from fertilization procedures should be handled and whether fetal tissue from abortions ought to be used in research.
Many nations have been more successful than ours in confronting the conflicting viewpoints and agreeing how to proceed. Americans have tended to polarize these issues rather than doing the hard work of devising research guidelines acceptable to most people. The Bush administration announced not long ago that it would continue to deny federal funding for human embryo and fetal research, and some members of Congress now are questioning the legality of the decision.
Such wrangling needs to be replaced by people coming together in a less politicized manner to search for consensus. Researchers are leaving the field, and millions of infertile couples are frustrated.
From a scientific standpoint, the research opportunities have never been brighter. Our committee identified dozens of promising avenues of study, from the development of sperm and eggs to the process of embryo implantation. It listed several current clinical practices, such as stimulating and obtaining eggs from in vitro patients, that might be improved.It also called for closer investigation of technological advances such as freezing eggs and embryos.
A related scientific field illustrates what might be achieved with increased research on human reproduction. Scientists have made tremendous advances in techniques to assist conception in animals through in vitro fertilization and embryo transfer. Sharp ethical and scientific differences between humans and other animals prevent these methods from being applied directly to the treatment of human infertility. Yet the progress achieved with animals is pertinent, and it contrasts with the slow pace of research on human reproduction. Increasing this pace could lead not only to better treatment of infertility, but also to improvements in contraception, food production and efforts to sustain endangered species.
It is entirely proper in a democratic country that ethical questions involving science are resolved by society as a whole, rather than by scientists alone. But as one who confronts the heartbreak of infertility every day, I wish more Americans would recognize what we could accomplish by pursuing this research. Instead of saying "I'm sorry" so often, people like me could say, "Congratulations! You're pregnant."
by CNB