Reproductive Rights Prof Blog

Prolific Sperm Donor Now Voices Concerns About Fertility Clinic Policies

Newsweek Magazine: Mapping the God of Sperm, by Rachel Lehmann-Haupt:

One of the Midwest's most prolific sperm donors may hold the key to understanding how genes affect our health.

It's a crisp fall day in Northville, Mich., a small suburb of Ann Arbor, and Kirk Maxey, a soft-spoken, graying baby boomer with a classic square jaw, is watching his 12-year-old son chase a soccer ball toward the goal. Maxey is doing what he does every Saturday, along with hundreds of other family men and women across the country, but he's not your average soccer dad. Maxey, 51, happens to be one of the most prolific sperm donors in the country. Between 1980 and 1994, he donated at a Michigan clinic twice a week. He's looked at the records of his donations, multiplied by the number of individual vials each donation produced, and estimated the success of each vial resulting in a pregnancy. By his own calculations, he concluded that he is the biological father of nearly 400 children, spread across the state and possibly the country.

When Maxey was a medical student at the University of Michigan, his first wife, a nurse at a fertility clinic, persuaded him to start donating sperm to infertile couples. Maxey became the go-to stud for the clinic because his sperm had a high success rate of making women pregnant, which brought in good money for the clinic. Maxey himself made about $20 a donation, but says he was motivated to donate more out of a strong paternal instinct and sense of altruism. "I loved having kids, and to have these women doomed to wandering around with no family didn't seem right, and it's easy to come up with a semen donation," he says. . . .

Lax Regulation of Surrogacy Can Lead to Ethical Dilemmas

NY Times: Building a Baby, With Few Ground Rules, by Stephanie Saul:

Unable to have a baby of her own, Amy Kehoe became her own general contractor to manufacture one. For Ms. Kehoe and her husband, Scott, the idea seemed like their best hope after years of infertility.

Working mostly over the Internet, Ms. Kehoe handpicked the egg donor, a pre-med student at the University of Michigan. From the Web site of California Cryobank, she chose the anonymous sperm donor, an athletic man with a 4.0 high school grade-point average.

On another Web site, surromomsonline.com, Ms. Kehoe found a gestational carrier who would deliver her baby.

Finally, she hired the fertility clinic, IVF Michigan, which put together her creation last December.

“We paid for the egg, the sperm, the in vitro fertilization,” Ms. Kehoe said as she showed off baby pictures at her home near Grand Rapids, Mich. “They wouldn’t be here if it weren’t for us.”  . . . 

Univ. of Nebraska Regents Consider Resolution to Limit Stem Cell Research to Cell Lines Approved by Pres. G.W. Bush

Omaha World-Herald: Right Now: Stem cell meeting, by Jeffrey Robb:

LINCOLN -- Omaha.com is providing live online updates as the University of Nebraska regents' decide whether to restrict embryonic stem cell research.

Four regents are co-sponsoring a resolution to restrict embryonic stem cell research to cell lines approved by then-President George W. Bush.

Keep checking Omaha.com for the latest comments and the regents' final decision.

NY Times: University Weighs Tighter Limits on Stem Cell Research, by Monica Davey:

LINCOLN, Neb. — In an unusual pushback against President Obama’s expansion of federal financing of human embryonic stem cell research, the University of Nebraska is considering restricting its stem cell experiments to cell lines approved by President George W. Bush.

The university’s board of regents is scheduled to take up the matter on Friday, and if it approves the restrictions — some opponents of the research say they have the votes, though others remain doubtful — the University of Nebraska will become the first such state institution in the country to impose limits on stem cell research that go beyond what state and federal laws allow, university officials say.

Religious Refusals Asserted in Ever-Wider Range of Medical Scenarios

USA Today: Conscience clauses not just about abortion anymore, by Adelle M. Banks:

WASHINGTON — Faced with a request to give an unmarried female patient a prescription for birth control pills, Dr. Michele Phillips looked to her conscience for the answer.

"I'm not going to give any kind of medication I see as harmful," said Phillips of San Antonio. The drugs would not protect her patient from "emotional trauma from multiple partners," Phillips reasoned, or sexually transmitted diseases. "I could not ethically give that type of medication to a single woman."

After the evangelical Christian refused to write the prescription, she resigned her position. She now does contract work at a faith-based practice that permits her to "prescribe according to my ethical values."

Mark Strasser on Distribution of Embryos Upon Divorce

Mark Strasser (Capital University Law School) has posted You Take the Embryos But I Get the House (and the Business): Recent Trends in Awards Involving Embryos Upon Divorce on SSRN.  Here is the abstract:

More and more couples must decide what to do with frozen embryos upon divorce. This article discusses the developing jurisprudence, comparing different approaches adopted or suggested in various jurisdictions. The article concludes that while the enforceable agreement approach has its own difficulties, it is far preferable to some of the other approaches currently proposed or adopted.

More NY Times on 21st Century Babies: The Implications of Multiple Births

NY Times: Grievous Choice on Risky Path to Parenthood, by Stephanie Saul:

21st Century Babies

. . . The birth of octuplets in California in January placed the onus for large multiple births on in vitro fertilization, a treatment in which eggs are joined with sperm in a petri dish and returned to the womb for gestation.

But [intrauterine insemination] is actually the major cause of quadruplets, quintuplets and sextuplets — the most dangerous pregnancies for both mother and children. While less effective than IVF, intrauterine insemination is used at least twice as frequently because it is less invasive, cheaper and more likely to be covered by insurance, interviews and data show.

Multiples can occur when the high-potency hormones frequently used with the procedure overstimulate the ovaries and produce large numbers of eggs. Parents are then left with . . . tough choices . . . : whether to eliminate some of the fetuses or keep the babies and face extraordinary risks.

NY Times Examines "21st Century Babies": IVF Brings Life, But Also Complications

NY Times: The Gift of Life, and Its Price, Stephanie Saul:

21st Century Babies

. . . An exploration of the fertility industry reveals that the success comes with a price. While IVF creates thousands of new families a year, an increasing number of the newborns are twins, and they carry special risks often overlooked in the desire to produce babies.

While most twins go home without serious complications, government statistics show that 60 percent of them are born prematurely. That increases their chances of death in the first few days of life, as well as other problems including mental retardation, eye and ear impairments and learning disabilities. And women carrying twins are at greater risk of pregnancy complications.

In fact, leaders of the fertility industry and government health officials say that twins are a risk that should be avoided in fertility treatments. But they also acknowledge that they have had difficulty curtailing the trend. . . .

Charles Camosy on Surgical Abortion and the Moral Status of Potential Persons

Charles Camosy (Theology, Fordham University) has posted Common Ground on Surgical Abortion?-Engaging Peter Singer on the Moral Status of Potential Persons on SSRN.  Here is the abstract:

The debate over surgical abortion is certainly one of the most divisive in ethical discourse and for many it seems interminable. However, this paper argues that a primary reason for this is confusion with regard to what issues are actually under dispute. When looking at an entrenched and articulate figure on one side of the debate, Peter Singer, and comparing his views with those of his opponents, one finds that the disputed issue is actually quite a narrow one: the moral status of potential persons. Finding this common ground clears the conceptual space for a fruitful argument: the thesis of which is that most, including Singer, who argue that potential persons do not have full personal moral status fail to make the necessary distinction between natural potential (which confers moral status) and practical potential (which admittedly does not).

Scholarship by Michelle Oberman

Michelle Oberman (Santa Clara Law) has posted Thirteen Ways of Looking at Buck v. Bell on SSRN. Here is the abstract:

This article is a review essay of Paul Lombardo's THREE GENERATIONS, NO IMBECILES: EUGENICS, THE SUPREME COURT AND BUCK V. BELL [Johns Hopkins Press, 2008]. Using Lombardo's rich and fascinating history of eugenics in the U.S. as a foundation, I propose and then explore a series of implications that stem from Buck v. Bell and are related to eugenic practices in the U.S. in the 1920s and 30s. The themes upon which Lombardo touches may be grouped into three general categories: the state role in regulating fertility; gender, race, and class issues in fertility regulation; and contemporary reproduction-related politics as they pertain to human attributes. The article is written with an eye to a semester-long study of the governmental regulation of reproduction, past, present and future. Among the themes that fall within the first of these three broad categories are issues of fiduciary duty, which grow out of Lombardo's examination of the roles of doctors and lawyers in the Buck case. I also consider the government's role in regulating population more generally, examining the eugenic implications of contemporary immigration and population policies. The themes relating to gender, race and class include the consideration of maternal-doctor-fetal conflicts, as well as historical and contemporary efforts to link fertility control to criminal punishment. Finally, the third set of themes includes a discussion of the eugenic implications of contemporary issues in reproductive technology. Lombardo's book is well researched and fascinating. It deserves a broad readership, and this review provides a mechanism for bringing this rich history to life in the classroom and beyond.

Professor Oberman has also posted Eva and her Baby (A Story of Adolescent Sex, Pregnancy, Longing, Love, Loneliness and Death) on SSRN:

This article is written in the form of a creative non-fiction essay in which I tell the story of Eva, a girl who was convicted of manslaughter in connection with the death of her newborn child. I undertook this mode of story-telling after years of writing in more conventional modes about maternal filicide in general, and neonaticide in particular. (Most recently, I co-authored a book entitled When Mothers Kill: Interviews from Prison (NYU Press, 2008)). The conventions governing standard law review writing and the relatively distant observer's voice I adopted in my earlier writings left me feeling as though I had failed to communicate an important part of the factors underlying neonaticide. This essay, in which I fuse Eva's story with my own, undertakes to tell a fuller truth about the complex factors that underlie this crime. The essay is part of a series of creative endeavors (essays and articles) in which I adopt an ethnographic or quasi-ethnographic approach to considering the nexus of criminal law and women's lives.

Aging Mothers

Slate Magazine (7/30): Fertile Old Ladies, by  William Saletan:

Is it OK to impregnate a 60-year-old woman?

Until recently, this wasn't an issue. Nature exhausted your egg supply, and that was it. But technology has surmounted that problem. Now you can get in vitro fertilization, donor eggs, and womb-rejuvenating hormones. You can freeze your eggs or embryos. You can even freeze your ovarian tissue, reimplant it later, and resume ovulating.

Everywhere you look, moms are older. Over the last three decades, the U.S. birth rate among women aged 35 or older has increased by 140 percent. These women now produce one of every seven American children. In Europe, women over 35 have increased their share of pregnancies from 5 percent to 20 percent. More than 100,000 American women aged 40 or older have babies each year. In the last 15 years, at least a dozen women aged 60 or older have done it. The oldest age at which a woman has given birth is now 70.

Is middle-aged motherhood getting out of control?. . .

Substitute for Embryonic Stem Cells Shows Promise

ScienceNow: Embryonic Stem Cell Substitute Passes Acid Test, by Gretchen Vogel:

Scientists have for the first time demonstrated that a possible alternative to controversial embryonic stem (ES) cells shares one of their key abilities. So-called induced pluripotent stem (iPS) cells can generate a live mouse in an experiment scientists say is the gold standard for pluripotency, the ability to become any cell type in the body. The feat, performed by two independent groups, suggests that iPS cells may be as powerful as ES cells, which many scientists hope will someday help cure a variety of diseases.

ES cells are prized by scientists for their flexibility. Taken from early embryos, they can in theory develop into all the tissues of the body. This talent makes them useful for studying--and perhaps someday treating--diseases. But because isolating ES cells involves destroying an embryo, they have proved ethically and politically controversial.

Many researchers believe iPS cells offer the best hope as an alternative....

Richard Storrow on Therapeutic Reproduction

Richard Storrow (CUNY Law School) has posted Therapeutic Reproduction and Human Dignity on SSRN.  Here is the abstract:

Bioethicists have long looked to literature for insight into the difficult questions that arise from developments in biotechnology. Two recent novels, Kazuo Ishiguro’s Never Let Me Go and Jodi Picoult’s My Sister’s Keeper, wrestle with the ethics of using reproductive technology to create donors of human tissue and organs. Read together, the novels call into question presumed distinctions between reproduction and therapy and between the family and the state that have animated debates about ethically permissible and ethically impermissible uses of reproductive technology. They caution that what we fail to appreciate in holding to these distinctions is that reproduction and therapy do not inhabit wholly separate spheres when either parents or the state undertake to harness reproductive power to create children for the therapy of others. In addition, the novels reveal the concept of human dignity to be an inadequate standard for determining what is good or bad about therapeutic reproduction. Although arguments against reproductive cloning often rest on beliefs that cloned humans would not truly be human, in Ishiguro’s reimagined Britain, it is actually the dignity of the cloned organ donors that underscores the indignity of creating them for the therapeutic needs of others. Picoult’s story asks whether any test or standard could ever adequately assess whether parents who create “savior siblings” have treated them with sufficient dignity. In affording readers a rare glimpse into a family brought to its knees by illness, the novel suggests that the least understood ethical aspect of this problem is what we expect of parents in times of crisis. As a pair of novels responding to scientific developments at the intersection of reproductive technology and human tissue and organ donation, Never Let Me Go and My Sister’s Keeper both counsel against ill-informed policymaking in the context of difficult bioethical questions.

Scientists Report Creating Human Sperm from Stem Cells

Time Magazine: Scientists Create Human Sperm from Stem Cells, by Alice Park:

Researchers at Newcastle University in England report they have coaxed the first human sperm cells from embryonic stem cells, in a remarkable demonstration of how quickly the field of stem-cell science is moving.

The achievement, described in the journal Stem Cells and Development, comes just 11 years after the first human-embryonic-stem-cell line was created — an eyeblink in scientific terms — in the lab of James Thomson at the University of Wisconsin. (See the top 10 scientific discoveries of 2008.)

Although the development once again raises the specter of creating humans in a petri dish or custom-designing egg and sperm cells for reproduction, lead author Karim Nayernia says that was not his team's intention. Rather, the experiment was a proof of concept that stem cells can generate any cell in the body — not only the dozens of tissues that make up the human body but also those egg and sperm cells that may give rise to altogether new bodies.

NY To Pay Women for Eggs for Stem Cell Research

Wash. Post: New York to Pay Women to Give Eggs for Stem Cell Research, by Rob Stein:

New York has become the first state to allow taxpayer-funded researchers to pay women for giving their eggs for embryonic stem cell research, a move welcomed by many scientists but condemned by critics who fear it will lead to the exploitation of vulnerable women.

The Empire State Stem Cell Board, which decides how to spend $600 million in state funding for stem cell studies, will allow researchers to compensate women up to $10,000 for the time, discomfort and expenses associated with donating eggs for experiments....

The little-noted decision two weeks ago puts New York at odds with policies in every other state that provides funding for human embryonic stem cell research and with prevailing guidelines from scientific organizations, including the National Academy of Sciences.

Census Data Shows Possibile Trend of Sex Selection

The New York Times: U.S. Births Hint at Bias for Boys in Some Asians, by Sam Roberts:

The trend is buried deep in United States census data: seemingly minute deviations in the proportion of boys and girls born to Americans of Chinese, Indian and Korean descent.

Demographers say the statistical deviation among Asian-American families is significant, and they believe it reflects not only a preference for male children, but a growing tendency for these families to embrace sex-selection techniques, like in vitro fertilization and sperm sorting, or abortion.

The findings published by Professors Almond and Edlund were bolstered this year by the work of a University of Texas economist, Prof. Jason Abrevaya. He found that on the basis of census and birth records through 2004, the incidence of boys among immigrant Chinese parents in New York was higher than the national average for Chinese families. Boys typically account for about 515 of every 1,000 births. But he found that among Chinese New Yorkers having a third child, the number of boys was about 558.

Julie Graves Krishnaswami

Cahn and Collins on Restricting Access to Fertility Treatment

Naomi Cahn (GW Law) and Jennifer Collins (Wake Forest) have posted Eight is Enough on SSRN.  Here is the abstract:

January 26, 2009, the nation's second set of live-born octuplets was delivered. The public fascination with this event quickly turned ugly when the media revealed that the mother was thirty-three year-old Nadya Suleman, who is single, unemployed, and already caring for six children under the age of eight.

The cultural backlash against Suleman has focused on three separate issues. The first revolves around Suleman herself, and her ability as a single, unemployed mother to parent fourteen young children successfully. A second set of concerns revolves around the medical procedures at her fertility clinic. How could the clinic agree to implant a woman under the age of thirty-five with at least six embryos? A final set of issues concerns more fundamental questions about screening parents. How could a clinic provide a single woman with six children with treatment that could double the number of children she has? As a result, commentators and legislators are calling for new, more restrictive regulation of the fertility industry.

We support some of these initiatives, specifically more meaningful limits on the number of embryos that may be transferred in any single IVF procedure. But we are far more troubled by another set of proposals: some commentators are now urging the imposition of restrictions on which individuals may receive fertility treatment. Under this theory, women with a certain number of children, or with limited financial resources, should be precluded from receiving further treatment. Our conclusion here differs from our position about regulating the medical procedures themselves: as we explain, neither fertility clinics nor the state should be in the business of restricting access to reproductive technology.

NIH Issues Draft Guidelines for Stem Cell Research

Wash. Post: Stem Cell Sense: NIH research guidelines avoid some moral minefields:

By limiting federal funding to research on stem cells derived from embryos that were created for reproductive purposes and that were slated for disposal, the National Institutes of Health's draft guidelines, issued yesterday, offer an intelligent solution to an issue that demanded great sensitivity. While a decision with such deep moral and ethical considerations shouldn't have been left to scientists alone, the NIH outcome is a good one.

President Obama issued an executive order last month that lifted the ban on federal funding of research on stem cell lines created after Aug. 9, 2001, and he instructed the NIH to develop guidelines for the research. Because stem cells can be transformed into different kinds of cells, scientists (and quite a few hopeful patients and their loved ones) believe them to hold the key to cures for a host of debilitating diseases and conditions, such as Parkinson's. But because stem cell lines are grown from human embryos, many people have ethical or religious objections to their use. President George W. Bush proposed a compromise that limited federal funding to a set of existing stem cell lines. But they proved too few, limiting potential research.

Judith Daar on Embryonic Genetics

Judith F. Daar (Whittier Law School) has posted Embryonic Genetics on SSRN. Here is the abstract:

Recent discoveries in the world of reproductive medicine allow prospective parents to peer into the genetic future of their children from the earliest moments of life. Armed with this information, parents can choose whether or not to continue along the procreative path by selecting or discarding embryos on the basis of their genetic composition. In making this decision, a parent's view of health and disability figure prominently, sometimes yielding outcomes that cause a larger community to rethink the concept of health.

This article explores the use of preimplantation genetic diagnosis (PGD) to detect the genetic health of early embryos prior to implantation. Genetic selection for medical reasons is explored from three rationales: 1) to ensure the health of the embryo, 2) to ensure the health of an existing person, and 3) to ensure the continuity of a genetic trait within the family structure. Ultimately, a matrix is suggested for policy-makers to utilize in reflecting on legal strcutures to govern the use of PGD and other advancing reproductive technologies.

Peter Steinfels and William Saletan on Stem Cell Research

Peter Steinfels' "Beliefs" column in yesterday's New York Times laments the absence of "moral argument" in the debate over stem cell research.  Steinfels suggests that there are important moral questions at stake in the debate, but he doesn't venture to say what they are, let alone take a position on those questions. 

NY Times: In Stem Cell Debate, Moral Suasion Comes Up Short, by Peter Steinfels:

Almost no one was surprised this week when President Obama lifted restrictions on stem cell research that involved the destruction of human embryos. Even jaded Washington watchers are adjusting to the idea that this is a president with an eerie determination to do exactly what he said he would do during his campaign.

Those who approve such research applauded Mr. Obama’s action. (“Fantastic,” said one stem cell scientist on PBS.) Those who disapprove condemned it. (“Deadly,” said an anti-abortion leader in The New York Times.) But some commentary focused at least as much on the nature of the president’s moral argument as on the specific conclusions he reached.

When it comes to the controversy over human embryonic stem cell research, moral argument has not been much in evidence. The president spoke of a popular consensus in favor of it reached “after much discussion, debate and reflection.” That is a kindly description of the hype, exaggeration and denunciation that have dominated the controversy.

Steinfels appears to admire an article by William Saletan in Slate, in which Saletan criticizes knee-jerk attacks on those who oppose stem cell research.  Steinfels then meekly concludes:

To label the opposition to embryonic stem cell research as “ideology,” Mr. Saletan suggests, is to “forget the moral problem.” To pursue this research is a moral choice. Not to pursue it is a moral choice. And moral choices of this nature properly wind up in the political arena.

Here's Saletan's piece: Winning Smugly: You just won the stem-cell war. Don't lose your soul. Saletan is more upfront about the kinds of moral choices at issue (and hints at where he stands on them, although he doesn't tell us where his concern about an ethical slippery slope should ultimately leave us on stem cell research):

At their best, proponents of stem-cell research have turned the question on its head. They have asked pro-lifers: How precious is that little embryo? Precious enough to forswear research that might save the life of a 50-year-old man? Precious enough to give up on a 6-year-old girl? How many people, in the name of life, are you willing to surrender to death?

To most of us, the dilemma is more compelling from this angle. It seems worse to let the girl die for the embryo's sake than to kill the embryo for the girl's sake, particularly since embryos left over from fertility treatments will be discarded or left to die, anyway. But it's still a dilemma. And as technology advances, the dilemmas will become more difficult. Already, researchers are clamoring to extend Obama's policy so they can use federal money to create and destroy customized embryos, not just use the ones left over from fertility treatments.

The danger of seeing the stem-cell war as a contest between science and ideology is that you bury these dilemmas....

On this point, Obama has been wiser than his supporters. "Many thoughtful and decent people are conflicted about, or strongly oppose, this research," the president acknowledged on Monday. "We will never undertake this research lightly. We will support it only when it is both scientifically worthy and responsibly conducted."

Georgia Bill That Attempts To Grant Embryonic Rights And Increase IVF Oversight Advances

The Atlanta Journal Constitution: Embryo Rights go too far in Senate (Editorial), by Maureen Downey:

Senate Bill 169 —- the Ethical Treatment of Human Embryos Act —- declares: “A living in vitro human embryo is a biological human being who is not the property of any person or entity.” Should that bill become law, it will halt the embryonic stem cell research in Georgia that offers the promise of curing Alzheimer’s and repairing spinal cord injuries.

More immediately, it will so complicate legal questions around frozen embryos that it could drive in vitro fertilization clinics out of the state, forcing desperate Georgia couples to go out of state as well.

The law’s real intent is to outlaw abortion, a goal its proponents acknowledge. At the hearing, testimony in favor of SB 169 came from Georgia Right to Life, the Georgia Baptist Convention and the Georgia Catholic Conference. While stem cell research may potentially save many lives, those opponents argued it deals a death blow to the embryo itself, which they see as an unconscionable trade-off.