Frozen at minus 380 degrees Fahrenheit, a human embryo is selected to be thawed, resulting
in the birth of Melina, now four years old.
Her brother Luke was created in the same way.
Her parents are Will, a lawyer in Los Angeles, and Marceline, who's a surgeon.
They've been able to have children because of a discovery made in 1978, that by bringing
together a man's sperm and a woman's egg in a laboratory, a baby could start its life
outside the human body.
It's called in vitro fertilization.
Marceline was a sperm donor for one and I was a sperm donor for the other, but we don't
tell the public or even our close friends or family who that is, but our children will
know.
Marceline's from a very large family, he's the youngest of 20, and I'm an only child,
so I sort of always idealized family life in a big family.
To me it was just a basic human desire to want to have children.
Since neither Will nor Marceline could carry their baby, they searched for a woman willing
to serve as a surrogate mother.
Many of the women we knew who wanted to help us didn't really want to carry a child that
they were biologically related to, and with IVF, our friends said, okay, if the egg's
not for me, I would feel comfortable carrying the child.
In vitro fertilization has enabled thousands of couples to create the family they desperately
want.
It has also opened a gateway to a brave new world where a child can have five parents
or be born to a mother in her 60s, where a baby can have its sex determined before conception
or be created with borrowed DNA, where an embryo no larger than a speck of dust can
have its genes scanned for diseases, or one day be designed with new strengths and talents.
What IVF does is it takes the process of reproduction out of the darkness of the womb into the light
of the laboratory, and all of a sudden you can do anything you want with these human
embryos and eggs, which couldn't be done before.
The new revolution in making babies is underway, one that could allow us to influence and even
shape the genetic fate of our children.
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Thank you.
I think it's very difficult for anybody to explain why they want a child.
And the thing that I always felt so strongly about, why as an infertile person do I have
to explain why I want a child where somebody who's not infertile doesn't?
And it's something that I think nobody is prepared for.
Nobody is prepared for somebody to sit across a desk from them and say, I'm sorry but you
can't have a child.
One out of every six couples struggles with infertility.
You come to realize how lucky so many other people are that they don't have a situation
like this.
And there are worse things, I definitely agree, but to us, we were devastated.
For many, in vitro fertilization is their last hope for a child, despite the stark reality
that it fails 70% of the time.
These patients have often gone through years of trying to get pregnant.
They're really stressed just from that alone.
And often by the time they reach the office of a specialist are depressed because of this
illness.
And not many people view this as an illness, but infertility is a rotten, horrible disease.
And it's not a disease that will kill you, but it wreaks havoc in these patients' lives.
It is not a cosmetic illness.
The disease of infertility once seemed incurable until the miraculous birth of Louise Brown
in 1978.
Her arrival marked an historic moment for Louise was the first human baby ever conceived
outside a mother's womb.
British doctors Robert Edwards and Patrick Steptoe had labored for years trying to help
women with blocked fallopian tubes.
They could surgically remove their eggs and fertilize them in the lab, yet they couldn't
figure out why the embryos failed to develop into pregnancies once they were returned to
the mother.
We had got all the techniques ready right at the stage of implantation, beautiful embryos,
and checked out the chromosomes and everything about them, and it was clear this method had
to work.
There was too much knowledge already in mice and rabbits and goats' mind.
The techniques we were doing were in advance of those.
So we felt that the human was not so different that the method could not work.
The breakthrough came when Steptoe and Edwards decided to transfer the embryo earlier, allowing
it to divide only three times before placing it in the womb.
We were trying to come earlier and earlier, really, to avoid long-term cultures.
That was my primary aim, and so suddenly the system started to work and we were there.
Three years later, Nova filmed the birth of America's first test tube baby, Elizabeth
Jordan Kahn.
Although Louise Brown was healthy at birth, many feared that IVF babies could well be
abnormal.
Ultrasound had shown that Elizabeth was small, and the doctors that created her, Georgiana
and Howard Jones, were extremely worried.
I had written out a press release that said that we had been disappointed at birth that
the child was abnormal, but that we did have a couple of other pregnancies come along behind
that, and we would hope that the others were perfectly okay.
And fortunately, I didn't have to use that.
All right, ladies, here she is, Elizabeth.
All right, yeah, I knew y'all would like it to be a girl.
I think the major moral concern was were you going to have a child born who had birth defects?
Were you going to have developmental abnormalities?
Did something go wrong later in the life of that person?
And I think the terror was that somehow doing something in a dish was going to create a
person that was less than healthy.
That's you, Louise.
But the terror faded quickly.
As the press followed Louise Brown and Elizabeth Kahn, it was clear that the girls who had
made medical history were growing up to be perfectly normal.
Every year, people pop up and say, oh, we'd like to do an update on Elizabeth.
And every year I say, well, I'm the same as I was last year, just a year older.
That's it.
It's kind of like they expect a wonderful answer, like, oh, yes, I feel so different.
I feel so special, and I don't.
Initially, IVF could only help a small percentage of infertile couples.
Today, it has become the starting point for treating almost every cause of infertility.
As defective eggs, weak sperm, or abnormal chromosomes, once insurmountable obstacles
are overcome.
Radical new techniques have proven that life on the cellular level is easier to manipulate
than ever imagined.
And for those who embark on this high-tech process, IVF remains a grueling ordeal.
The first hurdle is to endure daily injections of powerful drugs to force the ovary to produce
more than one egg.
Lisa had gone through three weeks of taking shots.
All of her body bruises every morning at 6 in the morning to go to give blood.
And you have a lot of guilt seeing your spouse go through all this stuff, knowing that if
I didn't have this problem, she wouldn't have to do this, you know, she's very fertile.
I mean, that's the best part.
Infertility was often seen as a woman's curse.
But in fact, 40% of cases can be attributed to male problems, like Darren's.
The sperm count is very, very low, and when you have such low sperm count, the challenge
is to select a normal sperm or what looks like a normal sperm and to get fertilization.
However, so long as we have some sperm and they're alive, we can allow the sperm to
get to the egg.
Because Darren's sperm are too weak to reach Alyssa's eggs, her eggs must be surgically
retrieved.
Using a long, thin needle, Rosenwax probes her ovary.
One by one, the tiny eggs are sucked out into test tubes and taken to the lab.
It is the quality and number of the eggs and sperm that will determine the outcome.
We had 15 mature eggs, and there are several motile sperm, but very, very few.
So they're looking, they have to search out quite a bit.
And the hope is, of course, to get at least an equal number of sperm to the number of
eggs we have.
And this is the kind of situation we're dealing with here.
A fertile man will produce millions of sperm.
Today, the doctors have found only 12 of Darren's to work with.
Using a thin glass needle, one sperm is grabbed by its tail.
Then, Alyssa's egg is placed into position.
It was only by accident that scientist Gian Palermo discovered he could inject a sperm
into an egg without damaging it.
When I was placing sperm around the egg, underneath the shell, then, accidentally, I perforated
the membrane of the egg, and then one sperm went inside.
Ironically, I didn't pay much attention.
I thought that egg would not survive the procedure, and I put a question mark to it because I
thought it was going to die.
But that was the only egg that fertilized that finally was transferred to the patient,
and this became the first ICSI baby.
Palermo called his discovery ICSI, for intracytoplasmic sperm injection.
Amazingly, creating a human being through the manual injection of sperm proved to be
just as effective as natural fertilization.
The only known safety risk seemed to be the possibility of passing on the gene for male
infertility.
ICSI's success would push forward a new frontier of reproductive biology.
If a fragile human egg could be penetrated without harm, perhaps a human embryo might
be manipulated in any number of ways.
These new techniques would open up uncharted territory for another couple, Anne and Michael,
as conventional treatments failed them.
People that are faced with infertility don't have the same decisions as people that aren't,
and these decisions, they're not what we would want.
These are the choices we're left with.
If I could make a choice, I would like it if my husband and I could get pregnant on
our own, and it's easy to sit there and say what you would or wouldn't do when you're
not in those shoes.
She'd been trying for over four years, and she had done several treatments.
She had done some of the more kind of low-key treatments, medication by itself, medication
with insemination using her husband's sperm.
She had had the full battery of diagnostic tests, none of which really revealed a smoking
gun cause as to why she was having difficulty, and she was climbing the ladder from least
aggressive to most aggressive treatment.
During Anne's first IVF cycle, her doctors retrieved 35 eggs, an astounding number.
But once the eggs were fertilized in the lab and began dividing, embryologist Jacques Cohen
noticed fragments, little pieces of cells that are left behind, when embryos divide
inefficiently.
And normally, they're not really a hindrance to further development and pregnancy because
they occur in about 85% of all embryos, but when you have a lot of them, it interferes
with normal development.
The cells then cannot interact, and that's what happened in their case.
There were so many of them that you couldn't even count the number of cells.
Let's say you had a four-cell embryo or an eight-cell embryo.
You couldn't make a count, which you normally can.
So on the one hand, I have an answer, which is finally, after like three years, I finally
have an answer of why I'm not getting pregnant.
Then, on the other hand, I have this news that I don't know if this is going to be fixable.
This may be a permanent problem that we could never fix.
For decades, no one dared to invade the inner sanctum of an embryo for fear of harming it.
But in 1990, Cohen began piercing the shells of fertilized eggs that appeared brittle to
help them hatch.
Today, he uses this technique to enter Anne's embryos and remove their fragments.
This plastic surgery is now routine in many IVF clinics in order to boost a poor-quality
embryo's chance of implanting.
To be honest, at the beginning, I don't think we were sure whether we were just making the
embryos look better or whether we were actually helping them to develop.
And then when we put the data together, it turned out that, yes, indeed, there's a window
of accumulation of fragments from about 15 to about 30 percent of the embryo.
Previously, that embryo didn't have much of a chance of implanting and turning into a
pregnancy.
But if you remove those fragments, they had a very good chance of turning into a pregnancy.
Five of the best-quality embryos were transferred back to Anne.
Although she became pregnant, six weeks later, she lost the baby.
During all this time, we were surrounded by people that were getting pregnant, and here
we were putting our financial savings into this.
A typical IVF cycle in this area costs $12,000 to $15,000.
And you would invest your time, emotions and your money, and to have a result like this,
you just feel like you've been beaten.
Anne endured one more IVF cycle.
Once again, she conceived and then miscarried.
Although she was only 29 years old, it seemed unlikely that she would get pregnant using
her own eggs.
Failure is not the only risk of IVF.
For those patients lucky enough to become pregnant, one-third will deliver more than
one baby.
Rosa and David May became the parents of triplets after three of their four embryos implanted.
Although they were desperate to have children, they were not prepared for the high risk of
a multiple pregnancy.
I had to go into the hospital and I had like a little pump that they installed to help
control the contractions.
I just ballooned, and the most painful part was I no longer had ankles.
They gave her six meals a day to make sure that all the nutrients and everything that
she needed and the children needed were there.
We had the option to abort some to increase the odds of the other ones being healthy,
but we tried five years and there was no question in our minds we were going for the multiple.
Fortunately, Laura May delivered three healthy children.
But not every family is as lucky.
Most triplets and higher order multiples are born prematurely.
Thirty percent will weigh less than two pounds.
And the data that we have on that shows that about one in four of those babies is going
to have serious disability, not mild disability, but real developmental handicaps in life.
Given the enormous risks, why not limit the number of embryos transferred back to the
mother?
When a patient goes through an IVF cycle and goes through all of what's involved, they
want the best possible chance.
How do you give them the best possible chance?
By putting back more embryos.
And how are clinics compared?
People look at success rates, even though they don't understand the nuances and differences
between patient populations, they want the one with the best percentage.
So there is this incredible pressure on us to have high pregnancy rates.
Because 70 percent of all embryos fail to develop, doctors transfer back several in
the hope that at least one will turn into a baby.
You know, when you look at an embryo under the microscope, as beautiful as it is, on
the first day after fertilization and when they're single cells, they just almost all
look the same.
You can't pick out the highest quality embryo on that first day.
Since the early days of IVF, doctors have transferred fertilized eggs back to the mother
when they reach the eight cell stage.
And recently, labs have been getting better at keeping embryos alive.
The hope has been to let nature take its course and keep them in culture for a few more days
after the stage we call the blastocyst, when really the embryo proper starts developing.
And the thought is at that stage, nature will have selected in our incubators the best embryos.
By transferring back only two embryos at the blastocyst stage, doctors avoid the risks
of multiples without diminishing the chance of a pregnancy.
But not every embryo can make it to the fifth day.
At Cornell University, Elissa and Darren anxiously await news about their 13 fertilized eggs.
Fortunately, eight have become viable blastocysts.
Now the challenge is to pick the two that are most likely to survive.
Yes, there is a possibility of having twins and I'd be ecstatic.
I'd be like so happy.
You know, I even joked, you know, can I request them?
And they're like, no, but you just want something to stick and hopefully it will work.
But if it doesn't, we would do it again.
Although more than half the couples going through IVF walk away childless, Darren and
Elissa hope that they will be the lucky ones who defy the odds.
Back in the lab, their two embryos are located beneath the microscope and carefully sucked
up in a catheter.
Having live embryos transferred to her womb will be the closest Elissa has ever come to
being pregnant.
But to become babies, they must implant.
You're not going to feel much, but what it does is it just goes through the cervix, right?
With blastocyst transfer, we have a very high success rate.
Nevertheless, it's age dependent and at the, in the early thirties, it's 50%.
It's still 50-50.
At the end of the day, it's the biology and the competence of that embryo and that depends
on both the egg and the sperm and the combination.
Most difficult part of IVF is every day you're waiting for results in something, waiting
to find out how much sperm and how many eggs there were.
Then a day later waiting to see, Hey, when are they going to inject them back into you?
And that, you know, that was very stressful.
That was four days of just waiting.
And now you don't hear anything until you find out if you have a child or not.
So now will be the greatest of all results, but you won't know for two weeks.
One final question.
Were they above average, the two that you put in there?
They looked very, very, I mean, she has the pictures, you can see it.
Very nice embryos.
All right.
We'll put that on a refrigerator.
Thank you very much.
It's a good life.
Thanks.
Okay.
Very good.
As technology advances, the treatment of infertility has been transformed from a small medical
specialty into a $4 billion a year industry.
At this trade fair, sales teams from all over the world pitch their services to doctors,
hospitals, and couples desperate for a baby.
The Center for Surrogate Parenting is in business to find surrogates and egg donors for infertile
couples.
This field started with everybody thinking that it was ungodly, satanistic.
I couldn't get a doctor to even talk to me when I first started.
I was considered such a maverick.
Doctors were afraid of being put in jail.
I cannot think of any other field of medicine that in 20 years has gone from being a pariah
to being considered a mainstream this quickly.
Many clinics insist that egg donors remain anonymous, but Bill Handel has launched a
thriving business, finding applicants willing to reveal their backgrounds and matching them
with infertile couples.
Our internet site, eggdonor.com, offers the profiles of 300 of our egg donors.
What are you looking for?
Do you have Jewish donors?
Absolutely.
In our area?
And your area is?
In California?
Yes, we do.
Jewish here?
Yes.
You can go on blonde, blue-eyed, Caucasian, Christian woman, and it will then select everybody
in our database that has those characteristics.
Bringing a third person into the reproductive process raises many troubling questions.
For an infertility patient like Anne, turning to egg donation or even adoption meant forsaking
a biological tie to her child.
As she grappled with this dilemma, the research team at St. Barnabas Hospital was pushing
forward a new frontier of reproductive biology involving the exchanging of parts from one
egg cell to another.
They offered Anne an experimental procedure called cytoplasmic transfer, designed to help
women whose eggs divide inefficiently.
The reason that an egg might not be able to do its job very well is that it may have abnormal
chromosomes inside.
On the same hand, there's a possibility that there's a defect in the ability of the egg
to distribute its normal chromosomes, and we most suspect that that's true in younger
women who we believe still have genetically normal eggs and in whom the usual in vitro
fertilization techniques uniformly result in very poorly developing embryos.
The procedure would preserve the nucleus of Anne's eggs that contain over 99 percent of
her chromosomes, the DNA or genetic material that makes her unique.
She would borrow from a donor egg a portion of its cytoplasm containing tiny cellular
structures.
Among them are thousands of mitochondria that provide energy for the cell to divide and,
incidentally, carry DNA for a small number of genes.
In theory, a deficiency in the cytoplasm might prevent an egg from developing normally.
The idea behind it was that if there were situations where it appeared that the cytoplasm
was damaged or insufficient in one way or another, even if one was unable to say precisely
what it was that was wrong with it, one might be able to replace it with a presumed normal
cytoplasm.
Cohen and Willetson experimented with animal models, mixing the cytoplasm from different
mothers of the same species.
As they had hoped, the babies appeared healthy and normal.
Although the doctors felt confident enough to proceed, Anne struggled with the risks.
When you're left with these choices, egg donation or adoption, or doing this new procedure,
egg donation, you don't know who is donating this egg, it's all anonymous egg donation.
You don't know any dispositions towards illnesses, whether it be mental or physical illnesses,
and you don't know how your children are going to react to the news when they grow up, that
they are not genetically your child.
With adoption, you have the same risks, except the adoptive mother can't want this child
back in their life, so you're looking at three options that are risky, and you have to decide
emotionally, medically, and financially which have the fewer risks.
Deciding to proceed with cytoplasmic transfer, Anne and a donor had their eggs harvested.
Then Cohen removed the cytoplasm from the donor's egg, carefully avoiding its nucleus.
One could argue, as indeed some people are arguing, that all this is unnatural and shouldn't
be done and just leave it alone.
But on the other hand, if we want to gain more insight, there can be a benefit in the
area of human reproduction.
Well then, every now and then, the boundaries have to be moved a little bit.
You simply cannot gain experience without experimenting, and it's as simple as that.
By using the fertilization technique of ICSI, donor cytoplasm can be safely injected into
Anne's eggs, along with her husband's sperm.
Three days later, when the developing embryos were examined, they appeared less fragmented.
Four were selected for transfer.
I think looking at the pictures of the four embryos that were transferred in a final cytoplasmic
attempt and compare them to the photographic material we have available from the previous
attempt, there were more cells and the cells looked healthier.
And therefore, my impression is that at least in one or two of the embryos, there seemed
to be a higher chance of development.
Unlike Anne, the majority of patients who turn to IVF are in their late 30s or early
40s.
Many find it difficult to get pregnant simply because of the age of their eggs.
Our peak fertility is in the mid-20s, early 20s, and yet most of us are delaying child
bearing until the late 30s.
Now it is clear that one of the reasons the older patients don't get pregnant with the
same efficiency as the younger patients is that the embryos are chromosomally abnormal
at a higher rate, and it all correlates with the egg and what happens to the egg.
In a woman's child bearing years, one egg is ovulated each month.
If it is fertilized, it will replicate its chromosomes and then divide, splitting them
in half.
Now when that process happens in a young woman's egg, it goes along just fine.
When it happens in an older woman's egg, it doesn't.
Chromosomes get lost or are missing and you make an unhealthy embryo from that.
So the theory is that there is something in the machinery or the cytoplasm, not the nuclear
portion of the egg, but the surrounding portion of the egg, that moves those chromosomes around
that causes these defects in the older woman.
To avoid the possibility of chromosomal damage, Griffo went one step further than cytoplasmic
transfer.
He carefully took the nucleus from an older woman's egg and injected it into a younger
donor egg that had had its nucleus removed.
The reconstructed egg was then fertilized and allowed to divide using the machinery
in the cytoplasm of the younger donor.
And we were able to reconstruct an egg in that fashion, get it to fertilize and make
embryos and we did it in a couple of patients and we transferred embryos and nobody got
pregnant.
We only transferred three or four embryos total in the experiment.
But then we got into trouble.
Criticized for unacceptable human experimentation, Griffo returned to the lab.
Nuclear transfer techniques had recently been used to clone animals.
And although Griffo was not trying to clone a human being, some feared his work might
take us one step closer.
There's a lot of criticism of human reproductive biologists who are using all these new technologies
to allow people to have babies because as a scientist you do all of this background
research and you don't try anything until you're absolutely 100% confident.
But in these cases we have women and men who are desperate to have children.
And what the reproductive biologists are working on is the basic premise that if you do a manipulation
and you've manipulated it too far, you don't get a birth defect, you get no fetus or baby.
On December 20, 1998, Anne delivered a healthy baby girl named Katie.
She was the third child born using cytoplasmic transfer.
This was my closure.
This birth was closure to five years of infertility.
And I really think this whole experience, when I look back on it, it made me and it
makes me appreciate my daughter and my family so much.
And every day I look at her in amazement that she's here and that she's my child.
She knows her background, she knows her roots and to me that's important.
Katie has a mix of her parents' genes as well as traces of mitochondrial DNA from the egg
donor.
But was cytoplasmic transfer responsible for her birth?
My problem with cytoplasmic transfer is I can't conceptualize very well what in fact
is the significant component that's being transferred from the cytoplasm of a donor
egg to the cytoplasm of the infertile woman's egg.
It's conferring upon that egg some kind of improvement in quality.
If in fact that's happening, I mean the numbers at this point don't allow us to say anything
in terms of efficacy and clearly they don't allow us to say much in terms of safety.
There's no scientific proof that the genetic change brought about the development of this
child, but there is scientific proof that this child has DNA from a source other than
her parents.
And so this is the first instance of genetic engineering, whether or not the genes themselves
really had an impact on allowing this child to be born, the threshold has been crossed.
We have already engineered embryos and so people can say, well we have to wait until
a certain point.
It's already been done.
With each new breakthrough in making babies, the limitations and randomness of nature are
slowly being overcome.
One of the most intractable barriers egg donation has pushed back is the limit of age.
Back in 1980, when Arcelia Kay got married, she was entering menopause and had no chance
of becoming pregnant or even adopting a child.
For years, she followed the development of IVF, hoping that new techniques might help
her become a mother.
She saw her chance with egg donation and at age 60, decided to bend the rules.
I really lied about my age because they have this age limit at 55 so I think I will not
qualify if I will not lie about my age and I really want to have a baby.
She presented herself as someone who was 50 years old, well within our age guideline
of 55, underwent the usual kinds of medical testing including a treadmill test and a variety
of other blood tests that we do on all the patients and as far as we were concerned,
we thought that she was just another routine patient.
Mrs. Kay took hormones to force the tissues lining the walls of her uterus to thicken.
Within months, her womb returned to its pre-menopausal state, capable of sustaining a pregnancy.
Then donated eggs fertilized with her husband's sperm were transferred back.
After spending $40,000 and enduring five IVF cycles, she gave birth to Cindy.
At age 63, she was the oldest woman to ever have a baby.
The deception had been obvious.
She knew that she had deceived us.
She did it consciously and successfully because she had attained the goal that she had wanted
to.
What should I tell her?
Scold her for being not forthright and I congratulated her.
I feel very happy actually.
She changed our life for a better one.
I just hope God will give me much longer life to be around her.
When an older woman has a baby, it's very likely that her partner or mate may be old
as well and I think it's risky to create orphans.
So you might want to set an age limit, if not on the age of the woman, then at least
on the couple so that you do what we do in adoption, which is to say at some age, we're
nervous that you can't be around to make sure that the child's interests are protected.
The creation of families with borrowed eggs, sperm, or wombs has raised a myriad of complex
issues.
One of the most difficult is explaining to children how they came to be.
Oh, help, there's a mouth about the house and it gave Mrs. B a fright.
That's okay.
When we turn to IVF from traditional methods such as artificial insemination, one of the
things we did think about was what story we tell our children because when you start separating
the functions of carrying the child versus donating the genetic material, then it becomes
more complex.
Will and Marceline created a birth book to explain to Melina why she doesn't have a mother
in the traditional sense.
It's a very simple story about how her daddy and papa met, fell in love, wanted a family
and how men don't have eggs and women have eggs and men can't carry children or deliver
children but women can and papa and daddy searched the world to find two women who would
help them.
There's like 18 different ways to make a baby now because of the technologies and that makes
us have to rethink what is a family.
Well the fact is what it means to be a family is to have a parent or two parents raise a
child and care for the child and have an attachment to that child that nobody else has and a responsibility
to that child that no one else has and that's really what matters.
Assisted reproduction began with the idealistic goal of helping infertile couples have babies
but increasingly it has given parents greater control over their unborn offspring.
At a leading infertility clinic in Virginia, a technology called Microsort is enhancing
the ability of science to determine one of a child's most important traits, it's sex.
The commonest types of individuals that we help are families who are at risk for having
children with X-link disorders, these are disorders that affect males and therefore
Microsort can be very helpful in producing disease-free female offspring in these families
and the other largest group come to us for family balancing where they already have a
preponderance of children of one gender in the family and they wish to weight the odds
in favor of the opposite gender.
Of the 23 chromosomes carried by the sperm, only one determines gender.
Sperm carrying an X chromosome will produce a girl, sperm carrying a Y chromosome will
produce a boy.
For $3200, sophisticated machines can detect the minute differences in size between male
and female sperm and sort them.
The chance of having a girl when that is sought exceeds 90% and the chance of having a son
exceeds 70%.
I think what's involved here is not the choice of boy or girl, it's the fear of sexism.
If we knew that the percentage of boys and girls would be about the same, I don't think
anybody would care.
So I think the issue isn't choice of sex, it's actually is it going to distort the makeup
of the population or reinforce stereotypes about men and women.
Sex selection has already led to an imbalance in India where there are an estimated 40 million
fewer women, primarily because of the routine abortion of female fetuses.
In China, the desire for boys at one point changed the sex ratio to 153 Chinese males
for every 100 females.
In contrast to the rest of the world, American parents are using microsort to have baby girls.
I think if patients want to use it and want to spend the amount of money that's required,
that's their choice.
To me, it's the wrong message.
To me, gender is not a disease and I'm not going to select against it.
I want people to have healthy babies and whether it's a healthy boy or a healthy girl, I don't
care.
Choosing a baby's sex is a far cry from designing our children, but eventually parents will
have even more choices using a powerful technique called pre-implantation genetic diagnosis
or PGD.
From a single cell plucked from an embryo, doctors can analyze individual chromosomes
and genes.
This microsurgery rarely harms embryos and helps doctors figure out which ones are disease
free.
One of the earliest pioneers to use PGD was Barbara Nastro.
I had many chemical, what they refer to as chemical pregnancies.
So that means that I would become pregnant and then within a couple of weeks of holding
the pregnancy, it would fizzle out.
When we see that, it's very suggestive that many of the fertilized eggs have abnormal
chromosomes and that the nature is just doing its best to stop these abnormal pregnancies
from developing.
At age 41, Barbara underwent IVF in order to use PGD to test her embryos.
A single cell was plucked from each one and analyzed with fluorescent dyes targeted to
bond with five specific chromosomes, most prone to have either an extra copy or a missing
one.
Embryos with the correct number of chromosomes, like this one with matching pairs of color
signals, could be transferred back.
In contrast, this embryo is missing one of its red signals and would not develop normally.
Barbara had nine fertilized eggs to test.
And it turned out that four of them were chromosomally abnormal, including some of the embryos that
looked very, very good that typically we would have transferred and would have resulted in
another miscarriage.
And we subsequently transferred the normal embryos and a successful pregnancy occurred.
Barbara gave birth to healthy fraternal twins, Gabriel and Luke.
Although PGD spared her repeated miscarriages, its cost in conjunction with IVF was almost
prohibitive.
The pre-genetic determination test alone, as I recall, is about $20,000, plus then when
our babies were born early, premature, six weeks, they then had to spend the three weeks
in the NIC unit.
That alone, I believe, was somewhere in the several hundred thousand dollars for them
to be there for that length of time.
It's an enormous amount of money, money that, you know, is inconceivable to most couples.
And for parents who risk passing on inherited diseases like cystic fibrosis, PGD offers
the hope of having a healthy baby.
At the moment, scientists can look for genes related to several dozen diseases.
But our ability to screen embryos will improve exponentially as a result of the decoding
of the human genome.
What's going to happen over the next decade is we're going to understand how those genes
cause all sorts of diseases like asthma or juvenile diabetes or severe depression or
predisposition to heart disease or Alzheimer's diseases.
All these diseases are going to be understood in terms of their genetic influence.
To exploit this knowledge, technology is emerging that allows DNA fragments containing thousands
of genes to be analyzed with automated gene scanners.
In the future, DNA computer chips may be able to tell you every single form of the approximate
30,000 genes that you've got.
They used to say that a child conceived in love has a greater chance of happiness.
Hollywood has already imagined the implications of this powerful technology.
I'll never understand what possessed my mother to put her faith in God's hands rather than
those of her local geneticist.
Ten fingers, ten toes, that's all that used to matter.
Not now.
Now, only seconds old, the exact time and cause of my death was already known.
Neurological condition, 60% probability, manic depression, 42% probability, attention deficit
disorder, 89% probability, heart disorder.
The amazing thing about Gattaca is that it's scientifically right on the mark because it
will be possible in the future to take a drop of blood from a child and know the predispositions
to every kind of disease that this child is going to face in his or her life.
DNA chips revolutionize our ability to look at human genes and it will be possible in
the future to use a DNA chip on embryos.
What I envision in 20 years is that someone will be able to go to the in vitro clinic
who's very fertile, who has no infertility problems at all, but simply says, if you can
tell me a lot about the kind of child that I'm likely to have, that I'm going to spend
the money and use an artificial way to create a baby to kind of get a better baby.
And then what a couple would be able to do is to look at their computer screen and look
at what the child's height would be, certainly what the hair color would be, whether the
child's going to go bald, whether the child's going to get asthma, whether the child's going
to be a bit aggressive or shy.
All of these things are going to come out of looking at a DNA chip profile from each
of these embryos.
The limitation to pre-implantation genetic diagnosis is that parents can only select
for genes that embryos already have.
But scientists have begun inserting new genes into embryos, endowing thousands of animals
with unusual traits.
A specific gene from a jellyfish can make mammals glow in the dark.
Molecules involved in learning and memory can be genetically augmented to create smarter
mice.
As reproductive biology and genetics merge, will parents of the future have the tools
to design their children with new strengths and talents?
Yes, these things could happen.
Right now they don't.
We don't know the genes for hair color, eye color, intelligence.
We don't know how to select for them.
We don't know how to analyze for them.
So these fears, while based in the potential reality that they could occur, are really
unfounded.
I think we'll see this happen.
I think it's going to be very difficult to say to people, you can't do this, because
in a sense today we're already down that road.
Some people do everything they can to environmentally advantage their kids.
Maybe we say they're morally wrong.
In fact, we say they're doing a morally good thing.
It's good to give your child, in a competitive market society, the best shot at success.
And I think that's the ethos that's going to carry us right straight into using pre-implantation,
genetic testing, and new genetic knowledge to design our descendants.
In many ways, the brave new world of assisted reproduction promises far more benefits than
perils.
In the 21st century, newborn children will be spared lethal diseases that plagued past
generations.
As the mysteries of reproduction give way to knowledge, even infertility might be overcome.
For Alyssa and Darren, Ixie has paid off.
They are now the elated parents of a healthy baby girl named Sarah, born January 29, 2001.
Anne's daughter, Katie, appears to be healthy and developing normally.
Although cytoplasmic transfer is still highly experimental, for the small group of patients
that have turned to it, 36% have become pregnant.
People are afraid of the unknown, and most people, therefore, reject new technology.
It takes the mavericks, the maverick scientists, and the people who have some guts to work
with the maverick scientists and clinicians to bring the technology into the public domain.
There are risks to these things, but there's also risks to not treating disease, you know,
and people forget that.
People forget how hard it is to live with infertility.
People forget how devastating that is, and people don't understand why patients are willing
to take these unknown kinds of risks to have that child because they forget about the disease.
Patients today have a surprising number of ways to help make a baby.
On NOVA's website, explore the more than 18 high-tech procedures now in use on PBS.org
or America Online Keyword, PBS.
Educators can order this or any other NOVA program for $19.95 plus shipping and handling.
Call WGBH Boston Video at 1-800-255-9424.
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