Morning:
8°c
"She's our little miracle," said Ruth looking at the toddler destroying a pot of marigolds. Listening to her story of how she and her partner tried unsuccessfully for six years to have a child, the strain it put on their relationship, the feelings of failure and disappointment, it was hard not to be moved. Eventually, they tried a third and final cycle of IVF treatment and, against the odds, conceived.
We were at the christening of my new godson, Harry, and there, playing in the garden, were eight children, four of whom had been conceived using IVF. Each parent told similar stories of the anguish they had felt at the prospect of being childless. Sitting out in the sun, the children playing on the lawn, the parents swapped tales of how their fertility had taken over their lives, dictated everything from moving house to when they went on holiday. It was obvious those who had conceived naturally could not comprehend what the others had gone through.
A generation ago, infertility was a life-long sentence. Medicine could offer no help and couples had to choose between adoption or remaining childless. But with the advent of IVF, a whole industry has developed to promote the idea that having a child is a right, not a biological privilege. Any challenge to this is controversial, so sensitive is the subject matter and so strong the sense of entitlement.
But while IVF specialists champion the incredible advances that have been made in recent years in their field, many other doctors are more reticent about its widespread use. Those such as neonatologists, paediatricians, neurologists and cardiologists witness first-hand the limitations of IVF and the increased risk that children conceived in this way have of severe, sometimes lifelong, complications.
Those who work in services where funding is tight, such as Alzheimer's care, cancer services and geriatrics and who face having to make clinical decisions based on cost, rather than medical need, question funding such procedures on the NHS when so many medications or treatments which could have a dramatic effect on people's lives are denied because the money is not available. And those, such as myself, who have worked with children in care, question the sense of bringing more children into a world where there are so many desperate for a loving, stable family life.
But perhaps what makes doctors most wary is that IVF has heralded a brave new world for which there are no tried-and-tested ethical frameworks. As more couples seek IVF, clinics have been overwhelmed with referrals and this, according to the Human Fertilisation and Embryology Authority, has resulted in errors being made with horrendous consequences. The recent revelations surrounding IVF blunders has thrown into sharp relief how the technology has advanced quicker than our ability to evaluate the ethical dilemmas. Who owns the embryo and where does the responsibility for its welfare lie? Does the child belong to those who are genetically its parents or the woman in whom the embryo was accidentally transplanted? And is it even right to talk in terms of ownership, to commodify life in this way?
There is a quasi-religious element to many aspects of medicine: the lame are made to walk; the blind to see. And now, the barren will bear children. Some see this as a step too far - meddling in the very essence of creation. Yet the technology is here to stay and it is inevitable that as women leave motherhood until later in life, we will become more reliant on it.
Medicine is not infallible: however stringent we are, mistakes will be made. While there are no easy answers to the problems these errors pose, we must ensure that, regardless of how controversial, we don't shy away from asking the questions.
