Review of Pandora's Baby: How the First Test Tube Babies Sparked the Reproductive Revolution

by Robin Marantz Henig

(Houghton Mifflin, $25.00, 336 pages, February, 2004)

Dr. Fred Bortz books

Reviewed by Dr. Fred Bortz

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Robin Marantz Henig is also the author of
The Monk in the Garden

From in vitro fertilization
Came doomsayers' vituperation:
"It's Pandora's Baby!"
While doctors said, "Maybe
It's cause for a grand celebration."

Robin Marantz Henig's Pandora's Baby: How the First Test Tube Babies Sparked the Reproductive Revolution is the story of an evolving technological controversy. It began more than three decades ago with gynecologists' best intentions. Their goal was to enable infertile women to become pregnant, specifically those patients with healthy ovaries whose healthy eggs failed to reach their healthy uteri because of blockages of their fallopian tubes.

The solution was simple in concept but difficult in practice: extract a woman's ripe egg, expose it to her husband's sperm in a Petri dish, and implant the resulting embryo in her uterus. The problem was that no one knew exactly which aspects of natural fertilization were necessary for conception, nor how to replicate the environmental conditions in a woman's reproductive tract that were essential to successful embryonic development and implantation.

The science and technology of the process were not controversial. Had this involved animal reproduction, it would have been viewed as commercially valuable. But since the object was to produce humans, science and technology immediately became tangled with religion and morality.

Like any technology, in vitro fertilization was subject to failure. Would the process produce a rash of birth defects -- even monstrosities? What about viable embryos that are not implanted? Is destroying them tantamount to murder?

And if the technology succeeded, there was the question of abuse. It would make surrogate motherhood possible. That controversial option would be a boon to women whose uteri were diseased or missing. But it would also enable fertile, wealthy women to pay poor women to carry their babies to term.

Today, when "test tube babies" are common, arguments about in vitro technology are no longer as heated. But successor techniques that it has enabled, such as those that drill entry points into eggs for sperm too weak to penetrate, still draw fire because of the increased risk of impaired babies.

And in vitro fertilization is a necessary precursor for cloning. Does that make it the first step on a classical "slippery slope"?

Ms. Henig does not state definitively where she stands on these questions or therapeutic cloning (though her personal view is not hard to guess). Rather, her purpose is to juxtapose today's circumstances with recent history and allow readers to draw their own conclusions. Are today's fertility doctors like Pandora about to open a box of horrors? Or are they discovering knowledge for a human race wise enough to use it well?

"It's treacherous, this striving to transcend our fate...," Ms. Henig admits, but "[W]e risk it anyway." By writing Pandora's Baby, she enables us to make that risk an informed one.

Fred Bortz is the author of numerous science books for young readers.