Science AMA Series: Hi, I’m Tom Ekman, J.D., M.Ed., and co-author of the forthcoming book ‘Babies of Technology: Assisted Reproduction and the Rights of the Child’ from Yale University Press. Ask me anything!

Abstract

Millions of children have been born in the United States with the help of cutting-edge reproductive technologies, much to the delight of their parents. But alarmingly, scarce attention has been paid to the lax regulations that have made the U.S. a major fertility tourism destination. And without clear protections, the unique rights and needs of the children of assisted reproduction are often ignored.

Babies of Technology, hardcover out April 4th from Yale University Press, is the first to consider the voice of the child in discussions about regulating the fertility industry. The controversies are many. Donor anonymity is preventing millions of children from knowing their genetic origins. Fertility clinics are marketing genetically enhanced babies. Career women are saving their eggs for later in life. And Third World women are renting their wombs to the rich. Meanwhile, the unregulated fertility market charges forward as a multi-billion-dollar industry.

Who will protect our babies of technology? Ask me about that, or anything.

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THANK YOU FOR ALL OF YOUR THOUGHTFUL AND PIERCING QUESTIONS. I AM NEW TO REDDIT AND IT MIGHT TAKE ME A FEW HOURS (OR DAYS), BUT I HOPE TO RESPOND TO YOU ALL. CHEERS!

Can you explain the controversy about career women saving their eggs?

Rinx

In short, its the tension between companies that pay $20k for their women to freeze their eggs (e.g., Facebook, Google) versus implementing family-friendly policies in the workplace.


Can you explain in what way the children need "protected"? Millions of children are born the natural way to single parents, or drug addicted parents, or abusive parents. Is it the job of a government regulatory agency to tell us who can reproduce and how they are allowed to do it?

Edit: I am in no way insinuating that single parents are similar to abusive parents. The author posed the scenario of an anonymous donor as a potentially negative situation. However there are many children born without fertility intervention with only one loving parent in their lives.

ZeneParker

a child has a right to know his or her origins, but they certainly don't have a right to have their sperm donor in their life. It can be important for genetic health reasons, or to avoid commiting incest with another child of the same sperm donor in your town (seriously!). It also has psychological important.

40% of kids in the U.S. are born to unwed mothers. The Leave it to Beaver family model only accounts for about 20%. Blended families are the new norm.

Our book is all about the ways to reproduce OTHER than "the natural way". and in those cases (gen engineering, sperm and egg donors, IVF, surrogacy) there are compelling medical and moral reasons for the government to provide some safeguards for the protection of children.


"And without clear protections, the unique rights and needs of the children of assisted reproduction are often ignored."

How are the children at risk?

owl541

The inability to know one's one lineage and identity confusion in general, several forms of discrimination, a range of health concerns, being taken away from your own mother, being used as a test subject for genetic engineering, having 3 parents instead of 2 (seriously...this has already happened) to name a few.


This is an incredibly short AMA, with several unanswered questions - which is weird given that only a handful of questions are answered. As such, it seems much more advertisement than engagement. Not sure if there was just a lack of interest?

sisyphist

nope -- I only saw 7 comments on my first go-round. apparently, they didn't refresh.


What regulations do you discuss or suggest for the United States or other countries to put in place so that these issues can be dealt with preemptively? Thank you for the AMA.

fleurriette

for the US: a regulatory agency to streamline the widely disparate state laws, keep track of procedures, promulgate safety guidelines, and provide a check-and-balance to fertility tourism and the assisted reproduction industry. Internationally: the US needs to sign the UN Convention on the Rights of the Child (finally joining the rest of the world after 25 years), and the Convention needs to be updated to reflect new technologies


Career women are saving their eggs for later in life.

All of the other examples I can see why people have a problem with them, but what are the possible drawbacks of saving your eggs?

tweetypi

There are some health concerns, as well as the impacts on the child of having older parents. But I think one big issue is: if this becomes the norm in industry -- i.e., career women are expected to freeze their eggs in order to stay competitive -- then we risk losing any chance at family-friendly policies in the workplace.


I recently found out at age 37 that I was fathered by a sperm donor. I feel like my parents should have had to tell me this at some point. Instead I found out on my own after learning that I couldn't possibly be my fathers son. Simple Punnett squares on eye color and blood type - as I became a doctor, not possible. They confessed but they were prepared to take it to the grave. What right if any, did I have to that information?

embracedk

Your feelings have been validated in all of Europe, where anonymity has been banned. The U.N. Convention on the Rights of the Child says you have a right to know your ancestry and biological origins.

Historically in the U.S, secrecy was the norm when infertile couples sought donor sperm. There were some real legal reasons for this, but it was mostly based on the fact that such things simply weren't discussed.


I'm a cancer survivor and my husband and I froze our embryos 8 years ago. I would like to have one of them, but I will need a surrogate. The negative views of purchased surrogacy make me feel far too guilty to pursue this. We have no family members who can/will volunteer. I feel like negative attitudes about surrogacy make a difficult situation even harder. If a woman wants to "rent her womb", for whatever reason, why is that anyone else's business?

felesroo

The issue splits people. Some say a woman should be able to do what she wants with her body, while others see it as an exploitative violation. Some countries that allow prostitution don't allow surrogacy, while some that allow surrogacy don't allow prostitution. When there is a dispute, some courts favor the surrogate, while others favor the contracting family. Some parents like to get to know their surrogate, while others don't ever want to see them.
My 2 cents would be to follow your heart. there are simply no clear-cut guidelines here.


What drew you to research this topic?

89grouch46

My co-author Mary Ann Mason and I collaborated on a science fiction book called The Donor back in 2012, about a super-rich, eccentric man who reaches out to all the hundreds of progeny his sperm donations. My co-author is interested in women's issues and children's issues; I'm more interested in science and tech.


What are the most immediately pressing issues which require attention at this very moment? What do we serve to gain by rectifying these issues?

chamora

The US needs to sign the UN Convention on the Rights of the Child like the other 174 countries. This will allow children of donor egg or sperm to know their genetic identity. We need to start regulating the US fertility industry to protect children from a range of medical and psychological risks posed by this vast, unchecked industry. We also need to collaborate internationally to stop scientists from further experimentation on the human genome, which could put our species at risk for disease, infertility or other unforeseeable downstream effects.


As I have yet to read your book, what are some of the more straight forward ethic problems/arguments concerning a fertility clinic offering "superior" genes?

wenwo16

You mean like the Nobel Sperm Bank? (there's a good story about that out there, btw). I think it upsets people because it's a way that the wealthy are commodifying life and buying themselves supposed genetic superiority. It's definitely got a ring of the old eugenics agenda to it.


I don't want the government or lawyers regulating my fertility. What I do with me eggs and if, how and when I decided to have a child is nobody's business but mine.

Why do you think children are being hurt by this?

The worst that I can think of is that they will not know their biological parents. But if they want or need to know their genetic background, they can get their own DNA tested.

princess-valentina

I said earlier that one concern is that if employers start expecting women to freeze their eggs, then it makes it less likely that family-friendly policies will be put into place in the workplace.


Did you receive your JD or MEd first? If JD, why did you go on to pursue and MEd? What concentration did you receive the MEd in?

2asdfasdf7

J.D. 10 years before...a long time ago, in a galaxy far, far away.

M.Ed. recently in 2dary school science.

Why? because I'm a lover, not a fighter. ; )


So I am a test tube baby and my biological mother was an egg donor. Is there any way to get in touch with her? Is it okay for me to get in touch with her, or should I respect her anonymity?

fuckthisusernameshut

yes! and maybe...all the answers are here:

www.donorsiblingregistry.com


So I am a test tube baby and my biological mother was an egg donor. Is there any way to get in touch with her? Is it okay for me to get in touch with her, or should I respect her anonymity?

fuckthisusernameshut

the Donor Sibling Registry has all of the answers. It's such an amazing resource that I'll let it speak for itself.


Good afternoon! I'm a woman who's married to a woman. We've always desperately wished we could reproduce together... "if only there was a way science could mix our genes!" is what my wife always says!

Do you think one day science will give my wife and I the opportunity to have a biological child?

queengazorpazorp

YES! it's in the book and I can't fish up the link right now, but they will be able to develop ova and sperm from stem cells, from either sex. I'm guessing within 5 years, if not sooner.


Why are state so cautious when it comes to regulation?

metasirena

If you mean: why do U.S. states have diff regulations? states like California are so permissive that clients come from all over the world to retain surrogates or perform sex selection. other states are virtual no fly-zones for assisted reproduction.

but if you mean: why is the state (e.g. the federal government) not regulating, it's a combination of having a legacy of not wanting to touch reproductive issues, and a super-powerful fertility industry that lobbies to keep their industry largely unregulated.


What is your opinion on insurance agencies covering IVF treatment for homosexual male surrogates?

ericamonkseal

if you mean: a surrogate retained by gay parents? If I understand your question, you are asking whether a gay couple can seek insurance coverage for infertility? Frickin' awesome question, if so. I wanted to say in the book that same-sex partners suffer from "cultural" infertility, but I think we took it out.
I think -- and I say this broadly -- that there are lots of children out there that need to be adopted by loving parents. So, an insurance company could argue that the male partners do have another option for having a child.


How do you think states opening of previously closed adoption records will affect the rights of children conceived by means of donor sperm/eggs to get medical information? Similar precedence or covered by contract?

Justanaveragedad

My co-author knows a lot more about the Open Adoption movement of the 90s than I. Are there actually "closed records" states that are subsequently opening adoption records? I seem to recall her saying that its extremely difficult to obtain those records.

Also, I think you refer to 2 different situations: adoption vs. sperm/egg donation. Or are they connected?


Your thoughts about the UK legalizing the creation of babies from 3 people?

Lowvizibility

I'm surprised they went forward. The U.K. is very measured about all things assisted reproduction; in fact, they really lead the world showing what a carefully regulated infertility industry looks like. I do know that mitochondrial transfer shows a lot of promise. However, as an environmental science teacher, I think there's a strong possibility those kids will be sterile. That's how Mother Nature keeps us in check...


You mentioned donor anonymity, in your research do most children want to know their origins?

P1kachu_assassin

There is some excellent research and knowledge in Finding our Families, by Wendy Kramer, founder of the Donor Sibling Registry.

But your question causes me to reflect: how do we know that this is what children want? (Finding our Families provides a lot of insight).

The U.N. Convention on the Rights of the Child states that this is something a child needs.

And in fairness, it's also adults of sperm/egg/embryo donors who want to know their origins.


What will be some of the legal issues be when the technology is developed to birth children from artificial wombs?

Bdsman64

Perhaps when they are wards of the state, or adopted by corporations? (The Matrix and the Truman Show are the references there).

While a full-blown artificial womb may be a long way off -- I know the biofeedback loops and hormones are extraordinarily complex -- medical science has gotten very good at artificially caring for babies porn prematurely.

I think the most we can do is look at surrogacy today. In 3rd world nations, as well as California, you can rent a womb. The woman doesn't even appear on the birth certificate.

Given increasing evidence of an epigenetic relationship of the baby to the gestating mother, there seems to be an increasing awareness that the womb environment is not generic, and does have an effect on the baby's development.


your thoughts on abortion??

animengus

The sensitive nature of the issue is the reason that the US fertility industry is so unregulated compared to Europe and other parts of the world. So, this book argues that we need to put those regulations in place. However, the reason for the regs is to protect the child, because the market cannot be trusted to do so. I think there are going to be more granular issues that will play out at the IVF stage, such as Snowflake Babies.


In your opinion, when should a fetus have human rights? I've been thinking it should be when the fetus has the brain function above that of a legally brain-dead adult. Or at the developmental time period generally when that milestone is reached.

some_a_hole

The rights of the unborn is such a grey area in our law. We primarily advocate for children who are born, though we do discuss epigenetics (what is happening in the womb; e.g., is the gestating mother being healthy)?

We also look a bit at the ramifications of genetic engineering, which will play out at the pre-embryo IVF stage. While one argument is that children have a right to be healthy, another is that no one should tamper with the DNA of unborn children. These may come to be some of the hardest choices we make as a society.


One interesting aspect of ART are the millions of fertilized embryos that are stored in freezers worldwide, only a tiny fraction of which get implanted. What generally happens to these embryos when potential parents stop paying storage fees and what rights do parents have to them at that point if they change their mind?

Edit: typo

Teslaviolin

yup, lowvizibility has it right there below (thanks for that). Also, "donate to another couple" may be a token option, as its very rare to have embryo adoptions.

In the U.K., they mandate destruction of the embryos after 10 or 15 years.


At what month in the mothers womb would you call it a living being?

DarthVenti

please see my stumbling attempt to answer the same question above. ; )


What's your favorite sandwich?

Muthafuckaaaaa

club


are you related to Paul Ekman?

fuckthisusernameshut

yup!


With an already overpopulated world, do you think the use of ivf should be illegal? Contrastingly, what do you about the use of reproductive technology for the majority of human conception, as a means to improve human kind?

mya_25

IVF accounts for just over 1% of US babies. It's not that significant a contributor to overpopulation. And the parents that use it don't have large numbers of children.

I think the use of assisted reproduction to improve SOME members of humankind is inevitable. (That being said, I don't think that the majority of people will benefit from these technologies.) The current impulse to better humans is not as insidious as the eugenics programs of "removing the unfit" from the first half of the 20th Century.


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