Dea Birkett 

Take your places for the fertility three-step

Dea Birkett: When even the regulators say women are having IVF too soon, infertile women really are in trouble.
  
  


Here we go again, trotting along to the same old tune. The band of protesters has struck up, and the dance started - one step forward, two steps back. The IVF backlash has begun.

We did the same dance for abortion and the pill, and now we're doing it for infertility treatment. IVF was initially greeted with enthusiasm then, slowly but surely, condemned. It is claimed, without evidence, that infertility treatment is being undertaken unnecessarily, that it is psychologically damaging to the woman, and physically damaging to the child, increasing the chance of birth defects. Errors abound: a white woman gave birth to black twins as a result of "IVF mix-up". We defy nature at our peril: one broadsheet newspaper recently claimed a British clinic was screening out potential sperm donors for having protruding ears.

But whenever medicine, science and the law allow a leap forward for women, it isn't long before the march backwards begins.

The introduction of the pill to Britain in 1961 was greeted by the Family Planning Association as giving women "the opportunity to make informed choices about their lives". Study after study showed that access to contraception didn't increase sexual activity; it only decreased unwanted pregnancy. Yet it was soon being argued that the pill promoted a promiscuous society.

Then, as has now happened with IVF, the scares began. In 1995, women taking the third-generation pill were told there was an increased risk of fatal blood clots. Thousands stopped taking it, leading to an additional 20,000 pregnancies and 10,000 abortions in the following nine months. The pill's reputation never recovered. The Brooke Advisory Clinic says that, as a result of misinformation, the number of young women taking the pill has fallen by more than half in the past decade and the number of unwanted teenage pregnancies has soared. Research showing beneficial health effects - protection against cancers of the endometrium and ovaries, and reduced risk of rheumatoid arthritis and thyroid disease - was largely ignored. The pill was transformed from woman's liberator to her enslaver.

When a cure is discovered for a disease, it is unreservedly welcomed. There's no debate a few years later as to whether it's really a good thing. But women's reproduction - from menstruation through to menopause - is still regarded as more of a psychological than physiological condition, so the backlash always comes.

Infertile women are deemed to be unhinged by their hormones. The trauma of discovering they can't conceive robs women of the ability to make rational decisions. They will go to any lengths to have a child, turning to IVF in panic. Even a spokeswoman for the Human Fertilization and Embryology Authority, which regulates the provision of IVF, last week warned that women "need to discuss with doctors exactly what their problem is and what is the best way of managing it, rather than assuming that IVF is always the answer".

In this example, it is the good doctors who are trying to talk women out of making irrational decisions. But in others, we're told that clinics bully women into having fertility treatment, as if infertile women are so mentally feeble that they can be forced to inject themselves with powerful drugs with little chance of a successful outcome. (No evidence of such bullying has ever been forthcoming.) The more cycles of treatment they have, the more pressure they must have been put under; that is, the more infertile they are, the more unhinged they become. This again resembles earlier anti-abortion debates. Vulnerable women with unwanted pregnancies were, the anti-choice lobby argued, being forced to terminate pregnancies by doctors. As a result they suffered a condition, unknown to science, called post-abortion trauma.

Interestingly, the anti-abortion lobby, manifested as the Society for the Protection of the Unborn Child, has largely given up on the abortion debate. Ninety-two per cent of us now agree with the right to choose. But the SPUC has discovered new territory in infertility treatment. In the mid-90s it announced, "we have expanded our remit to focus more on genetics and reproductive ethics". It began to talk about the threat of a eugenicist society.

But the lessons to be learnt from the 1967 Abortion Act and the subsequent widespread availability of abortion on the NHS are not of scares and dangers. Regulated and free abortions have made them safe, eliminating backstreet operators; readily available infertility treatment may well have the same regulatory effect. Nor has there been a vast increase in the number of women flocking for a termination. Similarly, arguments that increased access to IVF encourages women to delay having children in the knowledge that they always have the petri dish, have no factual basis. Both abortion and infertility treatment are chosen when there are no other choices.

Let's learn from the pill and abortion debates, and reject this latest backlash. Infertile women are neither bad nor mad. They are simply rational people who suffer from a condition for which medical treatment may offer a cure. deabirkett@aol.com

 

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