Light Showing Glow at the Second a Sperm Has Concieved a Babie

"18 Ways to Make a Infant"

PBS Airdate: Oct 9, 2001
Go to the companion Web site

NARRATOR: Frozen at minus-380 degrees Fahrenheit, a human embryo is selected to be thawed, resulting in the birth of Melina, now 4 years erstwhile. Her brother Luc was created in the same manner. Their parents are Will, a lawyer in Los Angeles, and Marcellin who's a surgeon.

They've been able to have children because of a discovery made in 1978—that by bringing together a man'southward sperm and a woman's egg in a laboratory, a baby could start its life outside the man body. It's chosen "in vitro fertilization."

Will: Marcellin was the sperm donor for ane and I was the sperm donor for the other. But we don't tell the public or even our shut friends or family unit who that is. But our children will know. Marcellin is from a very large family; he'south the youngest of twenty. I am an simply child, and so I sort of always arcadian family life in a big family. To me, it was but a basic human desire to want to have children.

NARRATOR: Since neither Will nor Marcellin could carry their baby, they searched for a woman willing to serve as a surrogate mother.

WILL: Many of the women we knew who wanted to aid united states of america didn't actually want to carry a kid that they were biologically related to. And with IVF, our friend said, "Okay, if the egg's not from me, I would feel comfortable carrying the kid."

NARRATOR: In vitro fertilization has enabled thousands of couples to create the family they desperately want. It has too opened a gateway to a dauntless new earth—where a child can have v parents, or be built-in to a female parent in her sixties; where a baby can have its sex activity determined before conception or exist created with borrowed DNA; where an embryo, no larger than a speck of grit, can accept its genes scanned for diseases, or one day be designed with new strengths and talents.

LEE Argent (Princeton University): 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 the sudden y'all can practice annihilation you want with these human embryos and eggs, which couldn't be done before.

NARRATOR: A new revolution in making babies is underway, one that could allow usa to influence and even shape the genetic fate of our children.

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ANNE: I think it's very hard for anybody to explain why they desire a kid. And the matter that I e'er felt so strongly nearly—why, equally an infertile person, do I have to explicate why I desire a child, where somebody who's not infertile doesn't? And it's something nobody is prepared for. Nobody is prepared for somebody to sit beyond a desk from them and say, "I'yard pitiful, but you lot tin can't take a child."

NARRATOR: One out of every six couples struggles with infertility.

ILYSA: You come up 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...nosotros were devastated.

NARRATOR: For many, in vitro fertilization is their last promise for a child, despite the stark reality that it fails 70 percentage of the time.

JAMES GRIFO (NYU School of Medicine): 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 role of the specialist are depressed considering of this illness. And non many people view this as an disease, but infertility is a rotten, horrible affliction. And, no, it's not a disease that will impale y'all, merely information technology wreaks havoc in these patients' lives. Information technology is not a cosmetic illness.

NARRATOR: The disease of infertility once seemed incurable—until the miraculous nascence of Louise Brownish in 1978. Her inflow marked an celebrated moment, for Louise was the beginning human baby ever conceived outside a mother'due south 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, all the same they couldn't effigy out why the embryos failed to develop into pregnancies once they were returned to the mother.

ROBERT EDWARDS (Bourne Hall Clinic): Nosotros had got all the techniques fix, right upwardly to the point of implantation—cute embryos—and checked out the chromosomes and everything about them. And it was clear this method had to work. There was also much knowledge already in mice and rabbits and goats. Mind you, the techniques we were doing were in advance of those, and then we felt that the homo was not and then different...that the method could not not piece of work.

NARRATOR: The breakthrough came when Steptoe and Edwards decided to transfer the embryo earlier, allowing information technology to separate just three times before placing information technology in the womb.

ROBERT EDWARDS: I tin see the embryo beautifully.

We were trying to come earlier and earlier, really to avert long-term cultures. That was my primary aim. And and so all of a sudden the organisation started to work and we were there.

NARRATOR: Three years later, NOVA filmed the birth of America's first "test tube" baby, Elizabeth Jordan Carr.

Although Louise Brown was good for you at nascence, many feared that IVF babies could well be abnormal. Ultrasound had shown that Elizabeth was small, and the doctors that created her, Georgeanna and Howard Jones were extremely worried.

HOWARD JONES (Jones Institute for Reproductive Medicine): I had written out a printing release that said that nosotros'd been disappointed at birth that the child was abnormal, but that we did take a couple of other pregnancies coming along behind that. And nosotros would hope that the others were perfectly okay. And fortunately, I didn't have to use that.

PEDIATRICIAN: "All correct, ladies, here she is—Elizabeth! That'southward right. I knew you would like information technology to be a girl."

ARTHUR CAPLAN (Center for Bioethics, University of Pennsylvania): I remember the major moral business organization was, "Were you going to have a child built-in who had birth defects? Were you going to have developmental abnormalities? Would something go wrong later on in the life of that person?" And I remember the terror was that, somehow, doing something in a dish was going to create a person that was less than healthy.

NARRATOR: But the terror faded quickly. As the printing followed Louise Brown and Elizabeth Carr, it was articulate that the girls who had made medical history were growing up to be perfectly normal.

ELIZABETH CARR (First American to be conceived through IVF): Every year people pop up and say, "Oh, nosotros'd like to practise an update on Elizabeth." And every year I say, "Well, I'm the aforementioned equally I was terminal year, only a year older. That's it." It'southward kind of like they look a wonderful answer like, "Oh yes, I feel so unlike. I feel so special. And I don't."

NARRATOR: Initially, IVF could only help a pocket-size percentage of infertile couples. Today, information technology has become the starting bespeak for treating near every crusade of infertility as lacking eggs, weak sperm, or abnormal chromosomes—one time insurmountable obstacles—are overcome. Radical new techniques have proven that life on the cellular level is easier to manipulate than ever imagined.

Merely for those who embark on this loftier-tech process, IVF remains a grueling ordeal. The start hurdle is to endure daily injections of powerful drugs to force the ovary to produce more i egg.

DARREN: Ilysa had gone through iii weeks of taking shots, you lot know? All over her body bruises...getting up every morn at six in the morning to go to give blood. And you have a lot of guilt seeing your spouse get through all this stuff, knowing that if I didn't have this trouble she wouldn't accept to do this. She's very fertile. I mean that's the best part.

NARRATOR: Infertility was often seen as a woman'south curse, but in fact 40 percent of cases tin exist attributed to male problems like Darren's.

DR. ZEV ROSENWAKS (New York-Weill Cornell Medical Center): The sperm count is very, very low. And when you have such low sperm count, the claiming is to select a normal sperm, or what looks like a normal sperm, and to get fertilization. All the same, so long as nosotros take some sperm and they're live, nosotros tin can allow the sperm to go to the egg.

NARRATOR: Because Darren's sperm are too weak to achieve Ilysa'southward eggs, her eggs must be surgically retrieved. Using a long thin needle, Rosenwaks probes her ovary. One past ane the tiny eggs are sucked out into test tubes and taken to the lab. Information technology is the quality and number of the eggs and sperm that will determine the outcome.

DR. ZEV ROSENWAKS: We had xv mature eggs, and there are several motile sperm, merely very, very few. So they are looking...they accept to search out quite a bit. And the hope is, of course, to get at to the lowest degree an equal number of sperm to the number of eggs nosotros take. And this is the kind of state of affairs nosotros're dealing with here.

NARRATOR: A fertile man volition produce millions of sperm. Today the doctors take institute only 12 of Darren's to work with. Using a sparse drinking glass needle, ane sperm is grabbed by its tail. Then Ilysa'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.

GIANPIERO PALERMO (New York-Weill Cornell Medical Middle): Well I was placing sperm around the egg, underneath the beat, then, accidentally, I perforated the membrane of the egg. And so i sperm went inside. Ironically, I didn't pay much attention. I thought the egg would not survive the procedure. And I put a question mark to it because I thought it was going to dice. But that was the only egg that fertilized. Information technology finally was transferred to the patient, and this became the commencement ICSI baby.

NARRATOR: Palermo called his discovery "ICSI" for intracytoplasmic sperm injection. Amazingly, creating a human being through the transmission injection of sperm proved to be just as constructive every bit natural fertilization. The just known safety take chances seemed to be the possibility of passing on the factor for male infertility.

ICSI's success would push forwards a new frontier of reproductive biology. If a fragile human egg could be penetrated without impairment, perhaps a human embryo might be manipulated in any number of ways.

These new techniques would open up upward uncharted territory for some other couple, Anne and Michael, as conventional treatments failed them.

ANNE: People that are faced with infertility don't accept 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 selection, I would like information technology if my hubby and I could get significant on our own. And it'southward easy to sit there and say what you would or wouldn't do when you're not in those shoes.

DAVID SABLE (Saint Barnabas Medical Eye): She'd been trying for over four years. And she had washed several treatments. She'd done some of the more...kind of depression-key treatments, you lot know? Medication by itself, medication with insemination using her married man'south sperm. She had had the full battery of diagnostic tests, none of which really revealed a smoking-gun crusade equally to why she was having difficulty. And she was climbing the ladder from least aggressive to well-nigh aggressive treatment.

NARRATOR: During Anne's first IVF cycle, her doctors retrieved 35 eggs—an phenomenal number. Yet one time 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.

JACQUES COHEN (Saint Barnabas Medical Center): And ordinarily they're not really a hindrance to further development and pregnancy, because they occur in about 85 pct of all embryos. Simply when y'all have a lot of them, it interferes with normal development. The cells then cannot collaborate. And that'southward what happened in their case. At that place were so many of them that you couldn't even count the number of cells. Let'south say y'all had a four-cell embryo or an 8-cell embryo. You lot couldn't make a count, which you normally can.

ANNE: And so on the ane hand, I have an answer which is finally...later on like three years...I finally have an answer of why I'm non getting significant. Then, on the other manus I have this news that I don't know if this is going to be fixable. This may be a permanent trouble that we could never fix.

NARRATOR: For decades, no one dared to invade the inner sanctum of an embryo for fright of harming it. But in 1990, Cohen began piercing the shells of fertilized eggs that appeared brittle to assistance them hatch.

Today, he uses this technique to enter Anne's embryos and remove their fragments. This plastic surgery is at present routine in many IVF clinics, in order to boost a poor quality embryo'southward hazard of implanting.

DAVID SABLE: To be honest, in the beginning I don't call up nosotros were sure whether we were just making the embryos await better, or whether we were really helping them to develop. And then when we put the data together, it turned out that, yes, indeed in that location'due south a window of accumulation of fragments from about fifteen to most 30 per centum of the embryo. Previously, that embryo didn't take much of a chance of implanting and turning into a pregnancy. Just if you remove those fragments, they had a very good chance of turning into a pregnancy.

NARRATOR: Five of the best quality embryos were transferred back to Anne. Although she became pregnant, vi weeks subsequently, she lost the baby.

ANNE: During all this time, nosotros were surrounded by people that were getting pregnant. And here we were putting our fiscal savings into this. A typical IVF cycle in this expanse costs 12 to 15 chiliad dollars. And you lot would invest your time, emotions, and your coin. And to have a result like this...you simply experience similar you've been beaten.

NARRATOR: Anne endured ane more IVF cycle. In one case again she conceived and then miscarried. Although she was merely 29 years onetime, information technology seemed unlikely that she would get pregnant using her own eggs.

Failure is non the only risk of IVF. For those patients lucky enough to become pregnant, one-tertiary will evangelize more than one baby.

Laura and David May became the parents of triplets after iii of their four embryos implanted. Although they were desperate to have children, they were non prepared for the loftier risk of a multiple pregnancy.

LAURA MAY: I had to get into the hospital and they had, like, a little pump that they installed to help command the contractions. I simply ballooned. And the most painful office was I no longer had ankles.

DAVID MAY: We gave her six meals a solar day to make certain that all the nutrients and everything that she needed, and the children needed, were there.

LAURA MAY: We had the pick to abort some to increase the odds of the other ones existence healthy. But nosotros had tried five years and there was no question in our minds. We were going for the multiple.

NARRATOR: Fortunately, Laura May delivered three healthy children. But not every family is as lucky. Virtually triplets and higher guild multiples are born prematurely. Xxx percent will weigh less than two pounds.

ARTHUR CAPLAN: And the information that we have on that shows that about one in four of those babies is going to have serious disability—not mild disability, merely real developmental handicaps in life.

NARRATOR: Given the enormous risks, why not limit the number of embryos transferred back to the mother?

JAMES GRIFO: When a patient goes through an IVF bike, and goes through all of what's involved, they desire the best possible chance. Now how do y'all give them the all-time possible hazard? By putting back more than embryos. And how are clinics compared? People look at success rates. Even though they don't empathize the nuances and differences between patient populations, they desire the one with the best percentage. And so there is this incredible pressure on us to have loftier pregnancy rates.

NARRATOR: Because seventy pct of all embryos fail to develop, doctors transfer back several in the promise that at least i will turn into a baby.

DOUG POWERS: Y'all know, when you await at an embryo under the microscope, as beautiful equally it is on the first day subsequently fertilization, when they're single cells, they just almost all look the same. You can't pick out the highest quality embryo on that start 24-hour interval.

NARRATOR: Since the early days of IVF, doctors have transferred fertilized eggs dorsum to the mother when they reach the eight-prison cell stage. But recently, labs have been getting better at keeping embryos alive.

DOUG POWERS (Boston IVF): The hope has been to let nature take its class and keep them in culture for a few more days—after the phase nosotros telephone call the blastocyst, when, actually, the embryo proper starts developing. And the thought is, at that stage, nature will have selected, in our incubators, the best embryos.

NARRATOR: By transferring back merely two embryos at the blastocyst stage, doctors avoid the risks of multiples without diminishing the run a risk of a pregnancy. But not every embryo can go far to the fifth day.

At Cornell University, Ilysa and Darren anxiously wait news almost their 13 fertilized eggs. Fortunately, eight take become viable blastocysts. At present the challenge is to choice the two that are most likely to survive.

ILYSA: Yes, there is a possibility of having twins and I'd be ecstatic. I'd be, similar,then happy. I fifty-fifty joked, y'all know, "Can I request them?" And they're like, "No." But you lot simply want something to stick and hopefully it will work. Only if information technology doesn't we would practise it again.

NARRATOR: Although more than one-half the couples going through IVF walk away childless, Darren and Ilysa 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 advisedly sucked up in a catheter. Having live embryos transferred to her womb will be the closest Ilysa has ever come to being pregnant. But to become babies they must implant.

DR. ZEV ROSENWAKS: With blastocyst transfer, we have a very high success rate. However, it's historic period-dependent, and in the early on thirties information technology's 50 percent. Information technology's still 50-50. At the end of the twenty-four hour period it's the biology and the competence of that embryo, and that depends on both the egg and the sperm, and their combination.

DARREN: The most difficult part of IVF is everyday you lot're waiting for results on something—waiting to notice out how much sperm and how many eggs at that place were. So a twenty-four hour period later y'all're waiting to come across, "Hey, when are they going to inject them back into y'all?" And that was very stressful. That was four days of just waiting. And at present you don't hear anything until you observe out if you have a child or not. So now will exist the greatest of all results, but you won't know for 2 weeks.

NARRATOR: As technology advances, the treatment of infertility has been transformed from a small medical specialty into a four-billion-dollar-a-year industry. At this trade off-white, 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 discover surrogates and egg donors for infertile couples.

WILLIAM HANDEL (Center for Surrogate Parenting): This field started with everybody thinking that information technology was ungodly, satanistic. I couldn't get a doctor to even talk to me when I showtime started. I was considered such a maverick. Doctors were agape 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 mainstream this quickly.

NARRATOR: Many clinics insist that egg donors remain bearding, simply Bill Handel has launched a thriving business finding applicants willing to reveal their backgrounds, and matching them with infertile couples.

WILLIAM HANDEL: Our Internet site, EggDonor.Com, offers the profiles of 300 of our egg donors.

NURSE: What are y'all looking for?

WOMAN: Practise you take Jewish donors?

NURSE: Absolutely.

Woman: In our surface area?

NURSE: And your area is...?

COUPLE: In California?

NURSE: Yes, we do.

COUPLE: Okay. Just click Jewish here?

NURSE: Yeah.

COUPLE: Brownish hair, brown eyes.

WILLIAM HANDEL: You can go on "blond, blue-eyed, Caucasian, Christian woman," and information technology volition then select everybody in our database that has those characteristics.

NURSE: And we'll submit.

NARRATOR: Bringing a 3rd person into the reproductive procedure raises many troubling questions. For an infertility patient similar Anne, turning to egg donation or even adoption meant forsaking a biological tie to her child. As she grappled with this dilemma, the inquiry team at Saint Barnabas Hospital was pushing frontward a new frontier of reproductive biology involving the exchanging of parts, from one egg prison cell to some other. They offered Anne an experimental procedure called cytoplasmic transfer, designed to help women whose eggs divide inefficiently.

DAVID SABLE: The reason that an egg might non be able to do its job very well is that information technology may have abnormal chromosomes inside. On the aforementioned mitt at that place's a possibility that in that location'due south a defect in the power of the egg to distribute its normal chromosomes. And nosotros nigh doubtable that that'due south true in younger women, who nosotros believe still take genetically normal eggs, and in whom the usual in vitro fertilization techniques uniformly result in very poorly developing embryos.

NARRATOR: The process would preserve the nucleus of Anne'southward eggs that contain over 99 percent of her chromosomes, the DNA or genetic textile that makes her unique.

She would borrow from a donor egg a portion of its cytoplasm, containing tiny cellular structures. Amid them are thousands of mitochondria that provide free energy for the cell to dissever, and incidentally, carry DNA for a small number of genes.

In theory, a deficiency in the cytoplasm might prevent an egg from developing normally.

STEEN WILLADSEN (Saint Barnabas Medical Heart): The idea behind it was that, if at that place were situations where information technology appeared that 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, ane might be able to replace it with presumed normal cytoplasm.

NARRATOR: Cohen and Willadsen experimented with animate being models, mixing the cytoplasm from different mothers of the same species. Every bit they had hoped, the babies appeared healthy and normal.

Although the doctors felt confident enough to proceed, Anne struggled with the risks.

ANNE: 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'south 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 abound upwardly that they are not genetically your child. With adoption, you have the same risks, except the adoptive mother could want this child back in their life.

And then y'all're looking at three options that are risky, and you have to decide emotionally, medically and financially which accept the fewer risks.

NARRATOR: Deciding to keep with cytoplasmic transfer, Anne and a donor had their eggs harvested. Then Cohen removed the cytoplasm from the donor'due south egg, advisedly avoiding it's nucleus.

STEEN WILLADSEN: One could argue, equally indeed some people are arguing, that all this is unnatural, and information technology shouldn't exist washed, and just leave it lonely. Only on the other hand, if we want to gain more insight that can be of do good in the area of human reproduction, well then, every at present and then the boundaries have to be moved a piddling bit. You but cannot gain experience without experimenting. And information technology'southward as simple as that.

NARRATOR: By using the fertilization technique of ICSI, donor cytoplasm tin be safely injected into Anne's eggs along with her husband'south sperm. Three days later, when the developing embryos were examined, they appeared less fragmented. Four were selected for transfer.

JACQUES COHEN: I call back looking at her pictures of the iv embryos that were transferred in a final cytoplasmic attempt, and comparing them to the photographic fabric we have available from the previous try, there were more cells and the cells looked healthier. And therefore, my impression is that at least in one or 2 of the embryos there seemed to be a higher chance of development.

NARRATOR: Different Anne, the majority of patients who turn to IVF are in their late thirties or early forties. Many find information technology difficult to get significant but because of the age of their eggs.

JAMES GRIFO: Our superlative fertility is in the mid-twenties, early twenties. And yet most of us are delaying childbearing until the tardily thirties. Now it is clear that one of the reasons the older patients don't go significant with the aforementioned efficiency as the younger patients is that the embryos are chromosomally aberrant at a higher rate. And it all correlates with the egg and what happens to the egg.

NARRATOR: During a woman'south childbearing years, i egg is ovulated each month. If it is fertilized, it will replicate its chromosomes and then divide, splitting them in half.

JAMES GRIFO: Now, when that process happens in a young woman's egg, it goes along only fine. When information technology happens in an older woman'due south egg, it doesn't. Chromosomes become lost or are missing and yous brand an unhealthy embryo from that. And then the theory is that there'due south something in the machinery or the cytoplasm, non the nuclear portion of the egg, but the surrounding portion of the egg, that moves those chromosomes effectually that causes these defects in the older woman.

NARRATOR: To avoid the possibility of chromosomal harm, Grifo went one stride further than cytoplasmic transfer. He carefully took the nucleus from an older adult female'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 separate using the machinery in the cytoplasm of the younger donor.

JAMES GRIFO: And we were able to reconstruct an egg in that fashion—go information technology to fertilize and make embryos. And we did it in a couple patients and we transferred embryos and nobody got significant. We just transferred three or iv embryos total in the experiment, but then we got into problem.

NARRATOR: Criticized for unacceptable human experimentation, Grifo returned to the lab. Nuclear transfer techniques had recently been used to clone animals. And although Grifo was not trying to clone a homo beingness, some feared his work might accept united states of america one step closer.

LEE SILVER: There'south a lot of criticism of human reproductive biologists who are using all of these new technologies to allow people to take babies. Because equally a scientist you exercise all of this background research, and you don't effort anything until you're absolutely 100 percent confident. Only in these cases we have women and men who are drastic to have children. And what the reproductive biologists are working on is the basic premise that if y'all do a manipulation, and you've manipulated it likewise far, you don't get a birth defect, you become no fetus or babe.

NARRATOR: On December xx, 1998, Anne delivered a salubrious baby girl named Katie. She was the third child born using cytoplasmic transfer.

ANNE: This was my closure. This nativity was closure to 5 years of infertility, and I really recall this whole experience, when I look back on it, information technology makes me appreciate my daughter and my family so much. And every solar day I look at her in amazement that she'south here. And that she's my child. She knows her background, she knows her roots, and to me, that'due south important.

NARRATOR: 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 nascency?

DR. DON WOLF (Oregon Regional Primate Research Centre): My trouble with cytoplasmic transfer is I can't anticipate very well what in fact is the significant component that is being transferred from the cytoplasm of a donor egg to the cytoplasm of the infertile woman'southward egg that's conferring upon that egg some kind of comeback in quality. If, in fact, that's happening. I mean, the numbers at this point don't allow the states to say anything in terms of efficacy. And clearly they don't permit us to say much in terms of safety.

LEE Argent: At that place'due south no scientific proof that the genetic change brought nearly the evolution of this child, but there is scientific proof that this child has Dna from a source other than her parents. Then, this is the start case of genetic engineering science. Whether or not the genes themselves really had an bear on on assuasive this child to be built-in, the threshold has been crossed. Nosotros have already engineered embryos, and so people tin can't say, "Well we have to wait until a certain signal." It'southward already been done.

NARRATOR: 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 Arceli Keh got married, she was entering menopause and had no chance of becoming meaning or even adopting a kid. For years, she followed the development of IVF, hoping that new techniques might help her become a female parent. She saw her chance with egg donation, and at historic period 60, decided to bend the rules.

ARCELI KEH (Woman who gave birth at 63): I really lied near my age because they take this age limit of 55. So I think I will not authorize if I will not lie nearly my age. And I really want to accept a baby.

RICHARD PAULSON: She presented herself as someone who was fifty 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 equally far equally we were concerned,we idea that she was just another routine patient.

NARRATOR: Mrs. Keh took hormones to force the tissues lining the walls of her uterus to thicken. Inside months, her womb returned to its pre-menopausal state, capable of sustaining a pregnancy. Then donated eggs, fertilized with her hubby'south sperm, were transferred dorsum.

Later on spending 40,000 dollars and enduring five IVF cycles, she gave nascency to Cindy. At age 63, she was the oldest woman to always have a babe.

RICHARD PAULSON (USC Center for Infertility): The deception had been obvious. She knew that she had deceived u.s.. She did it consciously, and successfully, considering she had attained the goal that she had wanted to. What should I tell her? Scold her for being non-forthright? I congratulated her.

ARCELI KEH: I experience very happy, actually. She changed our life for a amend i. I just hope God will give me a much longer life, you know, to exist around her.

ARTHUR CAPLAN: When an older woman has a babe, it'south very likely that her partner or mate may be old also. And I think it'southward risky to create orphans. So, you might want to set an historic period limit, if not on the age of the woman, and then at least on the couple. Then that you lot do what nosotros do in adoption, which is to say at some age, "Nosotros're nervous that y'all can't exist effectually to brand sure that the child'south interests are protected."

NARRATOR: 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.

Volition: "Oh aid! There is a mouse about the house!"

MELINA: "That's okay."

Will: "And it gave Mrs. B a fright."

MELINA: "That's okay."

Volition: When we turned to IVF from traditional methods, such as artificial insemination, 1 of the things we did retrieve most was what story nosotros tell our children. Because when you start separating the functions of carrying the kid versus altruistic the genetic material, and then it becomes more than complex.

NARRATOR: Volition and Marcellin created a birth book to explain to Melina why she doesn't have a mother in the traditional sense.

Volition: It's a very simple story about how her daddy and papa met, vicious in love, wanted a family unit. And how men don't accept eggs and women have eggs and men can't deport children or deliver children, merely women can. And papa and daddy searched the earth to notice two women who would help them.

JAMES GRIFO: There'southward, like, eighteen unlike ways to make a baby now, considering of the technologies. And, you lot know, that makes united states of america accept to rethink, "What is a family?" Well, the fact is, what information technology means to be a family is to have a parent or two parents raise a kid, and care for the child, and take an attachment to that child that nobody else has, and a responsibility to that child that no one else has. And that'due south actually what matters.

NARRATOR: 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 scientific discipline to make up one's mind one of a child's most important traits—its sexual practice.

JOSEPH SCHULMAN (Genetics & IVF Institute): The commonest types of individuals that we help are families who are at run a risk for having children with 10-link disorders. These are disorders that effect males and therefore microsort can be very helpful in producing illness-gratuitous, female offspring in these families. And the other largest grouping come to the states for family unit balancing, where they already have a preponderance of children of one gender in the family unit and they wish to weight the odds in favor of the opposite gender.

NARRATOR: Of the 23 chromosomes carried by the sperm, but i determines gender. Sperm conveying an Ten chromosome will produce a girl. Sperm conveying a Y chromosome volition produce a boy. For $3200, sophisticated machines tin can detect the minute differences in size between male and female sperm and sort them.

JOSEPH SCHULMAN: The adventure of having a girl, when that is sought, exceeds ninety percent. And the chance of having a son exceeds seventy percent.

ARTHUR CAPLAN: I think what's involved here is non the choice of boy or girl, it's the fear of sexism. If we knew the pct of boys and girls would exist about the aforementioned, 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 make-up of the population or reinforce stereotypes nigh men and women?"

NARRATOR: Sex pick has already led to an imbalance in India where in that location are an estimated 40 meg fewer women, primarily because of the routine ballgame of female fetuses. In Red china, the desire for boys at one signal changed the sex ratio to 153 Chinese males for every 100 females. In contrast to the rest of the earth, American parents are using microsort to take baby girls.

JAMES GRIFO: I think if patients want to use it, and want to spend the amount of money that's required that'due south their choice. To me, it's the incorrect message. To me, gender is not a illness, and I'm not going to select confronting it. You know, I want people to accept salubrious babies. And whether it's a salubrious boy or a healthy girl, I don't care.

NARRATOR: Choosing a babe'south sex is a far weep from designing our children. Simply eventually, parents volition have even more choices using a powerful technique called pre-implantation genetic diagnosis or PGD. From a single cell plucked from an embryo, doctors tin clarify individual chromosomes and genes.

This microsurgery rarely harms embryos, and helps doctors figure out which ones are disease-free. I of the earliest pioneers to utilise PGD was Barbara Nastro.

BARBARA NASTRO: I had many chemical...what they refer to equally chemical pregnancies. Then that means that I would become significant, and and then within a couple of weeks of belongings the pregnancy, information technology would fizzle out.

DAVID SABLE: When yous see that, it'due south very suggestive that many of the fertilized eggs have aberrant chromosomes, and that nature is just doing its all-time to stop these abnormal pregnancies from developing.

NARRATOR: At age 41, Barbara underwent IVF in gild to use PGD to test her embryos. A single prison cell was plucked from each one and analyzed with fluorescent dyes targeted to bond with 5 specific chromosomes almost decumbent to have either an extra copy or a missing one.

Embryos with the correct number of chromosomes, like this one with matching pairs of colour signals, could be transferred dorsum. In contrast, this embryo is missing 1 if its crimson signals, and would not develop ordinarily.

Barbara had nine fertilized eggs to test.

DAVID SABLE: And it turned out that four of them were chromosomally abnormal, including some of the embryos that looked very, very practiced—that typically, nosotros would have transferred, and would have resulted in another miscarriage. And nosotros subsequently transferred the normal embryos and a successful pregnancy occurred.

NARRATOR: Barbara gave nascence to healthy fraternal twins, Gabriel and Luke. Although PGD spared her repeated miscarriages, its toll, in conjunction with IVF, was almost prohibitive.

BARBARA NASTRO: The pre-genetic determination test lonely every bit I recollect, is near $twenty,000. Plus...and then when our babies were born early...premature...six weeks...they then had to spend three weeks in the NIC Unit. That alone, I believe, was somewhere effectually several hundred chiliad dollars for them to be there for that length of time. It'due south an enormous amount of money—money that is inconceivable to well-nigh couples.

NARRATOR: But for parents who take a chance passing on inherited diseases like cystic fibrosis, PGD offers the promise of having a healthy baby. At the moment, scientists can look for genes related to several dozen diseases. Only our ability to screen embryos will improve exponentially every bit a result of the decoding of the homo genome.

LEE Argent: And what's going to happen over the next decade is we're going to sympathize 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 of these diseases are going to be understood in terms of their genetic influence.

NARRATOR: To exploit this knowledge, applied science is emerging that allows Deoxyribonucleic acid fragments containing thousands of genes to be analyzed with automated factor scanners. In the future, DNA figurer chips may be able tell y'all every single form of the approximate thirty thousand genes that you've got.

GATTACA Prune: "They used to say that a child conceived in beloved has a greater run a risk of happiness."

NARRATOR: Hollywood has already imagined the implications of this powerful technology.

GATTACA PROGENY (played past ETHAN HAWKE): I volition never understand how my mother put her faith in God's easily rather than those of her local geneticist. Ten fingers, x 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.

GATTACA NURSE: Neurological status, 60 percent probability; manic depression, 42 percent probability; A-D-D, 89 percent probability; heart disorder, 99 percent probability; life expectancy 30 signal 2 years.

LEE Silver: The amazing thing about Gattaca is that it is scientifically right on the mark. Because it will be possible in the future to have a drop of claret from a kid, and know the pre-dispositions to every kind of disease that this child is going to face in his or her life. DNA chips revolutionized our ability to look at human being genes and it will be possible in the hereafter to utilize a Dna fleck on embryos.

ARTHUR CAPLAN: What I envision in 20 years, is that someone volition be able to go to the in vitro clinic who's very fertile, who has no infertility issues at all, but just says, "If you can tell me a lot nigh the kind of child that I'm probable going to accept, and then I'm going to spend the money and use an bogus way to create a baby...to kind of get a amend baby."

LEE Argent: And then what a couple would be able to do is to look at their computer screen and look at what the child'south height would be, certainly; what the pilus color would be; whether the child's going to go bald; whether the child'due south going to get asthma; whether the child'due south going to be a scrap aggressive or shy. All of these things are going to come up out of looking at a Dna chip contour from each of these embryos.

NARRATOR: The limitation to pre-implantation genetic diagnosis is that parents can only select for genes that embryos already have. Just scientists take begun inserting new genes into embryos, endowing thousands of animals with unusual traits.

A specific gene from a jellyfish can brand mammals glow in the night. Molecules involved in learning and retentiveness can be genetically augmented to create smarter mice.

As reproductive biology and genetics merge, volition parents of the future have the tools to pattern their children with new strengths and talents?

JAMES GRIFO: Aye. These things could happen. Right now they don't. We don't know the genes for hair colour, middle color or 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.

ARTHUR CAPLAN: I remember we'll see this happen. I think it'southward going to be very hard to say to people, "You lot can't practise this," because in a sense, today, we're already down that route.Some people exercise everything they can to environmentally advantage their kids. Do we say they're morally wrong? In fact, nosotros say they're doing a morally proficient affair. It's good to give your kid, in a competitive market society, the best shot at success. And I recollect that'due south the ethos that's going to carry united states correct straight into using pre-implantation genetic testing and new genetic knowledge to blueprint our descendents.

NARRATOR: 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 manner to cognition, even infertility might be overcome.

For Ilysa and Darren ICSI has paid off. They are now the elated parents of a healthy baby girl named Sarah, born January 29th, 2001.

Anne's girl, Katie appears to exist salubrious and developing ordinarily. Although cytoplasmic transfer is still highly experimental, for the small grouping of patients that have turned to information technology, 36 percentage have go significant.

LEE SILVER: People are afraid of the unknown and most people, therefore, refuse new technology. It takes the mavericks, the maverick scientists and the people who take some guts to work with the bohemian scientists and clinicians to bring the applied science into the public domain.

JAMES GRIFO: There are risks to these things, only there's besides risk to non treating disease. And people forget that. People forget how hard it is to live with infertility. People forget how devastating that is. And people don't empathise why patients are willing to accept these unknown kinds of risks to accept that child, because they forget about the illness.

Doctors today take a surprising number of ways to help make a infant. On NOVA's Web site, explore the more than 18 loftier-tech procedures now in employ—on PBS.org or America Online, Keyword PBS.

Educators can order this or any other NOVA program for $nineteen.95 plus aircraft and handling. Phone call WGBH Boston Video at 1-800-255-9424.

NOVA is a production of WGBH Boston.

Major funding for NOVA is provided by the Park Foundation, dedicated to education and quality telly.

Scientific achievement is fueled past the simple want to make things clear. Sprint PCS is proud to back up NOVA.

This programme is funded in part by the Northwestern Common Foundation. Some people already know Northwestern Mutual can aid program for your children's pedagogy. Are you there all the same? Northwestern Common Financial Network.

And by the Corporation for Public Broadcasting and by contributions to your PBS Station from viewers like yous. Thanks.

This is PBS.

Production CREDITS

eighteen Means to Make a Baby

Produced and Directed by
Sarah Holt & Peter Williams

Narrated by
David Ogden Stiers

Written by
Sarah Holt

Editor
Sarah Holt

Associate Producers
Jennifer Lorenz
Jackie Mow
Jennifer Callahan
Stephen Hopkins

Camera
Buddy Squires
Terry Hopkins
David Chilton

Music
Michael Salary

Audio Recordists
Mark Roy
Dick Williams
Martin Waller

Blitheness
Dan Nutu

Audio Editor
Rob Todd

Banana Editor
Dan Van Roekel

Online Editor
Ed Ham

Colorist
Mark Kueper

Product Manager
Peter Crook

Special Thank you
Center for Reproductive Medicine & Infertility - NY Weill Cornell
NYU Institute for Reproductive Medicine
St. Barnabas Medical Center
Boston IVF
Anne and Michael
Ilysa and Darren
Barbara Nastro and Michael Harrison
Genetics & IVF
Incyte Genomics
Agilent Technologies

Archival Material
BBC Worldwide
ImageBank Films
Peter Williams Boob tube
PhotoResearchers
Frontline, "Making Babies"
The New York Times
Time Mag
Greater Boston Arts/Jose Mateo Trip the light fantastic Theatre
La Plaza

NOVA Series Graphics
National Ministry of Design

NOVA Theme
Stonemason Daring
Martin Brody
Michael Whalen

Audio Mix
Richard Bock

Post Production Online Editor
Mark Steele

Closed Captioning
The Caption Heart

Production Secretaries
Queene Coyne
Linda Callahan

Publicity
Jonathan Renes
Diane Buxton
Katie Kemple

Senior Researcher
Ethan Herberman

Unit Managers
Sarah Goldman
Jessica Maher
Sharon Winsett

Paralegal
Nancy Marshall

Legal Counsel
Susan Rosen Shishko

Business Manager
Laurie Cahalane

Post Production Assistant
Patrick Carey

Acquaintance Producer, Post Production
Nathan Gunner

Mail service Production Supervisor
Regina O'Toole

Post Product Editors
David Eells
Rebecca Nieto

Supervising Producer
Lisa D'Angelo

Senior Science Editor
Evan Hadingham

Senior Series Producer
Melanie Wallace

Director
Alan Ritsko

Executive Producer
Paula South. Apsell

A NOVA Production by Peter Williams Tv International for WGBH/Boston.

© 2001 WGBH Educational Foundation

All rights reserved

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Source: https://www.pbs.org/wgbh/nova/transcripts/2811baby.html

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