Quality Control

Should we mess with nature?

You’ve thought it through carefully and you want to make a baby. Time for candlelight and romance and then, nine blissful months later, baby will arrive. Congratulations!

That would be a wonderful way for things to go, but life is not usually quite so smooth for modern couples. Along the way to becoming a parent, just about everyone invites in some sort of medical intervention. It may take high-tech intervention to make a baby, especially if parents are older, or if they are both men or both women. But even if conception is easy, pregnancy usually becomes medicalized early on, to ensure the best possible outcome for mother and baby.

Intervention to achieve conception used to be much more controversial than it is today. In particular, there was once a major debate about in vitro fertilization (IVF). It seemed freaky and potentially dangerous for fertilization to take place in a lab instead of inside the body, and various moral authorities disapproved, but today, fifty years after the first "test tube baby,” there doesn’t seem to be much remaining worry about IVF, per se. What still causes concern has to do not so much with lab conception, but with whose eggs and sperm are used by the prospective parents (theirs or a donor’s?), whose uterus will be used for gestation (will a surrogate be involved?), how many embryos will be implanted (should two, or three, or four be implanted to increase the chances of success?), and what will happen to any leftover embryos.

As interesting as they are, those are highly specialized questions, only pertinent to a pretty small minority of prospective parents. It’s more of an Every Parent’s question how much intervening to do for the sake of a better outcome, baby-wise. Though some have more options than others, and those already using assisted reproductive technologies have the most, prospective parents almost always find themselves with the chance to baby-optimize to some degree. Should we take all such opportunities, or none of them, or some of them?

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