<b>July 23 2003</b> – An estimated 1% of all babies born in the UK are conceived after IVF, with tens of thousands of couples each year visiting clinics in their search for a baby. However, as the birth of a "test tube baby" becomes an ever more routine occurrence, and ever more accepted by society as a perfectly normal way of having a child, attitudes against the fertility "industry" are hardening among some campaigners. Life, a charity known best for its work opposing abortion, originally took a fairly ambivalent approach to the breakthrough – opting to "wait and see" rather than take a strong stance for or against.
After all, this was a technique which, viewed from a certain angle, resulted in the creation of life that would not otherwise have existed – and who could be opposed to that?
But, 25 years on, its members are not only opposed to the latest developments in fertility treatment – such as embryo selection – but to the original method pioneered by Drs Steptoe and Edwards in the 1970s.
Surplus embryos
Life director Nuala Scarisbrick says that even the fulfilment of a couple's dream of parenthood does not justify what goes on inside the fertility clinic.
"We are so sympathetic to the plight of people who cannot have children – but IVF is fundamentally wrong," she says.
The central question is what happens to the "surplus embryos" generated by the average IVF cycle.
Guidelines limit the number of embryos that can be implanted into a patient at two, or three in exceptional circumstance – but often, a woman can produce many more than this number.
Once those considered to have the "best chance" of producing a pregnancy are selected, the rest are either frozen for later use, donated for research, or simply destroyed.
To most infertile couples, their desperation makes this an uncomfortable, but in the end unavoidable trade-off.
Nuala told BBC News Online: "You are deliberately setting out to create human beings – and then destroy them."
'Respect'
The law that governs IVF clinics in the UK, the Human Fertilisations and Embryology Act of 1990, has what is described as "respect for the embryo" as a key guiding principle.
Life believes that the decision to, in effect, scrap three out of four embryos created does not offer respect to the majority.
"It's a human being at an early stage of development – you just can't destroy life at any stage."
The woman in charge of regulating IVF treatments in UK for much of the last decade, Dame Ruth Deech said that the argument was not necessarily so clear-cut.
She told BBC News Online: "I was told by one of the leading fertility researchers that, in nature, a sexually active woman will produce many fertilised embryos that fail to implant and are lost.
"When I heard that, I found it quite comforting with regard to this question."
Nevertheless, say Life, it presents a terrible ethical dilemma for any woman contemplating IVF – and one in which her desperation for a child may cloud her judgment.
In addition, says the charity, there are plenty of other reasons why IVF should never be seen as the easy option for a childless woman.
Nuala said: "In order for a woman to produce the eggs needed for IVF, she must be given a high dose of hormones. We still don't know the long-term effects of doing this."
Certainly, in the short term, the risks of ovarian hyperstimulation – a common side-effect which is occasionally severe – are well documented. Evidence of any long-term effects is as yet absent.
Nuala Scarisbrick says there is anecdotal evidence – citing the case of magazine editor Liz Tilberis, who blamed repeated IVF cycles for her fatal ovarian cancer.
Alternative offered
And she says that women should remember that, even 25 years on from Louise Brown's birth, the live birth rate per cycle of IVF remains more or less the same – 18%.
This means that women embarking on treatment are more likely to fail than they are to succeed.
Life insists that there are alternatives to IVF – and is putting its money where its mouth is.
Nuala Scarisbrick first mentions the thousands of children eligible for adoption in the UK who cannot be placed.
However, for couples unprepared to do this – and this is the majority – she says that medicine can offer a different route.
Life runs its own infertility clinics, which test women for hormonal imbalances and attempt to correct them with treatment.
The success rates claimed are relatively impressive – of those women who are treated there, approximately 29% conceive within a year.
But this figure only refers to those actually treated – many couples would have to be turned away, as such techniques cannot help subfertile men, or many women with an obvious physical cause for their infertility.
Nuala says: "It remains a very positive alternative to IVF. Some of those who we have helped have failed to conceive even after IVF treatment."
The tide of public opinion is still firmly in favour of IVF, and even more recent developments such as the screening of embryos for disease – and the selection of embryos to help cure existing children – have failed to attract widespread condemnation.
Life is not among those groups willing to challenge such developments through the courts, but is convinced that the science has "gone too far".
Whether its campaigning can even dent the image of IVF is another matter.
