Issue Date: March 20, 2006

Reproductive Technology

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In November 1997, the nation witnessed what was widely viewed as a miracle: the birth of the first set of live septuplets in the U.S. The babies were born to Bobbi and Kenny McCaughey of Carlisle, Iowa. All seven of the McCaughey infants, despite being born premature and each needing intensive medical care, survived their early days and have so far escaped major health problems. The McCaugheys received a huge outpouring of support and many generous gifts from well-wishing strangers--a new minivan, a larger home, furniture, appliances and a lifetime supply of diapers.

Not all observers viewed the birth of the septuplets positively, however. The McCaugheys had battled infertility (the inability to conceive) and had achieved their pregnancy while using fertility drugs. Those drugs have enabled a growing number of women to become pregnant in recent years. But while they boost the chances for pregnancy, they also increase a woman's chances of conceiving a multiple pregnancy (a pregnancy with three or more fetuses).

Multiple pregnancies involve serious risks that the fetuses will be miscarried or develop medical problems. Pope John Paul II, the leader of the Roman Catholic Church, opposes fertility drugs on the moral grounds that their use often leads to multiple pregnancies, which some of the babies are unlikely to survive. (The Catholic Church opposes all forms of assisted conception.) Yet religious convictions also dictated the McCaugheys' decision to maintain their septuplet pregnancy. Doctors usually advise couples with multiple pregnancies to abort one or more of the fetuses to increase the chances that the others will survive and develop normally. The McCaugheys did not consider that an option because they oppose abortion.

The McCaughey case highlights one of the many difficult issues that arise in debates over assisted reproductive technologies. A series of scientific breakthroughs over the past 25 years have made it possible for more infertile couples to have children than ever before. Responding to growing demand, fertility clinics have offered an impressive array of reproductive alternatives. The rapid spread of clinics that perform procedures such as in vitro fertilization (IVF), the creation of a human embryo in a laboratory test-tube, has given many couples new hope of having children. In 1995, the use of assisted reproductive technology led to 11,315 births nationwide. [For a glossary of reproductive technology terms, see 1998 Reproductive Technology Terms Defined]

But while procedures such as IVF have fulfilled the dreams of thousands of people who thought they could never have children, new reproductive technologies have also presented thorny questions. Should fertility clinics be required to take steps to avoid creating multiple pregnancies in clients? Should anyone with sufficient financial resources be given access to reproductive technologies? Should a clinic help a woman of any age to become a mother? Is infertility a medical condition that should be covered by health insurers?

Ethicists are concerned about what they say is a lack of public debate over new reproductive technologies. They complain that as procedures have been developed and marketed to eager couples, debate over their possible social implications has been almost nonexistent. Many are troubled by the fact that the booming U.S. fertility industry--now worth an estimated $2 billion annually--is subject to very little government regulation. There are about 1,000 fertility specialists in the U.S.; analysts expect the field to grow at a rate of 20% annually over the next few years. Individual clinics have largely been left to their own devices to determine the kinds of procedures they will offer and the kinds of people they will offer them to.

State laws regulating reproductive technologies vary widely. Thirty-five states have laws clarifying paternity relating to sperm donation. Most of those absolve sperm donors of financial obligation for genetically fathered children. Only seven states have similar laws regarding egg donation, a more recently developed reproductive technology. Many states lack any legislation to deal with the most controversial aspects of reproductive technology, such as who should have legal rights to an embryo that was created in a lab and stored for possible future use.

The result, critics say, is that competitors in a private industry, guided chiefly by the profit motive, are determining what are morally acceptable standards in the uses of reproductive technology. Many observers want the exploding field to be subject to government or independent oversight. At the very least, they say, more neutral parties should have a voice in setting industry standards. They contend that fertility clinics have too much at stake financially to make objective decisions that are in the best interests of the public.

Most fertility specialists say that government regulation of the field would be an unnecessary and possibly harmful step. They point out that industry bodies, such as the American Society for Reproductive Medicine, have already set guidelines and undertaken steps to limit inappropriate uses of reproductive technologies. Industry insiders argue that legislators lack the expertise to set standards. Laws that would limit clinics' activities, they say, would only interfere with doctors' ability to exercise professional discretion on a case-by-case basis.

History of a Young Science

The oldest form of assisted reproductive technology, artificial insemination, was developed in the mid-1800s and first carried out in the U.S. in 1866. That procedure involves using a catheter to implant semen, which contains sperm, into a woman's uterus.

Although the first time that sperm fertilized an egg in a laboratory setting occurred in 1969, it has only been since 1978 that scientists have known that an embryo created outside of a woman's body could develop into a healthy baby. That year, the first "test-tube baby," Louise Brown, was born in Cambridge, England. Louise was created when her mother's egg and father's sperm were mixed together in a laboratory petri dish. The resulting embryo was implanted into Louise's mother's uterus, where it developed. The procedure became known as in vitro (Latin for "in glass") fertilization.

IVF technology was a major breakthrough for infertile couples, but the procedure was not offered in the U.S. until the early 1980s and remained rare until the mid-1980s. At first, IVF was offered only to women in their most fertile years--their 20s and 30s. In the early 1990s, IVF became more widely available to women in their late 30s and early 40s. In the mid-1990s, a more advanced type of IVF, called intracytoplasmic sperm injection (ISCI), became available. ISCI involves the manual insertion of a single sperm into an egg to create an embryo. It therefore differs from normal IVF procedures, which simply mix sperm and egg together and allow fertilization to occur. The American Society for Reproductive Medicine estimates that about 32,000 IVF procedures are performed annually in the U.S.

Surrogate motherhood, a reproductive option for women who are unable to produce eggs or carry a pregnancy to term, came to national attention in the 1980s. Surrogacy is an arrangement in which one woman agrees to bear a child for another. The agreement may be voluntary (a sister or close friend may offer to bear a child for a couple), or commercial (in which the surrogate is paid) and legally binding. The child may begin as an embryo created by the couple seeking the surrogate, or the surrogate mother's own egg may be fertilized with the male partner's sperm via artificial insemination.

In the 1980s, commercial surrogacy centers brought infertile couples together with surrogate mothers. Those arrangements led to legal complications over who ultimately had rights to the child, however. In 1986, surrogate mother Mary Beth Whitehead fought a high-profile custody battle with the couple for whom she had borne a child; she lost her case in a New Jersey court in 1987. In 1988, the New Jersey Supreme Court denied an appeal of that custody decision and ruled that paid surrogacy arrangements were an illegal form of child-selling. Several states and some countries now ban commercial surrogacy.

Another new technology to combat infertility is egg donation, in which a fertile woman takes fertility drugs so that she can produce and donate eggs to enable another woman to become pregnant. Either the infertile woman's partner's sperm or sperm from an anonymous donor may be used to fertilize the egg. The embryo is then transferred to the uterus of the infertile woman, who carries the child to term. The first babies conceived using donor eggs were born in the mid-1980s. In 1989, just 328 egg-donation procedures were attempted nationwide, resulting in 81 deliveries. In 1994, more than 900 women gave birth to children conceived using donor eggs. An estimated 6,000 women have given birth to babies conceived using donor eggs over the past 10 years.

Advances in reproductive technology have been linked to a controversy over federal funding for human embryo research. In 1979, Congress banned federal funding for such research. Human embryo research had long been controversial because many people believe that life begins at conception and that human embryos have the same rights as children. They therefore oppose embryo experimentation of any kind. Supporters argue that embryo research is essential if scientists are to learn more about fertility treatments, genetic disorders, birth defects and new methods of contraception.

A chief reason some scientists want to restore federal funding for embryo research is that federal oversight of such research stopped after the government withdrew its support. The result, many say, has been a lack of reliable studies on fertility. Federally funded studies are subjected to a strict peer-review process. Because much of the existing research on fertility has been produced by private centers and clinics, which depend on fees from infertile couples and are not subject to federal standards, the objectivity and authority of those studies has been called into question.

Multiple Pregnancies Debated

The birth of the McCaughey septuplets renewed an ongoing debate over multiple pregnancies. After trying unsuccessfully for months or years to become pregnant with just one fetus, couples using fertility drugs or IVF frequently find themselves pregnant with three or more. They then face a paralyzing dilemma--whether to continue a multiple pregnancy, knowing that each fetus's chances of surviving are lessened, or to abort one or more fetuses in hopes of increasing the chances that those remaining will survive.

The number of multiple births to women in the U.S. has risen sharply since the early 1970s, to nearly 5,000 in 1995 from fewer than 1,000 in 1971. An increased use of fertility drugs is the primary reason for the surge, although improved prenatal and neonatal care have also played roles. Fertility drugs often result in multiple pregnancies because they stimulate the ovaries to release more than one egg at a time, making it possible that more than one may be fertilized. IVF procedures can also result in multiple pregnancies because fertility doctors usually implant several embryos in a woman's uterus at once to improve her chances of becoming pregnant. Embryos may or may not develop once they are implanted. [See 1998 In Vitro Fertilization Standards Debated]

The number of women who take fertility drugs has nearly tripled over the past several years, rising to 2.7 million in 1995 from one million in 1988. About 75% of triplet pregnancies occur in women who have either taken fertility drugs or used IVF; 90% of quadruplets and nearly all quintuplets are conceived under those circumstances. A 1995 survey of 281 fertility clinics reported by the Centers for Disease Control and Prevention (CDC) found that 37% of births resulting from IVF were multiple.

Ethical quandaries surround multiple pregnancies. Those pregnancies are more likely to be dangerous to the health of both babies and mothers. They greatly increase the risk of miscarriage and premature delivery, as well as the chance that babies will be born with chronic lung disease, digestive problems, brain damage, cerebral palsy, mental retardation or blindness. Babies born in multiple deliveries are 12 times more likely to die within a year than babies born singly. Even twins are statistically more likely to be born prematurely or to be lost in miscarriage than single babies. Women who carry multiple fetuses run the risk of developing anemia, blood clots, hypertension and labor complications.

Because of the myriad health problems posed by multiple pregnancies, doctors usually recommend that couples "reduce" them, or abort one or more of the fetuses, so that those remaining will have a greater chance of survival. Despite the medical reasons for pregnancy reductions, abortion opponents see them as morally wrong. In the McCaugheys' case, both partners opposed abortion and neither considered reduction. Decisions about whether to reduce a pregnancy can be heartwrenching, especially for couples who have tried for many years to become pregnant.

Critics of the fertility industry complain that abortions have simply become accepted by many doctors and couples as an unfortunate part of the fertility-treatment process. Couples and their doctors are so eager to achieve a pregnancy, they say, that they do not take reasonable precautions to avoid multiple pregnancies, which often lead to abortions. Fertility doctors acknowledge that because their clinics compete so fiercely for patients, they are under constant pressure to boost clinic pregnancy-success rates. Some observers have called for standards that would require clinics to take more steps to avoid multiple pregnancies, even if those measures result in a lower overall pregnancy rate. [See 1998 In Vitro Fertilization Standards Debated]

Dr. Jonathan Cronin, a neonatologist at Massachusetts General Hospital in Boston, says that the McCaugheys' multiple pregnancy could have been avoided. The couple's doctors could have used ultrasound to detect that Mrs. McCaughey had produced a dangerously high number of egg follicles at once, he says. Normally in those cases, doctors simply do not administer a hormone that induces ripe eggs to burst from their follicles so that they can be fertilized. If a woman releases too many eggs despite efforts to monitor her hormones, he says, doctors should advise the couple to abstain from unprotected intercourse that month.

Many doctors frowned on the McCaugheys' decision to try to deliver all seven of their babies, saying that they simply put the fetuses at too great a risk. Nearly every woman pregnant with five or more fetuses miscarries one or more, they point out. Some doctors and ethicists worry that the survival of the McCaughey septuplets will send a message that multiple pregnancies are perfectly safe. Cronin believes that the American public's warm reaction to the septuplets reinforces the notion that risky pregnancies can be sustained and that the babies can develop normally. Jennifer McCrickerd, an assistant philosophy professor at Drake University in Des Moines, Iowa, contends that the McCaugheys were simply incredibly lucky. She asks, "What would people have thought if these children had been stillborn?"

In addition to medical and moral considerations, prospective parents may not be financially or emotionally prepared to raise three or more children at once. Many critics of the McCaugheys' decision to maintain their pregnancy doubt that any parents could give adequate emotional support and attention to seven babies of the same age. Many worry that the children will suffer psychological damage as a result of their celebrity status, fearing that they will become curiosities or that they may be exploited for commercial purposes. Others maintain that their older sister, Mikayla, now two years old, cannot expect a normal childhood.

Finally, some critics have questioned whether the money spent on the intensive hospital care required by the septuplets was a wise use of financial resources. Yes, those critics say, medical advances have allowed skilled professionals to help even very premature babies to survive. But should multiple births be encouraged because amazing medical feats can be performed to save babies whose chances of survival are slim?

Ezekiel Emanuel, an associate professor of medical ethics at Harvard Medical School in Cambridge, Mass., argues in a Wall Street Journal opinion piece (December 10, 1997), "The birth of these septuplets was not an unanticipated health problem, unexpected injury, or a chance genetic defect; it was a medically created, chosen health problem." He believes that the estimated $1 million spent on the McCaugheys' hospital expenses would have been better spent on "more urgent health needs."

Defenders of the McCaugheys support their decision to carry the pregnancy to term. They say that the couple stuck to their moral principles and did what they believed was right by refusing to reduce the pregnancy. In their view, the couple has been blessed with seven healthy new children and now faces a lifetime of challenge. The McCaugheys require and deserve all of the moral and financial support they can get, they say. Many, including the McCaugheys, believe that God has given them a special challenge to raise their children.

Older Women Having Babies

Ethical issues also surround the possibility that women past conventional childbearing age--women in their 50s and even their 60s--can use existing technology to become pregnant and bear children. The advent of IVF, combined with the still relatively new procedure of egg donation, means that for the first time, women who are past the age of menopause (when a woman's ovaries stop producing eggs, usually between ages 45 and 55), can give birth.

In May 1997, Dr. Richard Paulson, chief of the division of reproductive endocrinology and infertility at the University of Southern California in Los Angeles, published an article in the journal Fertility and Sterility containing the news that he had helped a 63-year-old woman to bear a child. The report made headlines--the woman, Arceli Keh, is the oldest woman on record to have given birth. The news touched off a debate over whether women of that age should be helped to have babies. Worldwide, fewer than 100 women are known to have become pregnant at age 50 or older.

People object to the idea of older women having babies for several reasons. Some say that it is simply unnatural. If a woman's ovaries have shut down, marking an end to her reproductive years, they say, that is nature's way of telling her she is too old to be a mother. Some are concerned that women who give birth in their 50s and 60s will lack the energy needed to care for demanding infants, toddlers and later, teenagers. Others carry that argument further, claiming that women who give birth so late in life are likely to leave their children motherless at a relatively young age. Doctors are also concerned that pregnancies can endanger older women's health.

Some critics claim that it is selfish for a woman to have a child at age 50 or older. While those women may satisfy their desire to bear a child, they say, the child's best interests are neglected. Daniel Callahan, a biomedical ethicist at the Hastings Center, a medical-ethics research group, says of technology that allows older women to bear children, "Most of this 'progress' has been for the benefit of parents, not the benefit of children."

How old is too old to have a child? There are no federal or state laws governing the subject, and most fertility doctors do not believe such laws are needed. The American Society for Reproductive Medicine has taken the stance that doctors should discourage postmenopausal pregnancy. Fertility clinics may set their own standards, however. Most impose a cut-off at age 50 or 55 for women seeking IVF procedures. Some make the cut-off at menopause; others do not impose a limit. In Keh's case, she had lied to her doctors, telling them she was 50.

Some observers do not see why using technology to assist a woman in her 50s or 60s to have a child is any different than using the same technology to help infertile women in their 20s or 30s. John Robertson, an expert in reproductive law, told the New York Times in 1997, "This upsets people because it somehow goes against nature. Well, everything we do goes against nature." Many others assert that society judges older women who want to be mothers differently than it judges older men who want to be fathers. Katha Pollitt, a columnist for the Nation, says, "Until we are ready to severely castigate the so-called start-over dads, I think we can't be too judgmental and moralistic about women who avail themselves of technology that exists."

Should Insurers Pay for Treatments?

Because their desire to have children is so strong, many infertile couples are willing to pursue expensive fertility treatments over the course of several years despite the fact that the procedures are not usually covered by their health-insurance plans. While some health-insurance companies reimburse plan members for fertility drugs and most cover the cost of surgical procedures to treat infertility, the vast majority of plans do not pay for advanced reproductive technology procedures. Those are procedures, such as IVF, that manipulate the sperm and egg to create a pregnancy. Most insurers consider infertility treatments to be "elective procedures" and not a matter of medical necessity.

According to a 1996 survey by William M. Mercer Inc., a benefits consulting firm, 40% of large employers (those with 500 or more employees) offer health plans that provide at least some coverage for fertility treatments, ranging from drug therapies to artificial insemination and IVF. Only about 20% of health maintenance organizations (HMOs) offer coverage for IVF, the survey found. Thirteen states, among them Connecticut, California, Texas, Illinois and New York, require health insurance plans to offer some reimbursement for fertility treatments. Massachusetts and Illinois specifically require insurers to cover IVF procedures.

At least one major insurance company has reassessed its coverage for advanced fertility treatments after realizing that the benefit was attracting large numbers of women to the plan, saddling the company with huge new costs. In January 1998, Aetna Inc., one of the nation's largest insurers, announced that its U.S. Healthcare plans would no longer cover advanced fertility treatments, effective in April 1998. The plans would continue to cover diagnosis of fertility problems, corrective surgery, oral fertility drugs and insemination procedures. Company officials explained that coverage of expensive treatments such as IVF had driven up overall plan costs.

Couples for whom fertility drugs and surgery have not worked must usually pay the cost of advanced fertility treatments themselves. Many couples pay huge out-of-pocket costs for IVF procedures, depleting their savings accounts and running up massive credit card debts. IVF procedures generally cost between $8,000 and $12,000 each, and a couple may undergo several attempts before either getting pregnant or giving up.

Infertile couples and their advocates, such as RESOLVE, a national support organization for infertile couples, claim that infertility is a disease like any other. They say that by denying coverage for fertility treatments, insurers are discriminating against infertile people on the basis of their particular condition. Elizabeth Prike, who was left $10,000 in debt by the time she became pregnant after seven years of fertility treatments, told the New York Times in February 1998, "I just feel cheated by my insurance company. I paid into the plan and then my disease isn't covered. That's just not fair."

Infertile couples and their advocates want states to require all insurers to cover infertility treatments. But some economists and ethicists oppose that proposition. The use of assisted reproductive technology is not a medical necessity, they say, but a chosen procedure. George Annas, chairman of the health law department at Boston University's School of Public Health in Massachusetts, says that forcing insurers to cover expensive fertility treatments will drive up insurance costs for other plan members and possibly put insurance premiums out of some people's reach. "To mandate it, given the growing numbers of uninsured people, makes no legal, economic or health care sense," he says.

Calls for Industry Regulation

There is little agreement among existing state laws concerning assisted reproductive technologies. Many observers say that consistent legal standards for fertility clinics are needed. In hopes of bringing more uniformity to the patchwork of state laws, a panel of the American Bar Association (ABA) is at work on an analysis of model legislation that its members want states to adopt. Panel members hope that the model law will, at a minimum, require fertility doctors to inform patients of the potential legal and ethical ramifications of the treatments they are seeking. The analysis is due to be released in summer 1998.

Regulation of the fertility industry is long overdue, according to some ethicists. Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania in Philadelphia, says the field is "screaming for oversight." Caplan and others point to a disturbing case to highlight the need for regulation. The case involved James Alan Austin, a 26-year-old bachelor from Pennsylvania. Austin paid a fertility clinic $30,000 to inseminate a surrogate mother with his sperm. After the baby was delivered, he beat the two-month-old child to death in January 1995. According to Caplan, the industry must at least monitor who is allowed to parent children, similar to the way that people must be screened before they are allowed to adopt. "Would [James Austin] have been able to adopt? Not without some kind of checks," he claims.

Susan Crockin, a Massachusetts attorney who has advised the ABA panel, believes that industry standards must be guided by moral, rather than financial, concerns. "Designer embryos where you pick a sperm and you pick an egg and you pick a woman to carry the child...I question the ethics of providing that kind of service," she says.

While most observers are not sure what form industry regulation should take, many agree that given the complicated emotional and social issues raised by reproductive technologies, some oversight is needed. Barbara Katz Rothman, a sociology professor at Baruch College in New York City, says, "I'm fairly certain we shouldn't just be turning this over to the forces of the market."

Bibliography

Ackerman, Elise. "Newfangled Babies, Newfangled Risks." U.S. News & World Report (December 22, 1997): 63.

Emanuel, Ezekiel. "Seven Is Too Many." Wall Street Journal (December 10, 1997): A22.

Fein, Esther. "Calling Infertility a Disease, Couples Battle With Insurers." New York Times (February 22, 1998): A1.

Hoffman, Jan. "Egg Donations Meet a Need and Raise Ethical Questions." New York Times (January 8, 1996): A1.

Kalb, Claudia. "How Old Is Too Old?" Newsweek (May 5, 1997): 64.

Kolata, Gina. "Harrowing Choices Accompany Advancements in Fertility." New York Times (March 18, 1998): F3.

Kolata, Gina. "Many Specialists Are Left in No Mood for Celebration." New York Times (November 21, 1997): A32.

Klotzko, Arlene Judith. "Science Fictions: Cloning Is Bad and Septuplets Are Good." Washington Post (December 14, 1997): C3.

Pollitt, Katha. "The Lord Moves in Mysterious Ways." The Nation (December 22, 1997): 9.

Raeburn, Paul. "A Delicate Issue Frozen in Time." Business Week (July 22, 1996): 42.

Selz, Michael. "Birth Business: Industry Races to Aid Infertile." Wall Street Journal (November 26, 1997): B1.

Weiss, Rick. "Babies in Limbo: Laws Outpaced by Fertility Advances." Washington Post (February 8, 1998): A1.

Weiss, Rick. "Women Bears Twins from Frozen Eggs." Washington Post (October 17, 1997): A1.

Additional Sources

Additional information about assisted reproductive technologies can be found in the following sources:

Belkin, Lisa. "Pregnant With Complications." New York Times Magazine (October 26, 1997): 34.

Crockin, Susan; Seibel, Machelle. Family Building Through Egg and Sperm Donation. Sudbury, Mass.: Jones and Bartlett Inc., 1996.

Contact Information

Information on how to contact organizations that are either mentioned in the discussion of reproductive technology or can provide additional information on the subject is listed below:

Keywords and Points

For further information about the ongoing debate over reproductive technology, search for the following words and terms in electronic databases and other publications:

Reproductive Technology Update (September 2001)

Since ICOF last covered reproductive technology on April 3, 1998, the world's first cloned pigs were born, a California woman gave birth to a baby conceived with sperm from her dead husband, and a woman in Texas, who had been receiving fertility treatments, gave birth to octuplets. Among the key events:

• On March 20, 1998 a group of prominent scientists gathered at the University of California, Los Angeles (UCLA) to discuss an emerging technique called germ-line gene therapy, which, some envisioned, could eventually allow people to alter the genetic material they pass on to their children and thus eliminate certain genetic diseases. Scientists at the meeting agreed that if research continues, germ-line gene therapy will most likely become possible in humans, although estimates of when that might happen varied from a few years to several decades. Warnings about the dangers of the technology were also raised. As one participant put it, "insertion of genes into germ-line cells is a classic method of generating mutants [in the laboratory]." Mutants are organisms whose DNA is severely mutated, or altered, and generally cannot survive or reproduce successfully. Another attendee urged the public to join the debate about germ-line gene therapy because "the gene pool is not owned by anyone. It is the joint property of society." [See Today's Science: Designing the Genes of Future Generations.]
• On September 2, 1998 the U.S. Food and Drug Administration (FDA) approved the first emergency contraceptive that would prevent women from getting pregnant after unprotected sex. The product, called "Preven," works by preventing eggs from being released from the ovaries. Unlike the controversial abortion pill RU-486, the treatment doesn't destroy embryos that have implanted themselves in a woman's womb. [See Today's Science: Reproductive Health.]
• On December 8, 1998 Nkem Chukwu of Texas gave birth to eight live babies, or octuplets, all at least three months premature. The youngest child died of heart and lung failure, the most common problem for babies born so prematurely. The event raised concern about fertility treatments, which often result in multiple births. Multiple births create more pregnancy complications for the mother and result in higher rates of premature births, lower birth weights and higher rates of developmental disabilities in children. [See Today's Science: Reproductive Health.]
• In what was the first event of its kind in the U.S., on March 17, 1999 Gaby Vernoff of Los Angeles gave birth to a baby conceived with sperm from her dead husband, an event that raised concern among medical ethicists, since her husband had never consented to the procedure. Vernoff had had her husband's sperm extracted 30 hours after he died in 1995. [See Today's Science: Reproductive Health.]
• A litter of five piglets, the world's first cloned pigs, was born on March 5, 2000. That development caused many observers to predict significant medical breakthroughs, since pigs are considered excellent candidates for growing gene-altered organs for transplantation into humans. The achievement was made by scientists at PPL Therapeutics, a Scottish research company, who acknowledged that they still had a long way to go to adapt the technology to the production of transplantable organs. Critics, however, argued that transplanting pig organs into humans could transmit viruses that could then become exceedingly dangerous. [See Today's Science: 5 Cloned Piggies, All in a Row.]

Reproductive Technology Update (March 2006)

Since ICOF's last update on reproductive technology on September 7, 2001, U.S. scientists reported that they had cloned several human embryos. A brief flurry of excitement greeted the announcement that South Korean scientists had cloned human embryos and harvested an embryonic stem cell line from one of the clones, but the research was later shown to have been falsified. Among the key events:

• Scientists at Advanced Cell Technology Inc. (ACT) in Worcester, Massachusetts, announced on November 25, 2001 they had cloned a number of human embryos, although they emphasized that their intention was not to create a cloned human being but to develop cures for diseases. Many scientists called the research promising, but abortion opponents, including social and religious conservatives, and many Republicans condemned it. On January 18, 2002 a panel of experts at the National Academy of Sciences (NAS) recommended a complete ban on human reproductive cloning but supported so-called therapeutic cloning for medical purposes. On July 11 the Council on Bioethics, which had been established by President George W. Bush the previous January, backed a four-year moratorium on human cloning for research purposes and a permanent ban on human reproductive cloning. [See 2001 Facts On File: Human Cloning--Scientists Clone Human Embryos; 2002 Medicine and Health--Reproductive Cloning Ban Recommended, Medicine and Health--Stem Cell Rules Said to Hinder Research; Other Developments.]
• Considerable interest met the announcement on December 27, 2002, that the company Clonaid and its parent group, the Raelian religious sect, had produced the first human clone, a healthy seven-pound (three-kilogram) girl nicknamed Eve, who had been born the day before at a secret location. However, skepticism was high, especially when on the following January 4 Clonaid revoked its promise to let scientists test the claim through DNA tests. Two days later, a journalist who had agreed to form an independent team to verify the assertion halted the effort, saying that the announcement might have been "an elaborate hoax" for publicity purposes. Clonaid also reported the births of two other clones, but as no proof was forthcoming, the story quietly faded from the news. [See 2002 Facts On File: Cloning--Group Says It Created First Human Clone; 2003 Legislation--House Passes Human Cloning Ban.]
• Doctors from China's Sun Yat-sen University in Ghangzhou announced on October 14, 2003 that they had induced pregnancy in an infertile woman using a hybrid-egg technique developed by a researcher at New York University. Doctors had placed the nuclei from eggs fertilized by the prospective mother into fertilized eggs, from which the nuclei had been removed, of a younger woman. Three viable hybrid eggs were then implanted in the mother's uterus and, because the nucleus contained most of an embryo's genetic information, the progeny would largely have been the infertile couple's genetic offspring. [See 2003 Facts On File: Genetics--Hybrid-Egg Pregnancies Reported; Other Developments.]
• A team of scientists at Seoul National University in South Korea, headed by stem-cell researcher Hwang Woo Suk, made headlines worldwide on February 12, 2004 when they reported that they had created the first verifiable cloned human embryos and had harvested an embryonic stem cell line from one of the clones. The scientists, whose work was published on the Internet Web site of the journal Science, said they were interested only in producing stem cells. On November 24, 2005 Hwang admitted to using human eggs donated by two research assistants and paying other women for their eggs. The scientific community considered these practices unethical, and Hwang resigned as head of the World Stem Cell Foundation and stepped down from the university. On January 10, 2006 an investigative panel at Seoul National University said that Hwang had used falsified data in the research paper. The report was discredited, and Hwang apologized on Korean television. [See 2004 Facts On File: South Koreans Clone Human Embryo; 2005 Stem Cell Research--S. Korean Scientist's Research Discredited, Genetics--Stem Cell Scientist Admits Ethical Lapse; 2006 Stem Cell Research--S. Korea Scientist's 2004 Paper Discredited.]
• It was reported on May 20, 2005 that researchers in Newcastle, England, had become the second group to successfully clone human embryos. In 2002, Britain had legalized therapeutic cloning and had granted Newcastle University the first cloning license in August 2004. The Newcastle scientists planned to use the embryos as a source of stem cells. [See 2004 Facts On File: Great Britain--Stem-Cell Cloning License Approved; 2005 South Koreans Create Stem Cells From Cloned Embryos.]
• On January 16, 2005 a 66-year-old woman in Bucharest, Romania, gave birth to a three-pound, three-ounce (1.6-kg) girl by Caesarean section in the 33rd week of pregnancy. The infant's twin sister was stillborn. The mother had undergone nine years of fertility treatments and had failed to carry two earlier pregnancies to term. The sperm and egg for the newborn girl had come from anonymous donors. [See 2005 Facts On File: Romania--Elderly Motherhood.]
• The United Nations General Assembly approved on March 8, 2005 a nonbinding resolution supporting bans on human cloning in all member countries. The declaration denounced forms of human cloning that were "incompatible with human dignity and the protection of human life." Some countries supporting therapeutic cloning, including Britain, Belgium and China, said they would disregard the ban. [See 2005 Facts On File: South Koreans Create Stem Cells From Cloned Embryos.]
• In the October 16, 2005 Web edition of the British journal Nature, researchers at the Whitehead Institute for Biomedical Research in Cambridge, Massachusetts, reported the development of a method of rendering embryos created through so-called therapeutic cloning incapable of developing in a uterus. The experiment was designed to counter ethical objections from some opponents of therapeutic cloning because the cloned embryo could never develop into a viable fetus but could be harvested for stem cells. In the same issue of Nature, U.S. scientists at ACT in Massachusetts reported that they had harvested embryonic stem cells from a fertilized mouse egg without apparently harming the nascent embryo. The experiment, if repeated with a human embryo, could help circumvent U.S. federal objections to and restrictions on embryonic stem cell research. [See 2005 Facts On File: Medical Research--Stem Cells Created Nondestructively; Other Developments.]