Economics of Infertility

Today's New York Times has an interview with Harvard economist Debora Spar, author of The Baby Business: How Money, Science and Politics Drive the Commerce of Conception. Dr. Spar begins with what I think (and I am willing to stand corrected) is a bit of misinformation:

As I talked about my book, people asked, "What's the next technology that will have this?" I became convinced it was reproductive medicine, which started only 30 years ago with the I.V.F.-facilitated birth of Louise Brown.

Haven't some standard fertility medications been in use longer than that? Or donor insemination? I'm pretty sure that DES treatment (used to prevent miscarriage) was stopped roughly thirty-five years ago, long before Louise Brown was born. Which, by the way, was in 1978. (Only twenty-eight years ago. Yes, I'm being nit-picky, but whatever.)

Addressing the questions of whether viewing fertility treatments as a business is rather "cold" and whether treatments should be covered by insurance, Dr. Spar responds:

But the baby business is a business. My argument is, We need to move away from the emotion that clouds this so that we can make better decisions.

I think many in this market don't want to see it as related to science or medicine, which also clouds their thinking.

[Insurance covers infertility treatment] in Denmark. But they've also considered some of the social issues that insurance brings up. The Danes say infertility is a medical condition for any woman under 40. Over that age, no coverage.

If we insured consistently, we'd have to ask, At what point is a woman is too old to have a child? We'd have to ask if we want to cover homosexual couples who are technically infertile if they want to have babies with their partners. Now, no one wants to grapple with any of that.

Damn right no one wants to grapple with it! It would be disparate treatment of a minority, unfair discrimination against the disabled. If you dare to answer the question of, "When is a woman to old to have a child?" then you'd better be willing to back it up with forced sterilization of all women upon reaching age 40 or 45 or whatever you decide that number should be. If you're not going to do that, then you're being dishonest with yourself about the question. It's not, "When is a woman, any woman, 'too old' to have a child?" but rather, "When do we judge an infertile woman (or a woman with a sterile partner, or a woman who wants to use ART to conceive a child without a male partner) to be undeserving of medical treatment?"

And while I don't necessarily think that every researcher must have first-hand experience with her area of investigation, it does smart a little to read that Dr. Spar:

is the mother of three school-age children, the youngest adopted, at age 6, from Russia. "I wanted a little girl," she said. "I had two children the old-fashioned way already, and the idea of trying adoption was very powerful."

You may find it powerful, Dr. Spar. Many find it to be one of the few narrow choices afforded to us when "the old-fashioned way" just won't work.

(I know someone else blogged about Dr. Spar's interview in Salon, and I'd love to link to that post, but I can't remember where I read it! A memory-jog would be much appreciated.)

Prop Your Hips has also posted about today's article - and apparently she is far more qualified than I am to discuss it.