Saturday, April 12, 2008

IVF treatment for social reasons

We are now increasingly seeing fertile couples who want IVF treatment because they want a baby quickly. While they are quite capable of making a baby in their own bedroom , they often come to us for medical assistance because they do not want to waste time on getting pregnant. These are often successful older couples, who are very used to making their decisions for themselves and getting what they want . They see IVF as a tool in order to achieve their life-goals, and not just as a treatment option to solve medical problems. For example, I recently saw a 36-year-old CEO who told me she wanted a baby in the next 2 months ; had realized that Nature was not very efficient in making babies ; and wanted IVF treatment in order to improve on nature’s inefficiency. This might seem like a very cold-blooded way of planning a baby, but from her point of view, this was the most time-effective option for her. She told me, “ I understand that it’s more fun making babies in my bedroom, and I do have a very active and satisfying sex life , thank you very much . I like to be in control of my life , and I want you to do IVF for me to maximize my chances of conceiving quickly, so I can have my baby, and move on with my life. After all, if I chose to spend thousands of pounds to fly the Concorde to save a few hours of my life ,why can’t I invest in IVF to save a few months ? “

This is a smart, well-informed woman, who knows her own mind, and is choosing to spend her own money to do IVF treatment. If medical ethics tell us to respect patient autonomy , am I justified in refusing to do IVF for her ? Am I being very old-fashioned and paternalistic in telling her that IVF is a medical treatment option for infertile couples and cannot be used for any other reason ? Who should make these decisions ?

Just like birth control allows women to regulate their reproductive destiny, doesn't IVF also empower them to do the same ? Can't women be trusted to make these decisions for themselves ?

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