A California state senator has taken action toward providing oversight for the state's unregulated fertility industry. Gloria Negrete McLeod (D-Chino) introduced SB 674, which would define fertility clinics and egg extraction sites as "outpatient settings," bringing them under the jurisdiction of the Medical Board of California and establishing accreditation standards and guidelines for their operation. In a press statement, Sen. Negrete McLeod said, "It is alarming that the State of California has no one watching out for patients who go to these fertility clinics or surgical centers. There should be a greater level of scrutiny over these clinics because of their increasing popularity."
The district of Sen. Negrete McLeod is just a few miles from the home of the mother of the recent octuplets. The senator is also the former chair of the California Legislative Women's Caucus. A few years ago, she introduced a bill which would have brought conflict-of-interest provisions to the state's stem cell research agency.
The National Academies of Science (NAS) has released a report on the tragic state of criminal forensics. Strengthening Forensic Science in the United Stateshas been received by many as a scathing critique of pretty much every modern forensic technique used in criminal investigations, including ballistics, blood splatter analyses, and fingerprint techniques. The NAS committee rightly calls for establishing a new agency independent of the Justice Department to oversee law enforcement’s use of forensic techniques. Attorney General Eric Holder is currently reviewing the report.
This has been a long time coming; many experts in the field of forensic science have been calling into question the techniques used to put thousands of people behind bars without any independent verification of their validity. Unfortunately, however, the report does not give as much scrutiny to the emerging issues surrounding DNA forensics despite several unresolved questions and growing ethical concerns. For a more detailed description, check out Chapter Three of the new CGS report Playing the Gene Card? A Report on Race and Human Biotechnology.
A silver lining of the octuplets-induced media storm is the attention it's rained on efforts to reduce the numbers of twins, triplets and beyond that IVF creates. This is a goal driven by the startlingly high risks of IVF multiples for mothers and babies. It's shared by nearly all reputable fertility doctors, and endorsed by the voluntary guidelines [PDF] issued (but not enforced) by the American Society for Reproductive Medicine.
Thankfully, the trend is in the right direction. But the US still lags very far behind the countries that take a less laissez-faire approach.
The latest available US figures, for 2006, show that "single embryo transfer" - which is recommended for most women younger than 35, and which does not significantly reduce the rate of successful pregnancies - was used in only 3.3% of cycles. By contrast, single embryos are transferred in 60% of cases in Finland, and in 70% of cycles in Sweden. Unsurprisingly, that pushes twin rates way down and makes triplets very rare.
In the UK, the government agency that regulates assisted reproduction (the Human Fertilisation and Embryology Authority) recently issued rules requiring fertility clinics to reduce their multiple birth rates from the current average of 24% to 10% by 2012. And a group of British assisted reproduction experts, professional organizations, and patient groups has launched an attractive and persuasive campaign called "One at a Time." Its website about the IVF-multiples situation compiles current numbers and trends, documents the risks, and calls clearly for the remedy - the eponymous "one at a time."
On the heels of the explosive and fascinating saga of the IVF octuplets, Los Angeles has produced another controversial development in assisted reproductive technologies. And it is adding more fuel to the fire of calls for oversight.
What’s particularly striking is that the "more" referenced by the Fertility Institutes, led by Jeffrey Steinberg, includes selecting "complexion." While the Journal article notes that this is not presently available for "other ethnicities such as Asians or Africans because key pigmentation markers for those groups haven't yet been identified," the writing is on wall. In fact, such research is actively ongoing.
While I generally avoid the phrase, this is clearly another step down the proverbial slippery slope. PGD can be a critical tool in avoiding the births of children with serious disease, but these new applications are about breeding babies that suit aesthetic preferences based upon social prejudices. My colleague Osagie Obasogie brought up these points in a 2007 article in the New Scientist, "Racial Alchemy." And another fellow BP blogger, Marcy Darnovsky, captured the hazards well in the WSJ article: "If we're going to produce children who are claimed to be superior because of their particular genes, we risk introducing new sources of discrimination."
One of the prospective parents in an early use of PGD wrote in a Los Angeles Times op-ed put it differently: "Abusing that hard-won knowledge to capriciously choose hair color, eye color and other cosmetic traits in a baby is wrong and repugnant."
Profiting from social prejudice is not new. Here's an ad from India for a skin lightening cream: