High-Tech Babies
Scientific breakthroughs now make it possible to reproduce ourselves in ways never before imagined. NOVA looks at the medical, legal and moral questions raised by this new technology.
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00:00Well, I was calling to let you know the results of the pregnancy test, and unfortunately it
00:08did come back negative for pregnancy.
00:11For infertile couples like Don and Nancy, news like this begins a long road of disappointment
00:15and despair.
00:16But today, remarkable medical breakthroughs offer new hope to people who can't make babies.
00:22Contraception in the 1960s separated sex from procreation.
00:26Now we're separating procreation from sex, and that has a variety of implications.
00:31Embryos can be produced in the laboratory.
00:34They can be frozen, stored, and transferred from one woman to another.
00:38But what price should we pay for these advances?
00:41Why spend a lot of scarce resources on trying to create babies when there seem to be lots
00:46of them around that might be placed with people who want them?
00:52With the power to create human life, the new reproductive technologies now challenge
00:56some of our most deeply held beliefs.
00:59Are we ready for a future of high-tech babies?
01:02Next on NOVA.
01:08Major funding for NOVA is provided by this station and other public television stations
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01:15Additional funding was provided by the Johnson & Johnson family of companies, supplying health
01:20care products worldwide.
01:24And by Allied Signal, a technology leader in aerospace, electronics, automotive products,
01:30and engineered material.
01:51If the sound is right, you know, turn it around a bit and let her look at it.
02:00In December 1981, a daughter was born to Judy and Roger Carr.
02:05For a couple who'd been trying to have a child for four years, Elizabeth was a miracle.
02:10For the rest of the country, she was a triumph of technology, America's first test tube baby.
02:18The doctors responsible for her birth were Howard and Georgiana Jones.
02:22The technique, pioneered in England, is called in vitro fertilization.
02:26It means that an egg is fertilized outside the mother's body in a glass laboratory dish,
02:32in vitro.
02:34In 1985, Elizabeth Carr, here in the arms of Howard Jones, joins 55 other babies conceived
02:41at his clinic in Virginia.
02:44There are now almost 150 in vitro programs in the country, and somewhere in the world,
02:49a test tube baby is born every day.
03:03One of the basic human drives is the need to reproduce ourselves, but one out of seven
03:08couples is infertile.
03:11Now in vitro fertilization, or IVF, offers many of them an increasingly complicated array
03:18of techniques for making babies.
03:26If a woman has blocked fallopian tubes, where conception normally occurs, her egg can be
03:30removed surgically and fertilized with her husband's sperm in vitro.
03:35In three days, the growing embryo is placed in her womb, or it can be stored in a freezer
03:40for later use.
03:43If a woman's womb cannot sustain a pregnancy, her embryo can be placed in a surrogate, who
03:49will carry the baby and return it to her at birth.
03:55In another case, if the woman has no eggs, she can use a donated egg and combine it with
04:00her husband's sperm in vitro to create an embryo that she will carry herself.
04:06Using IVF, a child can have five parents, the couple who donates the embryo, the surrogate
04:12who carries it, and the couple who raises the child.
04:16But as the options multiply, so do the controversies.
04:18I think the reason it's frightening is that it challenges something that we've always
04:22held as a long-term, stabilizing belief in our society, in every society.
04:28Mothers are biologically related to their children, and when you break the tie between
04:34mothering, gestational mothering, and the identity of the child as belonging to that
04:40mother, that's revolutionary.
04:42There are people ready to run away with this technology and be first in doing some rather
04:46strange things.
04:47Furthermore, it can get very closely tied up with commercialization, with, I think,
04:55some incompetence that can be unjust.
04:58In the media, we have the pictures of the happy mothers with the smiling babies when
05:04a birth actually occurs.
05:06But in fact, they don't understand that most women go away from these programs without
05:11a baby.
05:12The vast majority do that.
05:13At a news conference today at Good Samaritan Hospital, Dr. Richard Mars announced the first
05:18two pregnancies in this country using frozen embryos.
05:24This is a major breakthrough for Dr. Richard Mars, a prominent in vitro specialist.
05:29Now when a woman fails to get pregnant from IVF, she can try again with embryos of her
05:34own that she's frozen and stored.
05:37So far, the technology has had few successes.
05:41Zoe Leyland, born in Australia in 1984, was the first of only 10 babies in the world born
05:47from a frozen embryo.
05:50Embryo freezing is an experimental process.
05:53It's not something that's ready to be used in a widespread fashion, and we have to learn
05:58more about it.
05:59In any first approach at a new technology, there's going to be things that are done that
06:05are not the right way because we don't know what the right way is.
06:08Otherwise, we wouldn't be experimenting.
06:11And the patients understand that, and we understand that.
06:16Nancy and Don Rubenstein have been Dr. Mars' patients for five years.
06:21They've stored six embryos in his freezer.
06:24Now that he's achieved a pregnancy using frozen embryos, they've decided to have theirs thawed
06:29and put into Nancy's uterus.
06:31Perhaps this will give them the baby they've wanted for so long.
06:35Dr. Mars' clinic is one of the best.
06:38Because a single in vitro procedure costs around $5,000, it is an option most people
06:43cannot afford.
06:44Still, Dr. Mars' services are in big demand.
06:48Hi, you're interested in our in vitro program?
06:50We do have a waiting list for that program, and we have about a year to a year-and-a-half
06:57wait right now for the frozen transfer.
07:00Don, a physician, and Nancy, a student, are unlucky consumers of the new reproductive
07:06technologies.
07:07With ovulation problems, Nancy's tried hormones, artificial insemination, diagnostic surgery,
07:13and IVF.
07:14This year, she had to give up her job as a flight attendant, one more sacrifice to the
07:18demands of her infertility treatments.
07:21I was very depressed and really wanted to die.
07:26I think that's something that most women will go through.
07:29I don't think it's unique to myself.
07:32At the beginning, when things don't work, you get very optimistic before the procedures,
07:39and then after you get the negative results, you get very, very disappointed.
07:44You become obsessed with it.
07:47You incorporate it into every aspect of your life.
07:50You can't watch TV because of the baby commercials.
07:54You can't go outside because you may run into a lady strolling down the street with her
07:58baby.
08:00We don't have a terminal illness, so it's very hard for people to understand the pain
08:04and the trauma and the emotional depressions that we go through.
08:09Last month, Dr. Mars performed an IVF on Nancy that failed.
08:13There are so many variables that even at the best clinics, in vitro results in a pregnancy
08:18only 25% of the time.
08:21Here's how it works.
08:23Regular temperature readings pinpoint the day of ovulation, when a woman's ovaries will
08:27naturally release an egg.
08:30Hormone injections are given to stimulate the ovaries to produce more than one egg.
08:35When the woman nears ovulation, her ovaries are examined by ultrasound to see how many
08:40eggs are growing.
08:48In IVF, the chance of pregnancy seems to increase if several fertilized eggs are placed into
08:54the uterus at once.
09:11Dr. Mars performs a surgical laparoscopy to collect the eggs just before they are released
09:15by the follicles.
09:17First he inserts a fiber-optic tube, or laparoscope, into her abdomen to see the ovaries.
09:22There's a follicle right down the base of the ovary on the medial aspect.
09:26There's a nice large follicle there.
09:29A couple of secondary follicles.
09:32We'll hit this first big follicle over on this side and see if there's anything in it.
09:39A needle is used to puncture each follicle and suction out the fluid inside.
09:44The needle's being placed through the follicle wall.
09:48It's fairly tough.
09:49You can see the follicle collapsing now.
09:52The fluid, it's a small volume follicle again.
09:56With luck, this fluid will contain a mature egg.
10:05Third one for now.
10:13Four or five eggs like this one are often collected during one laparoscopy.
10:18There's a one to two plus in that last follicle.
10:24Now the husband's sperm is combined with the eggs in a dish.
10:28Then they are placed in an incubator so the process of fertilization can begin.
10:36The sperm surround the egg and try to penetrate its outer wall.
10:40When one gets through, chemical changes are triggered to make the egg impervious to any other sperm.
10:46This is the moment of conception.
10:49The fertilized egg now begins to grow by dividing.
10:52In three days, if developing properly, it is grown to an embryo containing eight, ten, or twelve identical cells called blastomeres.
11:01At this stage, the embryo can be placed in the woman's uterus.
11:06The embryos are collected in a small catheter for transfer.
11:10Nancy's laparoscopy a month ago produced seven embryos.
11:15You may feel a little catheter as it's going in through the cervical canal.
11:20Dr. Mars placed four embryos into her uterus because that has proved to be the optimal number to produce a pregnancy.
11:27He froze the other three.
11:29Before embryo freezing became an option, doctors felt compelled to transfer all viable embryos, sometimes as many as ten, back into the patient.
11:37As we've learned how to produce more eggs per patient, we've ended up with more embryos.
11:43Ethically and morally, we felt like we had a new life form and we had no place to put it.
11:49It was either put it back into the uterus or it would be discarded.
11:52So we felt that we had to place those embryos.
11:57The risk of placing all embryos that developed is a very significant risk of multiple pregnancies occurring.
12:04Twins, triplets, quadruplets, quintuplets.
12:07And that's a very difficult problem to deal with obstetrically.
12:10This is where the new technology of freezing can make a difference.
12:13Extra embryos can be frozen and stored.
12:16The liquid in each cell of the embryo first has to be removed and replaced with a cryoprotectant, which prevents the cell from disintegrating as it freezes.
12:25Next, the embryos are placed in a cooling chamber and over four hours frozen to minus 75 degrees centigrade.
12:33This procedure is experimental and there is still much to learn.
12:37At any stage, the embryo is at risk of being destroyed.
12:43Finally, the embryos are stored in a freezer filled with liquid nitrogen.
12:47Nancy and Don now have six embryos in this container.
12:51The extra three from her in vitro procedure and three from a previous laparoscopy.
12:58Today, Dr. Mars will thaw their embryos.
13:01Because in vitro fails so often, a further benefit of embryo freezing is that it gives a woman another chance at pregnancy without additional surgery.
13:11Well, we just finished the case. We're going to start thawing now.
13:15We've got two batches of frozen, three in the first and three in the second.
13:22I'm just going to thaw the first ones out first because they're the oldest and we'll see what they look like.
13:28If they look good, then we won't touch the second group of embryos.
13:33We treat these embryos as human life forms, whether we're freezing them or whether we're preparing them for transfer to the uterus.
13:40And we treat them with dignity that we would treat any other live human material.
13:45The controversy that will come about with embryo freezing is the embryos that don't survive the freezing and thawing process.
13:53We're only recovering about 60% of embryos that are frozen that look viable when we transfer.
14:02Now Dr. Mars and his assistant begin to thaw three of Nancy and Don's embryos.
14:07Contained within plastic straws, the embryos are brought to room temperature in one or two minutes.
14:15During the thawing process, we've seen a lot of embryos that initially look fairly decent that'll look bad after the thawing is complete.
14:22Because thawing, just like freezing, is still so experimental, Dr. Mars doesn't know if the embryos will survive this step.
14:30It took him 30 tries to get two pregnancies using frozen embryos.
14:34And he's still learning by trial and error how quickly to thaw and remove the cryoprotectant.
14:41You can see some blaster mirror outlines.
14:46Looks to be fairly intact.
14:48The first embryo seems to have survived.
14:53Now he looks for the other two.
14:59I don't see the third embryo, which probably means that there was damage occurring during the freezing and the embryo fractured or lysed.
15:11So we're ending up with two out of the three embryos.
15:16It's hard to know whether you're dealing with a viable structure or not.
15:21What we look for is clarity of the cells, the blaster mirrors.
15:25And you can see some blaster mirror separation in this one.
15:30I'd like them to look better.
15:32Of course, we'd like them to look as if they were fresh and never frozen.
15:37We haven't done enough transfers with these types of embryos to know whether these will go on and produce babies after transfer or whether they are non-viable structures.
15:55How many?
15:56Well, we thawed out three.
16:01We found two of the three.
16:03The third one probably lysed during the freezing process.
16:07But the two look pretty good.
16:10They didn't look real good right at first, but as we've diluted out the cryoprotectant, we're seeing the blaster mirror shapes, and they look fairly good.
16:18Good. Male, female?
16:21There's a boy and a girl.
16:23Good.
16:25They're both looking for moms, so.
16:27This is Dr. Mars.
16:29The longer you work with an individual couple, the more involved you get in trying anything that's possibly going to help them achieve their desire, which is to have a child.
16:39So it becomes almost a personal challenge at times to try to take one particular situation and make it work.
16:46Julie's got the catheter with the two embryos in it.
16:50I'm going to be placing this catheter up through your cervix.
16:54The transfer is usually painless, but because of the position of Nancy's uterus, Dr. Mars has to hold her cervix steady with a clamp so he can insert the embryos.
17:04I see a little cramp in the catheters inside the uterus.
17:10The embryos are going in now.
17:15I'll slowly pull the catheter out.
17:19Are you uncomfortable?
17:21Not too bad.
17:25Yeah, that didn't switch off.
17:28I'll take the spectrum out.
17:30There was no linkage of fluid or no bleeding, so you're okay.
17:35But what about a baby born from an embryo that has been frozen and thawed?
17:40Can it possibly be normal?
17:42Until we have a large number of babies by this process, we won't know.
17:47What we do know is that we think it's going to be the same as IVF and that the risk is extremely low
17:53because it's an all-or-none phenomena.
17:55If they survive the freezing and thawing and they develop a pregnancy, they're the hardiest and the most normal embryos, we believe.
18:03Nancy won't know whether or not she's pregnant for another two weeks.
18:06If she is, her struggle to have a child may finally be over.
18:10But she would still have three embryos in the freezer.
18:13What is the fate of unused frozen embryos?
18:17This question made international news when a millionaire couple from California died in a plane crash,
18:23orphaning their two frozen embryos in this Australian hospital.
18:27What does the in vitro team do with these particular embryos?
18:31Do they simply dispose of them?
18:33Do they give them the chance of life by implanting them in a womb,
18:36either to be raised as the children of the women concerned,
18:39or do they use a surrogate mother so that the children can be raised to maturity to share in the estate of their dead parents?
18:46The case of the frozen embryos fueled a national debate in Australia,
18:50where the technology was first developed and regulated.
18:53Embryos frozen in this country are not subject to any government regulations,
18:58so the few in vitro clinics that are freezing have established their own guidelines.
19:03But many questions remain.
19:05Should that embryo be given full rights as a person,
19:08now that it seems to have its own independent existence?
19:12Is it proper to transfer that embryo from one party to another?
19:16Does the state have any rights to those embryos if they've been abandoned in a freezer,
19:22or if a couple decide that they don't want to follow through with in vitro fertilization?
19:27The underlying issue here is the moral status of the embryo.
19:32And because our country is embroiled in a debate over abortion and the question of when life begins,
19:38there is no easy answer.
19:40There it is. It's in the dish, and one has to decide,
19:43is that something that is really morally worthy of respect?
19:46Does it have rights? Is it something that I'm going to try and say has dignity?
19:50Or is it just a glop of cells, no different from any other group of organic material?
19:56I'll do with it as I please, depending on the aims and goals that I have.
20:02Dr. Gary Hodgen, an embryo researcher now at the Jones Clinic,
20:06hopes to improve treatments for infertility
20:08and is developing techniques for evaluating embryos.
20:11To avoid controversy, he limits his work to animal experiments.
20:18An embryo is split.
20:20The purpose here is to learn how to remove a section of a living embryo.
20:24When and if this technique is tried on human embryos,
20:27some will be destroyed as it's perfected.
20:30But the benefits may be substantial.
20:33Biopsied embryos can be screened for genetic defects.
20:37This is just one example of the promise of human embryo research.
20:41It may also improve in vitro fertilization
20:44and unlock the mysteries of embryonic development and cancer.
20:48Yet because it involves growing human embryos
20:51and after about two weeks discarding them,
20:54researchers are hesitant to proceed.
20:57I think we're waiting for society to accept that our motives are proper,
21:03that they're approved,
21:05that what we're doing, society says back to us, is helpful.
21:09We haven't really had, in my judgment,
21:11a national debate of any significance on that subject.
21:14But if we come to a point where we're going to tolerate
21:17some kind of research, it should be, I believe,
21:20controlled by an appropriate authority, national in scope,
21:24because the matter is so important.
21:27Traditionally, government has had a hands-off attitude
21:30with respect to the family, sex, and procreation.
21:33It has basically said in the United States,
21:35we don't deal in the areas of reproduction and sex.
21:38That's a private area.
21:39Remember, the Supreme Court decision on abortion said
21:42we will not ban abortions in the first trimester
21:45because that is basically a private decision.
21:48I think the other reason we don't have any science policy
21:51with respect to artificial reproduction
21:53is that the regulatory authorities, the government bodies,
21:57are too afraid to get involved with it.
21:59It raises terribly disturbing questions about
22:02where to draw the line with respect to research.
22:05What is the moral status of an embryo?
22:07What types of obligations does government have
22:10to those who are infertile?
22:12Those are very difficult questions.
22:13Sometimes it's better to avoid a difficult question
22:16than to try and answer it at all.
22:18So I think we've got some ostrich-like positioning
22:21of certain authorities with respect to this technology.
22:25The absence of regulations puts individual doctors
22:28in the position of making up their own rules.
22:31Here in Cleveland, Mount Sinai Hospital runs a successful
22:35and until 1983 standard in vitro program.
22:38Director Dr. Wolf Udian.
22:40One day I got a most unusual telephone call
22:43from a couple out of state,
22:45making a request of our in vitro program
22:48for something that had not yet been done before.
22:51The idea was to try and get an egg from a woman
22:55who'd had a hysterectomy
22:57and therefore unable to carry a pregnancy,
22:59a sperm from her husband,
23:01to fertilize the embryo in vitro,
23:04and then to transfer the embryo
23:07to the uterus of a friend,
23:09a sort of surrogate carrier or surrogate host situation.
23:14For Elliot, a cardiologist, and his wife Sandy,
23:18Cleveland was the last hope.
23:20They had already been to England
23:22to see the doctors who produced the world's first test tube baby.
23:26In fact, Sandy became pregnant there
23:29after one in vitro attempt.
23:31It seemed that everything was working out
23:34and we were going to have a baby.
23:36And then in the seventh month,
23:39I developed severe pain and bleeding
23:42and that necessitated an emergency C-section
23:47and our baby was born at 28 weeks.
23:50She was a beautiful girl.
23:52Her name was Heather.
23:54She was a perfect baby.
23:56But unfortunately, she was very premature
23:59and though she put up a valiant struggle,
24:03after 13 days, we lost her.
24:05At the same time, I had a uterine tear
24:08and that necessitated that I had a hysterectomy.
24:13Though she still had ovaries,
24:15Sandy had lost her uterus
24:17and there was no available technique
24:19to help this couple have their own genetic child.
24:22But that didn't stop Elliot.
24:24Just one day the thought occurred to me,
24:26why not combine existing technologies
24:28and do in vitro fertilization with a surrogate?
24:32And when I thought of that,
24:34I mentioned it to Sandy
24:36and I was excited by the prospect
24:38and she was excited by the prospect.
24:40And then the next task was to really find
24:43not only a surrogate, but to find someone
24:45who was medically willing to do it.
24:47It was an original idea.
24:49Sandy's egg fertilized by Elliot's sperm in vitro
24:52and then implanted in another woman.
24:55Elliot called clinics around the world.
24:57Finally, Dr. Udian agreed to take their case,
25:00in part because they had a friend
25:02willing to undergo the pregnancy without being paid.
25:05We didn't want an association where we could,
25:07in any way, this would be construed as,
25:09if you like, dealing or marketing in babies as such.
25:14And therefore, we were pleased with the way
25:17the request had come to us,
25:19that this was a couple with a friend.
25:21Unfortunately, she developed a medical problem
25:25that made it really not health-wise
25:29a wise thing for her to do,
25:31and we had to go on and see
25:34what else we could do in terms of a surrogate.
25:38Hiring someone seemed the only option,
25:40so they ended up here in Detroit,
25:42where lawyer Noel Keane runs a thriving business
25:45brokering surrogates to infertile couples.
25:48The couple you met with on Saturday
25:50told me this morning and told me
25:52that they would like to work with you as their surrogate.
25:54She's going to take the child from the hospital
25:56and give it to the father outside.
25:58She didn't want the hospital to know that she was a surrogate.
26:01Keane specializes in traditional surrogacy,
26:03where a paid surrogate is artificially inseminated
26:06with the sperm of an infertile woman's husband.
26:09This baby's out in Texas.
26:11This baby went to Greece.
26:13Here's a couple that lived in London, England,
26:15and here's their surrogate right in the room with them.
26:17Yeah, I didn't know that they did this.
26:19It was so popular.
26:21I mean, I thought it was just now starting.
26:23No, no, no, we've been doing it for 11 years.
26:25Now Keane is also interviewing women
26:27who want to be in vitro fertilization surrogates.
26:30Most of these couples are of substantial wealth.
26:32They're generally professional people,
26:34either lawyers, doctors, or successful businesspersons
26:37that are earning enough money to pay for the cost
26:40associated with this program, which is around $25,000.
26:44The couples will pay you a $10,000 fee.
26:47In addition to that, they will pay all the related expenses.
26:51Expenses include Keane's fee, now $10,000.
26:55He quickly found a surrogate for Sandy and Elliot.
26:58They paid her the standard fee,
27:00but didn't tell Dr. Udian about the new arrangement.
27:03We thought that if he knew that she was being paid,
27:07there was the possibility that he might not do it,
27:10and I didn't want to risk that.
27:13So therefore, we felt it would be safer not to tell him.
27:17Nor did Dr. Udian ask.
27:19The hospital had already given him permission to proceed,
27:22so based on his original understanding
27:24that the surrogate was not being paid,
27:26he and his staff went ahead.
27:28But first, they had to make one major adjustment
27:31to the standard in vitro method.
27:33From a scientific point of view,
27:35what intrigued us about the procedure
27:37was there was a challenge to try and cycle two women concurrently
27:42so that they would both be ovulating within 24 hours of each other.
27:47Dr. Udian gave Sandy birth control pills
27:50so she would ovulate at the same time as the surrogate.
27:53Then the embryo could be transferred
27:55when the surrogate's uterus was ready to receive it.
27:58Next, Dr. Udian performed a laparoscopy on Sandy.
28:05She had surgery three times to collect eggs for transfer,
28:09but each time the surrogate failed to get pregnant
28:12and finally gave up.
28:14I started getting discouraged myself,
28:16and it was Sandy who said we should continue,
28:19and I felt that since she really was bearing all the risk,
28:23that I would continue with her.
28:27I was really concerned about how I would feel, say, in 10, 20 years
28:31when I looked back, and I would have thought to myself,
28:34well, perhaps if I had given it just a little longer,
28:37perhaps we could have succeeded.
28:39It took nine months to find another surrogate.
28:43Sandy underwent one more laparoscopy,
28:46and a single egg was successfully fertilized.
28:50In August 1985, the embryo was transferred into the surrogate.
28:55Two years and thousands of dollars after Sandy and Elliot came to Mount Sinai,
29:00their embryo began to grow in another woman's body.
29:04For the first time ever, a woman who had no uterus
29:07had a chance to have her own genetic baby.
29:12It was a type of icebreaker for future science,
29:17another step in this rapidly evolving science of reproduction.
29:24And perhaps one of the thoughts that crossed my mind was,
29:28considering myself really quite a traditionalist,
29:31would traditional medicine go with this,
29:34or think that we'd overstepped the mark, perhaps?
29:38When you separate the genetic function
29:43from the gestational and the rearing function,
29:47you've done something to untie the biological knot
29:51that we call parenthood.
29:53The first commandment in the Old Testament
29:55is to be fruitful and multiply and fill the land,
29:57which means to have children.
29:59And I can't see how anyone can think that
30:01fulfilling the first commandment in the Bible is unethical.
30:07Sandy and Elliot had to wait nine anxious months
30:10while another woman a thousand miles away carried their child.
30:16And they were troubled by legal issues.
30:19Would they have to adopt their own baby?
30:22What would happen in the unlikely event
30:24the surrogate refused to give it up?
30:26Their legal position was uncertain.
30:30I think the million-dollar question is,
30:32who is the real mother?
30:34Because we're dealing with a situation,
30:36as this type of medical science advances,
30:39where you can have four or five parents
30:42by some or other definition.
30:45In this particular situation here,
30:48we have a genetic mother.
30:50That's the wife who's given the egg.
30:53We have the carrying mother,
30:56who is the surrogate carrying the pregnancy.
30:59For the most part, we've legally presumed motherhood.
31:01We haven't even defined it.
31:02We're saying a woman gives birth to a child,
31:04it must be her baby.
31:05It's not true anymore.
31:06And we have recently filed a lawsuit in Michigan,
31:08asking the court for the first time
31:10to give us a legal definition of motherhood.
31:12The court ruled that in Sandy and Elliot's case,
31:14Sandy was the legal mother.
31:16They wouldn't have to adopt their baby
31:18and were protected if the surrogate changed her mind.
31:23It's Christmas in Cleveland, 1985.
31:26Sandy and Elliot's surrogate is four months pregnant.
31:29With everything going well,
31:31Dr. Udian wants to offer surrogacy
31:33as part of his regular in vitro program.
31:36But first he must seek the approval
31:38of several hospital committees.
31:41Udian has proposed that the hospital
31:43only work with unpaid surrogates.
31:46On the other hand,
31:47we've had some offers of people
31:49who would offer for financial reimbursement
31:51to carry a pregnancy.
31:53I'm just wondering how far away you would see
31:56perhaps a couple who,
31:58perhaps out of some sort of inconvenience
32:00to their careers or just lack of a desire
32:02to want to go through with a pregnancy,
32:04but they have plenty of money
32:06to find somebody to bear their genetic child.
32:09I personally find the idea
32:13of using somebody else to carry a pregnancy
32:16because it's inconvenient being distasteful.
32:19So I doubt that our program
32:21would ever offer something like that.
32:23You know, remuneration sounds fine.
32:26Wet nurses, for instance,
32:28are paid to take care of infants.
32:31And other nurses are paid
32:33to take care of small children, of course.
32:36So I think that there's nothing sinister
32:38about the idea of remuneration.
32:41How many institutions have approved programs
32:43in the country today?
32:45We're probably the first one.
32:47Other existing in vitro programs
32:48have been referring requests of this nature to us
32:51because they haven't got into this particular issue yet.
32:54I think many of them are actually looking at us
32:56as the so-called icebreaker.
32:58Let's take it then one at a time.
33:00The surrogate host program, all in favor?
33:03Raise your hand.
33:05Opposed?
33:07We then have an approval by...
33:10To Udian's surprise, the hospital has approved
33:12of in vitro and to paid surrogates,
33:14a decision that will bring them prominence.
33:17But in breaking new ground,
33:19these men have set a controversial precedent.
33:22The possibilities for abuse are just a hundredfold.
33:26You can see poor people
33:28who have no other way of getting money
33:30renting out their womb.
33:32This is a reduction of a woman to a function.
33:36It has been possible for centuries
33:39to sell women for sexual services
33:42in sexual prostitution.
33:44It is now possible to sell women
33:47for reproductive services in reproductive prostitution.
33:51Surrogacy was basically made illegal
33:53in some other countries
33:55because they felt that it was wrong
33:57to commercialize procreation.
33:59You may hear and others may argue
34:01that further reasons were involved
34:03about enforceability of contract
34:05and the difficulties in knowing exactly
34:07who was the party of responsibility,
34:09but I really believe
34:11it was the commodification,
34:13the commercialization of procreation
34:15that led to a kind of moral repugnance.
34:17Now, the United States hasn't shown itself
34:19to be as equally repelled
34:21by commerce and business and profit
34:23when it comes to dealings among human beings.
34:27Nor has the government been ready
34:29to involve itself in the growing field
34:31of reproductive technologies.
34:33In 1979, the Department of Health
34:35and Human Services made a feeble attempt
34:37by establishing an ethics advisory board.
34:40Its report approved in vitro fertilization
34:43and related research on the early embryo.
34:45It even recommended federal funding
34:47under certain conditions,
34:49but these recommendations have been ignored
34:51by government officials.
34:53Father Richard McCormick was on that board.
34:55First of all, it's a political hot potato,
34:58very controversial.
35:00The mail that was received
35:02after our recommendations appeared
35:04in the Federal Register,
35:06mail was overwhelmingly negative.
35:08There is a natural tendency
35:10on the part of people in public service
35:14to shy away from issues of this kind.
35:19Add to that the fact that our nation
35:22is involved in a very turbulent debate
35:26about the implications of abortion
35:28with the battle lines drawn very clearly,
35:32and you get a volatile mixture.
35:36And the path of least resistance
35:40is for people to say,
35:42I don't want to have anything to do with it,
35:44just keep it out of the public area altogether.
35:49The National Institutes of Health
35:51support biomedical research.
35:53When the 1979 recommendations
35:55failed to become policy,
35:57the result was a de facto moratorium
35:59on funding any research related
36:01to the new reproductive technologies.
36:04The moratorium continues today,
36:06and in this area,
36:07no funding means no regulation.
36:10One of the terrible problems
36:11of having no regulation
36:12and no public discussion
36:13is that there's absolutely no way
36:14to control anybody's desires and purposes
36:16with respect to this technology.
36:18So if someone wants to use it
36:19for eugenic purposes,
36:20if someone wants to open
36:21a Nobel Prize sperm bank,
36:23if someone wants to open
36:24a surrogate mother's farm,
36:26they go about it and do it.
36:27Usually when a new medical technology
36:29is introduced,
36:30there's some government funding,
36:31either federal funding, state funding.
36:33But since this is such a controversial area,
36:36and since the federal government
36:37has refused to fund,
36:39the practitioners have been forced
36:41to seek funding
36:42from commercial sources.
36:44This can lead to problems
36:45when the bottom line dollar
36:48becomes more important
36:49than patient concerns.
36:53It's October 1985,
36:55and financial printers
36:56are producing a prospectus
36:58for Fertility and Genetics Research,
37:00FGR,
37:01a Chicago company
37:02trying to start
37:03a business of making babies.
37:05You have to put the words
37:06and the picture on together.
37:07Can we crop the picture?
37:08Investment banker Larry Soucy
37:10is chairman of FGR.
37:11He and his lawyer
37:12are completing the document
37:13they need to sell stock
37:14to the public.
37:15If Soucy can raise
37:16four million dollars,
37:17he can market a new technology
37:19called non-surgical
37:20embryo transfer.
37:21He became interested
37:22in the idea seven years ago.
37:24I thought immediately
37:26that this would be
37:27an important technology
37:29with a lot of extensions
37:32that dealt fundamentally
37:34with us as humans.
37:35The power of reproduction,
37:37the need to reproduce,
37:40dealing and working
37:41with basic procreation.
37:43I said, if you can do that,
37:44transfer an embryo
37:45from one woman to another
37:47non-surgically
37:48and make it medically viable,
37:50that is terribly important
37:51and will be.
37:56The embryo transfer technique
37:57was first developed
37:58in the cattle breeding industry
38:00to increase the production
38:01of high-quality stock.
38:03The embryo of a prized cow
38:05is transferred into the uterus
38:06of an ordinary one
38:07which carries the calf to term.
38:09This way, the prized cow
38:10can produce 18 or more
38:12offspring a year.
38:14Soucy and others
38:15banked on the idea
38:16that embryo transfer
38:17could be applied to humans.
38:20This technique could help
38:21a woman with tubal
38:22and ovulation problems
38:23or whose eggs contained
38:25a genetic defect.
38:26Another woman could donate
38:27an egg to be fertilized
38:29by the husband
38:30through artificial insemination.
38:32Five days later,
38:33without surgery,
38:34the embryo could be flushed
38:35out of the donor's uterus
38:37and transferred to the wife
38:38who'd have the experience
38:39of pregnancy.
38:40Here, the mother is
38:41the woman who gives birth
38:42to a baby,
38:43not hers genetically.
38:45Excellent.
38:46Glad to hear it.
38:47It seemed simple,
38:48but it would take Larry Soucy
38:49three million dollars
38:50from private investors
38:51to make it work.
38:53Thanks a lot.
38:56For medical know-how,
38:57he contracted
38:58with a team of researchers
38:59from Harbor Branch UCLA Hospital
39:02in Torrance, California.
39:05Dr. John Buster
39:06is an endocrinologist
39:07who became interested
39:08in the area
39:09of reproductive technology
39:10after the birth
39:11of the first test-tube baby.
39:13He welcomed
39:14a research project
39:15in this field
39:16and a source of funding
39:17for the work.
39:18In the late 1970s,
39:20there was not a brass penny
39:22available from the
39:23federal government
39:24for work in a field
39:25we thought was
39:26supremely important.
39:27There had been decisions
39:28made by the politicians
39:30that the field
39:31was not fit to support
39:32for a lot of
39:33important reasons.
39:35So we looked
39:36at two things.
39:37One was how we could
39:38enter the field differently,
39:40and the other was
39:41how to enter it
39:42in a financially
39:43responsible way,
39:44since I can't work
39:45and my people
39:46can't work for free.
39:51Dr. Maria Bastillo
39:53also played
39:54a central role.
39:55The catheter used
39:56to flush the embryo
39:57out of the uterus
39:58had to be adapted
39:59from cows to women.
40:01Basically when we started out
40:02we thought the simple catheter
40:03very similar to the cow
40:04would work easily,
40:05but that turned out
40:06not to be the case
40:07because the woman's uterus
40:09is quite different
40:10from the cow.
40:11The main difference being
40:12that in the cow
40:13one can put lots
40:14and lots of fluid
40:15and not have to worry
40:16about it leaking
40:17out of the uterus,
40:19and one can then retrieve
40:20that fluid easily.
40:21In the human, however,
40:23the uterus is quite small.
40:25The inside or the cavity
40:26of the womb leaks.
40:28That is, if you put
40:29any amount of fluid
40:30with pressure in it,
40:31it will go out
40:32the fallopian tubes
40:33and into the abdominal cavity.
40:34That obviously would not be
40:36worthwhile to do
40:37because then one would
40:38lose the embryo
40:39out into the abdomen
40:40or not be able
40:41to retrieve the embryo.
40:43Therefore, the catheter
40:44had to be greatly modified
40:45to be able to accomplish
40:46what we wanted.
40:48Essentially the catheter
40:49is fairly simple
40:50and only this plastic part
40:51goes inside
40:52the uterine cavity.
40:54It works very simple
40:55in that fluid is injected
40:57through this inner tube,
40:58smaller one,
40:59into the uterine cavity
41:00and then it is sucked out
41:01through the larger tube
41:02into this flask
41:03where we recover the embryo.
41:06Developing the instrument
41:07was only the beginning.
41:09Could they get anyone
41:10to donate an egg?
41:11Over a hundred women
41:12responded to this ad
41:13which offered,
41:14as reasonable compensation,
41:16$250 a procedure.
41:18In 1982, experimental trials
41:21began with nine
41:22anonymous donors
41:23matched to 12 infertile couples.
41:25Using the special catheter,
41:26the uteruses of the donors
41:28were flushed out,
41:29a process that Dr. Bustillo
41:30acknowledges has some risks.
41:33Because it is a procedure
41:34that you technically
41:35introduce something
41:36into the uterine cavity
41:37and anytime you do that
41:38there is a small risk
41:39of infection.
41:40So that's the first risk.
41:41The second risk
41:42is that we do not get
41:43the embryo and the donor
41:44becomes pregnant
41:45and that actually has happened
41:46to us twice
41:48in the same woman
41:49and that is a risk we have
41:51and we only recover embryos
41:52about 50% of the time
41:54and so that some of them
41:55might implant.
41:57We don't think that's likely
41:59because I think the catheter
42:00does a pretty good job
42:01of washing it
42:02and it probably disturbs
42:03the lining enough
42:04so that implantation
42:05is very unlikely
42:06to take place.
42:07But that is a risk.
42:08The next and other risk
42:09is that the egg
42:10never got there
42:11and is stuck
42:12in the fallopian tube
42:13which can happen normally
42:14and or that we pushed it out
42:16into the fallopian tube
42:17and the patient
42:18would then have
42:19an ectopic or tubal pregnancy
42:20that would have to be
42:21taken care of surgically.
42:24From 52 flushings,
42:2525 embryos were recovered
42:27and transferred.
42:30At last,
42:31in January 1984,
42:32a success.
42:34The eyes of the medical world
42:35are focused on
42:36Harbor-UCLA Medical Center
42:38tonight where human history
42:39has once again been made.
42:42Pregnancy was uneventful.
42:44It was absolutely healthy.
42:45The child was in
42:46robust condition at birth
42:48and went home healthy
42:49as did the mother.
42:50In spite of the publicity
42:51in the birth of the second baby,
42:53embryo transfer came to a halt
42:55two years ago.
42:56FGR ran out of money
42:58and the research trials ended.
43:00But letters poured in
43:01from more than
43:023,000 infertile couples
43:03waiting for the procedure.
43:05Now the challenge
43:06was to raise money
43:07to open clinics
43:08around the country.
43:10After failing to find
43:11private capital,
43:12FGR decided to sell stock
43:15and go public.
43:16In November 1985,
43:18Susie and his investment
43:19counselors took to the road
43:21to present FGR to brokers
43:22around the country.
43:24Chicago,
43:25Seattle,
43:26Los Angeles,
43:27New York,
43:28and today,
43:29Boston.
43:30One reason FGR
43:31can sell stock
43:32is that they have
43:33a major asset,
43:34a patent on the
43:35special catheter
43:36and a patent pending
43:37on the embryo transfer
43:38process itself.
43:40We simply set about
43:41to do what every
43:42technology company does
43:44and that is to get
43:45the best patent protection
43:47possible on the technology
43:49being developed.
43:51And that included,
43:52of course,
43:53the technology being
43:54developed and the
43:55process itself.
43:56Can you imagine
43:57the situation where
43:58physicians went out
43:59and said they were
44:00going to apply
44:01for a patent
44:02for hysterectomy
44:03and appendectomy
44:05and every minor
44:06procedure that existed
44:09and that someone
44:10would have to pay
44:11royalties to somebody
44:12else for actually
44:13doing an operative
44:14procedure on someone.
44:17It's a nightmare
44:18situation.
44:19It would be
44:20out of control.
44:21It's never been
44:22that way.
44:23The situation,
44:24in terms of sharing
44:25of knowledge,
44:26has worked extremely
44:27well up to this
44:28point in time.
44:29And I think to create
44:30a precedent of allowing
44:31a medical technique
44:32to be patented
44:33would be about
44:34the single worst
44:35thing the U.S.
44:36Patent Office could do.
44:37We have an obligation
44:38to our investors
44:39to protect the
44:40technology that
44:41we've developed
44:42and retain that
44:43within the company.
44:46The difficulty is
44:47that the procedure
44:48is so experimental
44:49and has such
44:50relatively poor
44:51outcome still,
44:52with so few babies
44:53being produced
44:54out of many efforts,
44:55that to talk about
44:56patent at this point
44:57is to change
44:58something into a
44:59therapy when it's
45:00still basically
45:01research.
45:02We are looking,
45:03we believe,
45:04at about 70 to 90,000
45:09procedures annually.
45:11FGR makes a
45:12strong sales pitch
45:13to a group of
45:14Boston stockbrokers.
45:15We expect that
45:16about 15,000
45:17of those,
45:18of the 70 to 90,000,
45:19will be able to
45:20afford one to
45:21four tries,
45:22which will cost
45:23approximately
45:24$12,000.
45:25How do they plan
45:26to tap this affluent
45:27market?
45:28By selling the
45:29technology to clinics
45:30who will pay
45:31them a royalty.
45:32We do not like
45:33the use of the
45:34term franchise
45:35as connected
45:36with this technology,
45:37because that
45:38implies an analogy
45:42with hamburgers
45:43and where people
45:44take something away
45:45and simply pay you
45:46something and
45:47utilize it.
45:48We think this
45:49requires extensive
45:50quality control,
45:51extensive consistency
45:52of the medical
45:53protocols,
45:54continued involvement
45:55by our medical
45:56people,
45:57because if someone
45:58should have an
45:59unfortunate
46:00misadventure,
46:01it would reflect
46:02on all of us
46:03and on the whole
46:04technology.
46:05And we don't
46:06intend to permit
46:07that to happen
46:08if we possibly
46:09can.
46:10The issue of
46:11liability is
46:12coming up.
46:13If we are
46:14providing embryos
46:15to workers
46:16who are
46:17pregnant,
46:18if we are
46:19providing embryos
46:20to women,
46:21are they products
46:22or is it a service?
46:23If it's a service,
46:24then liability
46:25is one thing.
46:26If it's a product,
46:27it's another.
46:28But the demand
46:29for this technology
46:30is just incredible,
46:31and I think the
46:32system will
46:33air it out.
46:34It's an intensely
46:35exciting time
46:36for this work
46:37that we're doing.
46:38And a high-margin
46:39business.
46:40Oh, well,
46:41there's no limit
46:42on that.
46:43It would be
46:44such an opportunity
46:45to give.
46:47I'd be glad
46:48to share the gift
46:49of life.
46:50I have done 50
46:51public offerings.
46:52I have participated
46:53in hundreds of others,
46:54and I've never seen
46:55a deal structured
46:56for a venture
46:57capital deal
46:58structured to the
46:59benefit of the
47:00public investors.
47:01This is.
47:02Baby U,
47:03FGR's trading
47:04symbol,
47:05appeared on the
47:06market six weeks
47:07after they began
47:08selling shares.
47:09Their public offering
47:10was a success,
47:11and now that they
47:12have $4 million
47:13in the bank,
47:14they must identify
47:15a handful of
47:16fertile egg donors
47:17so they can
47:18open clinics.
47:19The fertility
47:20of the donors
47:21is maximized
47:22by choosing
47:23the right ones.
47:24There are some
47:25women who become
47:26pregnant at the
47:27drop of a hat,
47:28and those kinds
47:29of women will be
47:30very effective
47:31and efficient
47:32donors.
47:33FGR had hired
47:34a market research
47:35team to design
47:36this ad
47:37and survey the
47:38availability of
47:39women willing to
47:40serve as regular
47:41donors for $250
47:42a procedure.
47:43At the new
47:44company's first board
47:45meeting in December
47:461985, the report
47:47was a major item
47:48on the agenda.
47:49We retain the
47:50firm of professional
47:51practice builders
47:52because we all
47:53recognize that the
47:54recruitment of
47:55appropriate donors
47:56and adequate numbers
47:57of donors was
47:58central to the
47:59success of the
48:00company.
48:01And Richard
48:02Bernstein of
48:03professional practice
48:04builders is going
48:05to summarize that
48:06for the board
48:07today.
48:08The medical
48:09technology is a
48:10given.
48:11You've created
48:12and developed
48:13and have proven
48:14that this
48:15non-surgical embryo
48:16transfer is state
48:17of the art.
48:18It works.
48:19It's wonderful.
48:20But that doesn't
48:21translate into
48:22getting one woman
48:23to say, I will
48:24toss away all my
48:25concerns and my
48:26ethics and my
48:27morality and the
48:28advice of friends
48:29or relatives or my
48:30physician and share
48:31my fertility.
48:32Can you, in fact,
48:33retain a significant
48:34number, let's say,
48:3550 donors for each
48:36market that the
48:37program would go
48:38in?
48:39That was the
48:41essence of what we
48:42were there to find
48:43out.
48:44And I bring you, I
48:45think, good tidings.
48:46Absolutely and
48:47unequivocally, yes.
48:48The tremendous
48:49opportunity that this
48:50company has for
48:51business growth quite
48:52simply is reflected
48:53because your primary
48:54resource for that
48:55growth, the donor
48:56woman and her
48:57fertility, exists in a
48:58cost-effective
48:59abundance.
49:00And I can't state
49:01that strongly enough.
49:02Now, how do you
49:03retain a significant
49:04number of
49:05donors for each
49:06market?
49:07Well, the
49:09Now, how we plan on
49:10going about it?
49:11First of all, I want to
49:12thank all those people
49:13who have made this
49:14possible.
49:15It's great to be here
49:16tonight.
49:17But above all, I want
49:18to toast the first
49:191,000 mothers and
49:20their children that
49:21will come from this
49:22process.
49:23A toast to those
49:24first 1,000.
49:25Dr. John Buster, now
49:26a vice president and
49:27stockholder, hopes FGR
49:28has a bright future, but
49:29some people are
49:30concerned about their
49:31plans.
49:32I think there's
49:33difficulty in
49:34understanding what
49:35we're doing.
49:36I think there's
49:37difficulty in
49:38franchising and
49:39commercializing any
49:40aspect of medicine,
49:41especially a very
49:42sensitive area such as
49:43infertility therapy.
49:44Patients are very
49:45driven to have a
49:46child, and when you
49:47take that into
49:48consideration and the
49:49fact that they'll do
49:50anything to have a
49:51child, then
49:52manipulation of those
49:53couples can't occur.
49:54We genuinely feel that
49:55no aspect of what we
49:56are doing is in any
49:57way inconsistent with
49:58what else is
49:59going on.
50:00And I think that's
50:01one of the reasons
50:02why we're doing
50:03what we're doing.
50:05Drug companies have
50:06always been among the
50:07highest return on
50:08investment industry,
50:09and physicians are the
50:10single highest paid
50:11group of individuals
50:12within our country.
50:13In 1984, Representative
50:14Albert Gore held
50:15congressional hearings
50:16to look into
50:17commercialization and
50:18other issues raised by
50:19the new reproductive
50:20technologies.
50:21Since the federal
50:22government turned you
50:23down, you've had
50:24to go to the
50:25private sector.
50:26You've had to
50:27go to the
50:28pharmaceutical
50:29companies.
50:30You've had to
50:31go to the
50:32pharmaceutical
50:33companies.
50:34The federal
50:35government turned
50:36you down, and
50:37since you were
50:38forced to go into
50:39the private sector
50:40to get the money...
50:41Two years before
50:42Dr. John Buster
50:43became a vice
50:44president of FGR,
50:45he testified as one
50:46of the expert
50:47witnesses.
50:48...that the source
50:49of private financing
50:50requested in return
50:51for their money.
50:52Is that...
50:53Well, the motivation
50:54is not to withhold
50:55it.
50:56It is open it.
50:57And make more
50:58money from it.
50:59And the way that
51:00they make money
51:01from it is through
51:02a system which is
51:03simply a system for
51:04paying back on
51:05investment.
51:06Well, now, in fact,
51:07your sponsors, you
51:08and your sponsors,
51:09have in mind having
51:10embryos flown from
51:11city to city where
51:12and when they are
51:13needed on a nationwide
51:14basis and making a
51:15rather large business
51:16out of it.
51:17That's what you have
51:18in mind, isn't it?
51:19They do have plans
51:20like that.
51:21What I have in mind
51:22is to be a scientist
51:23and do my research
51:24work.
51:25Yeah, that's what
51:26your business
51:27partners have in mind.
51:28This is what our
51:29sponsors have in
51:30mind.
51:31And it does sound
51:32like a big business
51:33because a lot of
51:34work needs to be
51:35done.
51:36A lot of women out
51:37there that want
51:38these babies.
51:39Yeah, yeah.
51:40A year after these
51:41hearings, Congress
51:42established an ethics
51:43board to examine
51:44issues raised by the
51:45new reproductive
51:46technologies and
51:47other biomedical
51:48advances.
51:49But because these
51:50areas are still so
51:51controversial, the
51:52board may not get the
51:53support it needs to
51:54deliver its
51:55recommendations by
51:56its 1989 deadline.
51:58And even if it does,
51:59will the new
52:01committee succeed
52:02where others have
52:03failed?
52:04The British tried to
52:05regulate the technology
52:06by setting up a
52:07national commission.
52:08And I think they got
52:09themselves in trouble
52:10because the commission
52:11did a very conscientious
52:12job in examining the
52:13many ethical questions
52:14raised, but it didn't
52:15have enough political
52:16and social support for
52:17its conclusions.
52:18Other people weren't
52:19brought into that
52:20dialogue.
52:21In the United States,
52:22we haven't had any
52:23commissions, we
52:24haven't had anybody
52:25attempt to do a
52:26systematic analysis of
52:27the consequences of
52:28this technology.
52:29But that may be in
52:30our advantage if we
52:31take the time as a
52:32society to try and
52:33struggle a little bit
52:34with the answers to
52:35questions like, what
52:36priority should we
52:37give to fertility?
52:38Do we all understand
52:39the need to do some
52:40more research on
52:41embryos if we're going
52:42to perfect this
52:43technique?
52:44What sorts of
52:45conditions are we going
52:46to put on
52:47experimentation with
52:48respect to embryos?
52:49And so on.
52:50We need to lay the
52:51groundwork for
52:52regulation.
52:53But regulation must
52:54come.
52:57On April 13th,
52:581986, Sandy and
52:59Elliot's surrogate
53:00delivered a healthy
53:01baby girl.
53:02They were handed
53:03their daughter at
53:04birth and left the
53:05hospital the proud
53:06parents of their
53:07own child.
53:12All that we've gone
53:13through, all the ups,
53:14all the downs, now that
53:15I have the baby, it's
53:16all worth it.
53:17It really is a dream
53:18come true.
53:19And we really do hope
53:20that we can give hope
53:22to other couples.
53:28Nancy did not get
53:29pregnant with her first
53:30batch of frozen embryos,
53:32or even her second.
53:33A further in vitro
53:34attempt also failed,
53:35but left her with more
53:36embryos in the freezer.
53:38She and Don planned to
53:39keep trying, but just
53:40in case, they've hired
53:41a surrogate.
53:43I actually feel very
53:44fortunate because at
53:45this time I have
53:46alternatives that 10
53:47years ago women did
53:49not have.
53:50I can go through
53:51in vitro.
53:52I can go through a
53:53frozen embryo transfer.
53:54I can seek surrogacy.
53:57My aunt, who had the
53:58same problem that I do,
54:00is childless because the
54:02alternatives were not
54:03there for her.
54:09Let me not push!
54:10I won't push.
54:11This is where it all
54:12began.
54:13Elizabeth Carr,
54:14America's first test
54:15tube baby, is now
54:16four years old.
54:18Don't put a hand
54:19on anyone.
54:21I won't put a hand
54:22on anyone.
54:25I feel like I'm
54:26flying like a bird.
54:28Because what the new
54:29reproductive technologies
54:30produce is so precious
54:32and in such great
54:33demand, it seems that
54:34they are here to stay.
54:36But who will make
54:37the rules?
54:38Doctors and their
54:39patients?
54:40The federal government?
54:41The marketplace?
54:43As we avoid making
54:44the difficult decisions,
54:45the techniques could
54:46develop in directions
54:48we may not want.
54:50So much has happened
54:51since the birth of
54:52Elizabeth Carr.
54:53What will reproduction
54:54be like when she is
54:55ready to have a
54:56child of her own?
55:26Making pie.
55:30Leather belt.
55:34Leather belt.
55:38Leather belt.
55:47What's for dessert, mom?
55:50Pie.
55:51Oh, that's good.
55:56Pie.
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