Dear List members,

Many thanks to Doug Hunt for sharing the piece on BW syndrome with with
us.

The topic of risks and scams (such as mixed-up babies) associated with
IVF/ET was my major research area during the 1980s.  I wrote a "contractor
document" for the Office of Technology Assessment (OTA), which they
published in 1988; it was "Risks of Infertility Diagnosis and Treatment."
(By the way, shortly afterwards the Office of Technology Assessment was
abolished.  I think that the U.S. does not want its technologies assessed
-- certainly not the military ones!)

Back in those pre-internet days, I had to use paper-search engines and
follow up by reading medical journals, mostly at the Univ. Mass. Medical
School in Worcester. And the OTA didn't allow me enough time.  Most of my
pages were on adverse reactions to the myriad of hormone and hormone-
mimicking drugs that were being tried in a somewhat hit-or-miss way on IVF
patients.  Pituitary glands were being zapped (and still are, of course)
to stop them from fine-tuning the women's natural hormonal cycles.  My
data were NOT taken from reports out of IVF clinics, but from adverse
reactions reported elsewhere or from case studies in the literature.

Definitely people are not interested in doing/paying for follow-up studies
of IVF patients.  And, for cancer to appear, one needs quite a time-lag.
In Holland in 1985-86 (with a Dutch colleague) I sent a questionnaire to
patients from the first and largest IVF clinic, but we asked only such
questions as how distressed they were with infertility, what treatment
step was most stressful, whether they would recommend the treatment to a
friend, how satisfied they were with the clinic, etc., etc. as well as
some questions about what to do with extra embryos and whether the
government's health fund should pay for IVF.  (Published in a Dutch and an
American journal) The clinic director did not allow us to send
questionnaires to the 80% of the patients who failed to get a baby.

I also reported on the hepatitis B epidemic in early 1988 among patients
at that same clinic.  It seems that they put a few drops of blood from
normal pregnant women into the early embryo culture medium.  AND one of
those women had hepatitis B.  This putting of blood into the culture
medium is only one example of the hocus-pocus experimenting (rarely with
controls) done worldwide throughout the 1980s and 1990s.
        May I quote from Macbeth Act IV:
Second witch:
        Cool it with a baboon's blood
        Then the charm is firm and good . .

I cannot evaluate the Australian study cited by Susana Sommer.  I do know
that the country that keeps the most extensive records is the UK, where
all clinics are required to report annually their success rates to the
"Human Fertilisation & Embryology Authority" (HBAC).  BUT no long-term
follow-ups are requested.  Yet, mixed-up babies seem to be reported more
from the UK than elsewhere, perhaps due to clever investigative reporters.
(BUT I BELIEVE THAT ALL CLINICS (worldwide) ARE SOMEWHAT LESS THAN CAREFUL
WITH THEIR LABELING OF SPERM AND EGG CONTAINERS.)

In the UK, the patient booklet prepared by the HBAC does tell future
patients some possible risks of each step of the procedure.  (If patients
mesmerized with the idea of maybe FINALLY having a baby can read anything
thoughtfully.)  It tells what symptoms should signal that they call a
doctor.  And it mentions the very serious ovarian hyperstimulation
syndrome (not calling it that), and recommends "urgent hospital
admission."  (It doesn't mention that women can die from it.)

Some recent evidence from the UK is that babies born after ICSI may have
more birth defects (statistically speaking) than other IVF babies.  ICSI
stands for "intracytoplasmic sperm injection" and means that the clinician
injects one sperm into an egg (instead of allowing a posse of sperm to
approach the egg with the 'best man' penetrating).  The HBAC is now
conducting a study of ICSI babies.  The biological theory behind the
possibility that ICSI may not be "the way to go" is that an egg, despite
its appearing spherical, actually has an internal orientation.  A normal
sperm can tell where to enter, but to the doctor holding the egg at the
tip of a pipette, the egg is a perfect sphere, so inject anywhere.

Well, Becky has rambled on much too long already, so I'd better quit now .
. as you can see, it's a favorite topic . .
                Becky Holmes

*   *   *   *   *   *   *   *   *   *   *
Becky Holmes
Center for Genetics, Ethics and Women
24 Berkshire Terrace, Amherst MA 01002-1302
phone: 413-549-1925; fax/phone: 413-549-1226
*   *   *   *   *   *   *   *   *   *    *