Pandora's Baby: How the First Test Tube Babies Sparked the Reproductive Revolution (Paperback)

~ (Author)
Key Phrases: clonal man, ethics advisory board, fetal research, Vande Wiele, New York, Landrum Shettles (more...)

Editorial Reviews

From Publishers Weekly

In her judicious history of the development of in vitro fertilization (IVF), NBCC finalist Henig (The Monk in the Garden) notes that many of the objections posed to IVF in the 1970s would later be used against human cloning, in particular the argument that artificial reproduction interfered in intimate processes best left to nature and that it was the first step on a "slippery slope" leading to genetic engineering and selective breeding. Ironically, because IVF was such a political hot potato, the U.S. government declined to fund research in the field, leaving it essentially unregulated except by the imperatives of a marketplace. Henig's narrative begins in the days when IVF was controversial, experimental science; she describes the work of maverick Columbia University researcher Landrum Shettles; of English doctors Robert Edwards and Patrick Steptoe, responsible for the birth of the first "test tube baby," Louise Brown, in 1978; of Howard and Georgeanna Jones, who made the East Virginia Medical School a pioneering IVF center; and of doctors and philosophers in the new field of bioethics who strove to get a grip on the moral implications of it all. Few of the more frightening predictions about IVF have come true, the author notes, but the rate of birth defects in IVF babies is much higher than in normal conceptions. We don't know where reproductive technology ultimately will take society, Henig concludes, but it's likely that "we will adapt to new discoveries the way we have so often adapted." Her level-headed book provides a welcome context for the current debate over cloning.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to the Hardcover edition.

From The Washington Post

In 1973, Landrum Shettles was an established if somewhat eccentric New York fertility doctor, known for -- among other things -- publicizing a number of low-tech ways in which he claimed that couples could predetermine their baby's sex. The so-called Shettles method, which incredibly enough still turns up on Internet chat rooms, involved everything from hot baths to loose underwear to a last-minute cup of coffee to certain unnerving douches involving vinegar (to yield a girl) and baking soda (for a boy).

Far more significant, in his spare time Shettles was also trying to gain even more control over conception, experimenting to see whether it was possible to unite sperm and egg outside the womb. That year, he took an egg that had been retrieved from a woman named Doris Del-Zio, combined it with sperm from her husband, placed the mixture in a culturing medium and, without telling anybody, really, put it to incubate in a laboratory in Columbia Presbyterian Medical Center. It was his intention, in a couple of days, to transfer the mixture into the uterus of Del-Zio, with the hope that a pregnancy would take.

The world has long forgotten, but hospital staffers present that day still vividly remember what happened when Shettles's boss, Raymond Vande Wiele, found out what was percolating, unauthorized, in his lab. Without spoiling the central organizing narrative of Pandora's Baby, Robin Marantz Henig's lively history of the science of in vitro fertilization (IVF), suffice it to say that the trouble was not permitted to brew very much longer. The Del-Zios, distraught at the unhappy end of their years-long effort to conceive, eventually sued. The notoriety and confusion that surrounded this botched experiment are, Henig clearly believes, a better symbol of the haphazard and frequently uncontrolled progress of IVF science than was the birth, in 1978, of a British baby named Louise Brown.

Thanks largely to the publicity surrounding Brown, and the reassuring normality displayed by her and by the other test-tube babies that followed, Henig worries that we have forgotten the dark, tortured, surreptitious and often just plain weird origins of in vitro technology. She exhumes these beginnings, and in the process reminds readers of just how tentative and suspect IVF was. She also stresses how very recent this lurch into the brave new baby-making world has been and how, like so many other technologies, IVF moved rapidly from horrified disbelief into routine acceptance. In 1969, she reminds us, a Harris poll showed that more than half of Americans believed that the emerging reproductive technologies were "against God's will" and would "encourage promiscuity." Fewer than 10 years later, more than half of Americans said they would use IVF if they were married and having trouble conceiving.

Most of all, Henig wants us to know that many of the same shocked questions that were asked when the Del-Zio case broke into public view have still not been satisfactorily answered. Among these were questions of health and development -- Would IVF work? If so, would it result in disabled babies? Unfairly advantaged designer babies? -- as well as questions of scientific ethics, such as what to do about a human embryo's obvious inability to give informed consent, even to the experiment that creates it. And there were and remain what might be called the woo-woo questions, questions involving the sacred and profane that were raised by skeptics such as biologist Leon Kass, whom Henig quotes as going on record against IVF early and often, worrying that it was part of "a new holy war against human nature," and would violate the "mysterious and intimate processes of generation." In comparison to IVF, abortion was almost easy. If you are opposed to abortion, for example, how do you think about a procedure that both produces life and experiments upon it? I am not as convinced as Henig seems to be that antiabortion forces presented a strong and united front against IVF; it seems to me that the thinking is a lot more unclear in both the pro- and antiabortion camps. But precisely because these issues were so controversial and hard to think about -- and because they necessarily did involve abortion politics -- American lawmakers and the regulatory apparatus they controlled tried, as long as possible, to stay out of the fray.

As a result, Henig convincingly argues, the popular and profitable field of fertility medicine sped ahead without benefit of U.S. research dollars and the scrutiny that goes with them. Particularly in this country, ethical concerns, ironically, have led to "less control over IVF rather than more."

To be sure, Henig's story includes not only Shettles but also many of the other scientists who were working on IVF in the 1970s. These researchers sought to perfect the lab techniques involved in coaxing sperm and egg together, while also acquiring medical expertise necessary to snip tiny eggs from ovarian follicles and, later, transfer an embryo into a woman's body. At the same time, pure research on embryos and miscarried fetuses was going forward, often for the purpose of learning more about fetal development, and federal authorities were having a great deal of trouble knowing what to do about any of this. During the Del-Zio trial, Vande Wiele argued that he curtailed Shettles's experiment in part because he thought IVF was included in a ban that prevented federal money from being used for embryo research. He may have been right. Nobody seemed to know.

And nobody seemed inclined to figure it out. As Henig shows, the American confusion over such questions just persisted and persisted. There is a reason why the United States was ultimately the fourth country to produce a test-tube baby. Many others, including England, Australia and much of Europe, have managed to develop coherent policies, with oversight boards that both monitor IVF and permit it to go forward. But in this country, the when-life-begins question has led to endless federal dithering, amid which scientific knowledge was the loser: Early on, Henig recounts, a Vanderbilt scientist named Pierre Soupart applied for a grant that would enable him to create embryos using IVF, then test them for chromosomal abnormalities. He died almost a decade later, never having received an answer to his request. This important question -- does IVF ever hurt babies? -- has still not been resolved. Indeed, debate has intensified, with recent studies suggesting that IVF children may be susceptible to certain defects, including Beckwith-Weidemann syndrome, a chromosomal disorder that predisposes children to cancer.

Henig marshals an impressively detailed narrative that shows just how little was known about the procedure even as would-be parents lined up for spots in clinics. Here in the United States, the first clinic to produce a test-tube baby was Norfolk's Jones Institute for Reproductive Medicine, headed by the marital team of Howard and Georgeanna Jones. On the day their first IVF baby was due to be delivered, Howard Jones was so afraid the baby would be deformed (ultrasound suggested a small head) that he had a press release to that effect in his pocket. The baby was okay, but Jones's precaution reminds us how far researchers had wandered into terra incognita.

Pandora's Baby suffers somewhat from a profusion of characters. There are a lot of players, and some unnecessary digressions into related science like gene-splicing, as well as some 1970s cultural ephemera that probably shouldn't be taken quite so seriously. And of course there is no central antagonist: just the vast befuddled presence of HEW and FDA and NIH and Congress and all those varied advisory panels. One does wish, too, that when it comes to the pursuit of scientific knowledge, writers would invoke cautionary legends other than Prometheus, the Frankenstein monster and Pandora.

Still, Pandora's Baby sheds a great deal of light on this too-little-appreciated set of scientific breakthroughs, and stresses the odd ways in which women were thrust onto the sidelines of this drama. The subjects of IVF -- especially in the early phases of research -- were quite deliberately kept in the dark about what was being done with their wombs. In the 19th century, for example, a Philadelphia doctor performed the first artificial insemination on an unconscious woman undergoing what she believed to be a routine ob-gyn examination. The woman's husband was infertile; curious to know whether another man's sperm would work, the doctor inseminated her, successfully, with a sample taken from a med student. He later told the putative father, but nobody ever saw fit to tell the mom. Similarly, almost a hundred years later, the doctors attending Louise Brown's mother, Lesley, never told her that her pregnancy, if it took, would be the first one in the world. Overall, it's striking how so many of the people working on IVF -- as well as those opining on its implications -- were men.

And boy, did the men opine. Henig's central point is that in this country, real regulation gave way to what she calls "commission ethics." Whatever else it may be, IVF technology has become a full employment program for the professional bioethicist. A million test-tube babies have been born since Louise Brown, and it sometimes seems that as many bioethicists have been produced with them, destined to convene as part of federal advisory panels and to debate, endlessly, issues on which the U.S. government may or may not act. The latest of these is the President's Council on Bioethics, which is currently looking at not only cloning and stem cell research but, yes, IVF, under the leadership of none other than . . . Leon Kass.

Reviewed by Liza Mundy

Copyright 2004, The Washington Post Co. All Rights Reserved. --This text refers to the Hardcover edition.

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Product Details

• Paperback: 336 pages
• Publisher: Cold Spring Harbor Laboratory Press (May 30, 2006)
• Language: English
• ISBN-10: 0879698098
• ISBN-13: 978-0879698096
• Product Dimensions: 8.1 x 5.5 x 0.9 inches
• Shipping Weight: 1.1 pounds (View shipping rates and policies)
• Average Customer Review: 4.3 out of 5 stars  See all reviews (3 customer reviews)
• Amazon.com Sales Rank: #1,339,532 in Books (See Bestsellers in Books)

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Customer Reviews

Most Helpful Customer Reviews

7 of 9 people found the following review helpful:

5.0 out of 5 stars A delightful guide through a bioethical thicket, April 14, 2004

By	Indienne - See all my reviews

This review is from: Pandora's Baby: How the First Test Tube Babies Sparked the Reproductive Revolution (Hardcover)

Adjectives like "judicious" and "level headed" (see the Publisher's Weekly review) don't do justice to this lively and probing and timely book. Henig has the gift of conveying complex scientific information painlessly and the stories she tells are riveting, full of hubris, lawsuits,medical cowboys, desperate would-be parents, nutty fundamentalists (in one protest at an in-vitro clinic, they carried a sign that read "Incest in a Test Tube") and, of course, politics. If you've been following the debate over stem cell research, cloning or the work of the President's commission on bioethics ( its chairman,Leon Kass, appears in this book as an early opponent of IVF ) Pandora's Baby is invaluable. And if you haven't been following, this is a great place to start.

6 of 8 people found the following review helpful:

5.0 out of 5 stars The story of a technology under fire, April 5, 2004

By	Midwest Book Review (Oregon, WI USA) - See all my reviews

This review is from: Pandora's Baby: How the First Test Tube Babies Sparked the Reproductive Revolution (Hardcover)

In Pandora's Baby, Robin Henig tells of a confrontation which came to a head in 1973, where a hospital administrator in New York learned of a rogue experiment in progress which might have created the first human fetus through in vitro fertilization. His decision fostered a new era in reproduction technology and issues which continues to this day, and Henig's survey of IVF procedures and history provides the story of a technology under fire.

2 of 4 people found the following review helpful:

3.0 out of 5 stars Interesting Topic - Dry Read, December 27, 2006

By	N. Sexton (AZ United States) - See all my reviews (REAL NAME)

I got this book after reading the excerpts from a online book club since it is a topic I am interested in. Overall the book was very difficult to get through. It is really about medical ethics than it really is about the history of assisted reproduction. The "cast of characters" was very confusing to follow. To learn more about the couple you meet in the beginning takes chapters. I am not a science person but enjoy reading factual accounts. This book is more of an education lesson than entertainment.