Mommy, where do babies come from? Parents have dreaded this question ever since the stork made its first delivery. But today’s mommies and daddies have more explaining to do than their own parents could possibly have imagined. Though the birds and bees discussion was never easy, its elements were fairly straightforward: the fireworks exploding, the train chugging through the tunnel, the waves pounding the shore, the occasional reference to anatomy. Once upon a time, baby-making was synonymous with whoopee-making, and frozen eggs were for pastry dough, and seven was how many times you should let the phone ring before you hang up, not how many fetuses you could fit in a womb.
These days, though, the facts of life can sound a lot like science fiction, as late-twentieth-century humanity grapples with the rise of noncoital conception. There are now more than a dozen ways to make a baby, the vast majority of which bypass the antiquated act of sexual congress. The last three decades have seen the advent of such high-tech interventions as fertility drugs, in vitro fertilization, donor eggs, donor sperm, donor embryos, and surrogate mothering. In the works are still more advanced technologies, such as the transfer of cell nuclei, embryo splitting, and even, if at least one man has his way, the cloning of human adults.
These techniques generally are gathered under the heading of assisted reproduction. All the ones in use today were pioneered for and are usually employed by infertile couples of childbearing age. But they are also used by people with less conventional notions of parenting—singles, postmenopausal women, and gay partners. In the near future, assisted reproduction may become standard procedure for anyone who wants to conceive, and who can afford it. The allure, of course, is control: control over the timing of parenthood, control over embryo quality, control over genetic disease, control over less pernicious characteristics, such as gender, that are also determined by genes.
So far, owing to federal policy and societal preference, the practice of assisted reproduction is largely unregulated. One specialist has even called it the Wild West of medicine. It’s also expensive, bothersome, inefficient, and fraught with ethical complications—but none of those considerations has slowed its growth. Since 1978, when the first test-tube baby was born, the number of fertility clinics in the United States has gone from less than 30 to more than 300. The multibillion-dollar fertility industry has created tens of thousands of babies. Assisted reproduction has relieved the anguish of men and women who, just decades ago, would have had to abandon their hopes of having children. It’s also created a world where a dead man can impregnate a stranger, where a woman can rent out her uterus, and where a child can have five parents—and still end up an orphan. It’s not at all clear how this new world will change the meaning of family. But it has already transformed what used to be known as the miracle of birth.
Last November in Iowa a couple in made history, national television, and the covers of Time and Newsweek when their seven babies were born alive. We’re trusting in God, the McCaugheys told reporters when asked how they would cope with the sudden surfeit of offspring. But to conceive for the second time, Bobbi McCaughey had trusted in Metrodin, a fertility drug that stimulates the ripening of eggs in the ovaries. A woman on Metrodin can produce dozens of eggs in a month instead of just one.
