Daily chemical cocktail
It has been almost two years since Marco Serra gave his wife Michaela the last injection. There were times when he gave her one shot a day - in the thigh, in the belly, in the butt.
Artificial Insemination in the United States? Almost anything is allowed
Sometimes when Michaela came home from work she would open the door pushing her with her butt and say, "Darling, where's my fix?" Marco was usually already in the corridor waiting for her with the syringe in one hand and the miraculous medicine in the other. So, with brief interruptions, she went on for almost ten years, until September 2001. Then in the end she Michaela decided not to take her anymore.
The substance was legal - Lupron, Pergonal, Fertinex. After all, getting pregnant with the help of the pharmaceutical industry is not prohibited. When it comes to infertility, almost anything is allowed in the United States. After four artificial inseminations, eight attempts at in vitro fertilization (IVF), a cytoplasm transfer and an egg donor, the Serra are still childless - and about $ 250.000 less. On the other hand, they produced nine embryos which are stored frozen in a laboratory. They pay $ 500 a year for this service. What will be done with the embryos is currently under discussion between the two spouses.
Michaela Serra is 48 years old. The tortures she inflicted on her body cannot be seen from outside of her. She's skinny and she's back in size 40 instead of the 46 she wore when she "took the Lupron and it leavened like a cake". She speaks with the concentration of a woman with a busy schedule, and she earns enough not to go into debt trying to have a child of her own. Michaela Serra in Manhattan has a very good name as a kinesiotherapist, which she however asked her not to disclose in this article. Marco Serra, also 48, is still waiting to break through as a writer, so his contribution to the family economy is rather small.
You have to have been in a New York waiting room to understand how the desire to have a child can be transformed into the pretense of having happiness tailor-made.
There are over 400 assisted reproduction clinics in the US
Lawyers, journalists, stock brokers or wealthy women with four honorary positions: all here for egg retrieval or blood tests, all on the threshold or over 40, all pumped with hormones, all with the same confidence in the eyes.
There are over 400 assisted reproduction clinics in the United States. Nowhere else could the turnout be as high and the anticipation as great as in New York, where people are more impatient than elsewhere. It offers everything: on the internet, single women or lesbian couples can choose spermatozoa, classified by genetic characteristics, IQ and character of the donor, which are then delivered by couriers in one night, which is why we also speak of "overnight. -male ", the man of a night.
If you are looking for foreign eggs, on the other hand, in university clinics the students sell their eggs for 7 thousand dollars or more. Agencies provide mothers for rent in case the client is unable - or unwilling - to give birth. Cost: about $ 50.000. For those looking for a cheaper variant, it is possible to "adopt" that is, for "only" 3.000 dollars, to have the embryo of another couple implanted.
35 Americans conceived artificially
The United States is the only country where "assisted reproduction" is mainly regulated by market laws. The breeding industry has an annual turnover of several billion dollars. About 100 times, in 2000, artificial reproduction technicians were employed, and 35 children came into the world with artificial fertilization, egg donation, sperm donation or rented mothers.
About 6 million American men and women are afflicted with infertility problems
This represents only 1% of annual US births so far, but the procreation industry is growing. This is because about six million American men and women are afflicted with infertility. In addition, career women continue to postpone pregnancy, forming an almost endless customer base. The strict foreign laws also guarantee this market an increasing influx of international customers, especially Japanese, German, Del Paeseni, Latin Americans and Russians.
Read also: Medically assisted procreation techniques prohibited in the country
The reportage continues on the second page
Older and older parents
It's ten o'clock on Friday morning. At the Center for Women's Reproductive Care, on Broadway, Mark Sauer meets two collaborators. Sauer is one of the gurus of reproductive medicine, contemptuous of taboos and bioethics.
Man has the natural desire to have an heir
In 1991, Mark Sauer first made headlines for helping Jonie Mosby Mitchell get pregnant with hormone injections, egg donation and in vitro fertilization - egg and sperm vial fusion and embryo implantation. thus obtained in the uterus -. Jonie Mosby Mitchell was 52 years old.
Today Sauer sometimes suspects that the fact that parents are already retired when their children start going to school is perhaps not the prerequisite for a happy family. "But man", says the doctor laconically, "has the inalienable need to have an heir".
Sauer treats around 150 infertile clients each year - or people who have lost their temper after a couple of years of unsuccessful attempts at unprotected sex. Mr and Mrs Serra approached Sauer for the first time in 2000. Michaela was already 45 years old, had already undergone seven cycles of IVF and was ready for the next step: getting pregnant with a baby conceived in a petri dish with semen. of Marco and the egg of a donor. Cost: about $ 20.000.
A privilege for the rich?
If they had approached Sauer a year earlier they could have chosen a cheaper option: homemade embryos. In fact, the American social security funds, if they do so, bear the costs only for the first cycle of IVF. Egg donation, rented mothers and other subsidies are at the expense of the individual. The alleged "right to procreation" has therefore become a privilege for the rich. This had long ago aroused the ire of Mark Sauer, who ranks politically in the ranks of the liberals.
One day, finding himself with eggs destined for a woman who didn't show up at the last moment, he ordered a couple of test tubes from a sperm bank and had the egg and sperm combined in a petri dish. For the choice of criteria he limited himself to coarse options: blond with blue eyes or black hair and dark eyes. Sauer then offered these embryos to wealthy couples for "adoption". The future parents did not have the possibility to choose the genetic characteristics in more detail and only paid the costs of transferring this sprout of life to the woman's uterus: $ 2.700. They were, so to speak, pre-packaged models.
We do everything possible
Sauer, of course, had not committed any crime.
In the US, the laws on assisted fertilization are not very restrictive
In the United States, there is no law and no court to prevent doctors from creating embryos at will, as long as they have the consent of the egg donor.
"Basically if an experiment worked on animals, it is also tried on a woman," writes Lori Andrews, a law professor and critical reporter of the American procreation industry. It was about "learning by doing", regardless of whether it was ovarian stimulation, intracytoplasmic sperm injection (ICSI), as the introduction of a single sperm into the egg is called in technical jargon, or embryo transfer. The legislators of the individual states have imposed almost no limits on reproductive medicine.
In 1978, shortly after the birth of Louise Brown, the first child born to IVF, the Illinois Parliament passed an "intimidating law" that required all doctors to care for the embryos they produced through IVF. A federal court soon after enacted this unconstitutional law; since then the federal states have proceeded on the basis of two principles in matters of reproductive medicine. First: we do what we can. Second: any problems will be dealt with by the courts.
Multiple parts skyrocketing
A consequence of this policy of laxity is the very rapid growth of multiple pregnancies. In the United States, there is no law that limits the number of embryos that can be implanted in an IVF patient. How many more, the better, the motto initially said. Even today, five or six embryos are usually implanted, even in elderly women, according to the idea that at least one will succeed.
It is normal to implant five or six embryos in older women
The partly tragic consequences of artificially induced multiple pregnancies are evident in delivery rooms, where premature babies with serious health damage are treated, or in clinics and medical offices where women go for "selective reduction", which includes killing one or more embryos so that others are more likely to develop properly.
The report ends on the third page
Egg donors and rented mothers
Wilshire Boulevard is Los Angeles' children's "shopping street". At number 5455, the CHA Fertility Center of Doktor Thomas Kim hides among the palm trees and perfectly manicured lawns, offering not only in vitro fertilization, but also the state-of-the-art freezing technique.
My husband wanted the donor to have green eyes like mine
A couple of blocks down, at 5757, is the office of Growing Generations, an agency for those who want to have children dedicated to homosexuals. At number 4727, extension 600, is Shelley Smith's plaque, MFCC, an abbreviation for Marriage, Family and Child Counselor, "Marriage, Family and Child Counseling." Shelley Smith provides egg donors and rented mothers.
Thirteen years ago in a dream she had the inspiration to give up her lackluster career as a television actress to go into the egg trade. You placed an ad in an actor's newspaper and found the first donors. Some doctors were quick to advise childless couples to see her. The legal situation at that time was still "a bit confused". Shelley Smith's donors signed a document on her donation day requiring her to renounce the right to provide for potential babies that would be born from her ovum. The buyers, for their part, waived in writing that they would take care of the child.
Mr and Mrs Serra learned of the Smith agency through friends. For three months they had studied dozens of documents on the internet; each contained a photo of the potential donor and information about her physical structure, ethnic background, educational background, medical history, hobbies, and a psychological assessment.
"My husband wanted the donor to have green eyes like mine," says Michaela Serra. "I wanted her to be smart." In the end, the choice fell on a green-eyed woman from Minnesota of German-Portuguese-French descent whom we here call Tiffany for reasons of anonymity. In the questionnaire, under "My favorite books" she had not put the Bible like many other candidates, but the writer Paolo Coelho. Literary preferences are not inherited genetically, but Marco Serra still found it reassuring.
AAA donors wanted
The trade in body parts is prohibited in the United States, but sperm and eggs do not fall under this law.
Eggs from beautiful and intelligent women can cost as much as $ 50
For the sale of eggs, Shelley Smith calculates $ 9, of which $ 5 goes to the "donor" and $ 4 to his agency - for legal fees, insurance, psychological and medical evaluation of the donors. It is an affordable price if you consider that couples who independently seek donors by placing ads in the student newspapers of elite universities offer sums of up to 50 thousand dollars to particularly beautiful and intelligent women.
Despite these lavish honoraria, the American Society for Reproductive Medicine (ASRM) continues to use the euphemism "donor" and suggests a contractual model in which the donor is rewarded not only for the eggs but also for the "waste of time, faced and the risk ".
And indeed the procedure can be painful and dangerous: the donor has to synchronize her cycle with that of the recipient of the egg, which usually occurs through artificially induced menopause. Then, like the IVF patient, she has to overstimulate her ovaries with hormone injections that often cause her lower abdomen to swell considerably.
The last injection is used to induce ovulation. All of this happens without any medical assistance, and the donor has to give herself the injections. 36 hours later she goes to a clinic where, while she is under a light sedative, her eggs are aspirated. The ASRM recommends not repeating this procedure more than six times. The possible consequences are still unknown.
According to Shelley Smith, egg donors are young women who are aware that they do good and who want to try something out of the ordinary. She says that it was embarrassing for her to have recently set up a "premier category" made up of "carefully selected" candidates whose "donation" led to pregnancy several times. The fee for these donors is $ 7.500. This doesn't quite fit the spirit of the firm, but Smith was afraid, in the face of the price explosion in the market, that it would suddenly appear as an under-cost option.
The reason, as always, can be seen from success. "Premier girls are selling like hot cakes." 300 small cards complete with passport photos, descent characteristics and body mass are posted on the "donor wall" of the agency, divided by category "blonde", "brunette", "Asian", "African American", and "premier". It looks like a collection of photos from the senior year of high school, with Shelley Smith as the maternal director and a nose for business. "Even when you buy a machine you first want to see the technical data sheet and know which accessories it is equipped with."
Boy or girl?
At the Huntington Reproductive Center in Los Angeles, doctors removed 12 eggs from Tiffany, the Serra donor. Nine have fertilized them with the semen of Mr. Serra, three for safety have treated them with a second method, that is by taking the cytoplasm, the substance contained in the cell. This was drawn into a pipette that contained Marco's semen, then the whole was injected into Michaela's egg to rejuvenate it. There were now fertilized eggs in the petri dish to which three people had contributed.
With an additional contribution you can choose the sex of the child
Marco Serra asked the clinic to select the sex of the unborn child at an additional fee of 250 dollars. "Do you prefer a girl or a boy?" He asked his wife. She was sitting in the gynecologist's chair, still lightly sedated after the egg retrieval, and she just said, "Do as you like." "We would like to have a boy," Marco Serra told the embryologist. However, the pregnancy did not go through: of the three "rejuvenated" fertilized eggs not one survived the treatment.
Meanwhile, the Food and Drug Administration has placed limits on cytoplasmic transfer, much to the anger of the doctors involved in the field of assisted fertilization. A couple of days later Michaela Serra was implanted with three of the "conventionally" produced embryos, made from Tiffany's eggs and her husband's sperm. "Come and visit us", the couple told the donor at the time of their separation "when we have a baby". However, the embryo transfer from the Huntington Reproductive Center did not go through. Now the Serra couple want to make the last attempt: the rented mother.
- assisted fertilization