Debora Spar: The Baby Business

baby_biz.jpgOne of the more important and timely books of last year, The Baby Business: How Money, Science, and Politics Drive the Commerce of Conception (Harvard Business School Press) doesn't seem to be coming out in paperback. In fact, you can grab the hardcover for $6.62 on Amazon. Where's the fairness in that? The masses should be in an uproar.

Anyway, I caught up with its author, the stylish Debora Spar, as she was treading the pathways of City College in upper Manhattan. She was there to lecture a group of young undergraduate feminist theorists.

An interview with her had just been aired an hour before on National Public Radio, she had to catch a plane in three hours, and yes, in-between there was that chat in a tiny room of CCNY's Political Science Department, while her studly son waited downstairs reading a tome.

But a hectic schedule is nothing new to Boston-based Debora Spar, the Spangler Family Professor at the Harvard Business School. After all, in her previous acclaimed book, Ruling the Waves: From the Compass to the Internet, a History of Business and Politics along the Technological Frontier, the plight of frenzied man caught amidst a cornucopia of previously unimaginable inventions was gracefully detailed.

However, in The Baby Business, she concentrates on the past, present, and future of the infertile couple and what they're willing to go through and pay for to get a child. Would you believe coughing up $50,000 for the eggs of an Ivy League student? Or a rich white couple hiring a poor black woman to be implanted with their embryo? As Spar notes, "This is a $3 billion market without any established framework." Almost anything goes.

BJ: How do you define motherhood nowadays?

DS: It used to be easy, right? You knew who your mother was. It's much harder now with these technologies. You can have numerous mothers, and a couple of fathers, but the mother part is where it really gets complicated.

For example, what you can do now is you can pick a pre-made embryo. Because what's happened is, as IVF (in-vitro fertilization) has become more popular, there have been a huge number of excess embryos created. So you go through IVF and you jack up the number of eggs produced. Let's say you fertilize all of those eggs. You wind up, if you're lucky, with six to eight embryos. The couple doesn't want to implant, hopefully, all of them. They only pick one or two of them. What do you do with the other six?

You can't quite wash them down the drain, especially for folks who have been dealing with infertility for many years, which is almost always the case by the time you reach the IVF state. So what do you do?

Well, what you do with them is you stick them in a vat of liquid nitrogen. Guess how many of these embryos in vats of liquid nitrogen there are in this country?

BJ: 400,000.

DS: That's pretty good. You've read the book. (Laughs)

Yes, 400,000 embryos. What do you do with them? This has raised lots of political questions. They won't destroy the embryos. They won't use the embryos for research. One of the things you can do with them now is that you can donate those embryos to another couple with a similar religious conviction, and this turns out to be quite an attractive option. It's actually become popular among religious conservatives who, for reasons that you can imagine, really don't want to destroy the embryos because they believe those are "pre-children."

So this is happening more and more. There has not yet really become a big market for it, but I'm sure there will be. Because if everything else has been sold, there's no reason in my mind why we won't sell embryos as well. Right now they're still being "donated," but I'm sure within a few years they will be sold.

But think what you've created now. You can have children who have biological siblings somewhere -- full siblings -- who may even be twins, because IVF tends to create a larger number of twins, being raised by different parents. So actually you could see your twin, who's two or three years younger than you, being raised by a different set of parents. This technology kind of freaks me out at a personal level. The others I have learned to deal with. This one I find really kind of weird, but it's happening.

Feminist Theorist Student: Concerning surrogate moms, isn't a third of a child's genetic material gotten from the mother who carries it to term?

DS: No, there's no genetic transfer from the mother who carries the child to the child. Now, people will argue that with the mother who carries the child, there's an environmental relationship. So if the mother sings to the child, the child at birth may recognize her voice. That's never been proven, but it's thought of.

What there is, there's another technology, which is really out there, called "cytoplasmic transfer." Imagine you're 42. Your eggs are tired. What doctors are doing in some cases, although this has been outlawed in the U.S., is that they'll take my egg, and they will suck out the cytoplasm, which is the material that surrounds the nucleus of the egg. Then they will inject it with your cytoplasm because you're younger and have healthier cytoplasm. In that case, the child is born with the genetic material of three people: the father and two mothers.

There's another technology that doesn't have to do with the creation of the child per se as much as the selection of a child. It's called "pre-implantation genetic diagnosis," which is based on IVF. So you go through IVF, you create these eight embryos again. Now what doctors can do, is that they can pluck a single cell from each of the eight cell embryos, and they can subject them to genetic tests. And they can screen the embryos for -- let's start with an easy case: cystic fibrosis.

So if you know that there's cystic fibrosis in the family, you don't want to have a child who's going to be plagued with this disease. You go through IVF. The doctors review all the embryos. And they can say, "Well, you've made eight embryos. Four of them are going to produce children with cystic fibrosis. We advise you not to carry these embryos to term." So you discard those embryos, and you implant the healthy embryos. It seems relatively straightforward if slightly spooky. The issue that emerges is, what are the things you want to screen for at the embryonic space?

So what is the easiest thing to screen for genetically?

BJ: Sex.

DS: Right. So the doctor says, "Congratulations you have four girl embryos and four boy embryos." Which ones do you want? Or you can say, "Well, I know right off the bat, I want a boy. I don't want a girl." So instead of producing a baby the old-fashioned way and throwing the dice, why don't I spend $18,000, which is the going price right now, and go to a clinic, use IVF instead of the old fashioned way, and just make sure I get my boy?

So there is a market for sex selection up front, and it's only a small step technologically to move on. If we can screen for genetic diseases and we can screen for sex, we can screen for genetic traits like hair color, eye color, height. Not quite yet height. We can, though, screen for it at the extremes like dwarfism.

BJ: Homosexuality?

DS: Not yet, but possibly. So this technology raises the issue of where you draw the line and what kind of selection you will put in the hands of parents. Brandon Judell


Mr. Judell, who's currently teaching "The Image of the Jew in Post-World War II European Cinema" at City College, has written on film for The Village Voice, indieWire, Detour, and dozens of other publications.