Law Lags Far Behind Clinics’ Rapid Growth

Despite the explosive growth of fertility clinics nationwide--and the thorny ethical issues associated with them--the enactment of laws to regulate the clinics lags behind, biomedical ethicists said Friday.

“The good news is that [with Friday’s announced UCI clinic settlement] there’s a $10-million warning shot that’s been fired in the air,” said Arthur Caplan, director of the Center for Biomedical Ethics at the University of Pennsylvania.

“The bad news is that the policies and regulations that would ensure that this couldn’t happen have still not been put in place everywhere.”

Since 1980, when the first in vitro fertilization clinic opened in the U.S., the number of these clinics in the country has grown to more than 300, with at least one in every state, according to Larry Schneiderman, a medical ethics consultant to UC San Diego.

Tens of thousands of hopeful parents--mostly affluent but some willing to risk their life savings on the chance of having a baby--have become patients of the clinics, where conception methods range from stimulating egg and sperm production to connecting egg and sperm donors with recipients otherwise unable to bear children.

The result is a new generation of children nurtured in the wombs of women who are not their genetic mothers, reared by men who may or may not be their genetic fathers.

But while the steps required to adopt a child in the U.S. reach into the most intimate personal and financial corners of the adoptive parents lives, “those steps are much more restrictive and clear than if you want to hire somebody to bear you a child,” Caplan said.

In the strongest response yet by California officials to the fertility scandal at UC Irvine, Gov. Pete Wilson signed legislation into law last September making it a felony to transfer or implant human eggs or embryos without the informed consent of both donor and recipient.

And in March 1996, the University of California ordered tighter controls over its four remaining fertility clinics to prevent a repeat of the scandal that shut down UCI’s once prestigious fertility center.

But dozens of fertility clinics around the country are not regulated by such reforms. And a raft of other issues surrounding the use of fertility technology has yet to be addressed by legislatures, including questions of who should be able to operate fertility clinics, how to maintain laboratory standards and whether embryos should be allowed to be donated for research.

“How can we regulate? How can we make sure that imprudent people don’t have the power to create life? How can we convince infertile couples that there is more to life than having their own offspring? These are the questions we have to answer,” Schneiderman said.

“How do we make sure that the people who create life are the sorts of people who have the interests of their patients at heart?”

With such questions unanswered, and the number of children created by rapidly advancing fertility technologies growing, the answers may not be sorted out for generations, if ever, Caplan said.

For the children born to patients of the former UC Irvine fertility clinic, the questions are particularly poignant, Caplan said.

“There are children there who’ve been created who are going to force us to address some other questions about children who have been conceived in this manner potentially wanting to find out biological information about their parents and ancestors,” Caplan said.

“So the settlement is still not the final word about the reverberations of the misdeeds that took place. The reverberations of the scandal will be heard for decades to come.”