• For the first time since the 1939 World's Fair, New Yorkers will be able to see Vermeer's famous painting "The Milkmaid". It will be on display at the Met, alongside all 36 known paintings by the Dutch master. • Over 15 years ago, a fertility clinic at the University of California, Irvine, made the news for giving away embryos without consent. Two dozen lawsuits resulting from the mixed up embryos have finally been settled, but Shirel and Steve Crawford are still searching for their biological children. "Our children are out there somewhere," Shirel said, "maybe someday they will find us." • We mentioned yesterday the disappearance of Yale University graduate student Annie Le, who has still not yet been found. The FBI has joined in the search for Le, and in a horrible/ironic twist, MSNBC reports that Le wrote an article earlier this year on how to stay safe on campus. • An Australian teenager could be sentenced to seven years in prison for taking RU-486 to induce an abortion at her home — the drug is illegal to take without medical supervision. • Caster Semenya has withdrawn from South Africa's national cross country championships this Saturday. Her coach says she's "not feeling well." • The first transsexual marriage in Iran is set to take place, but only after the transman is medically examined to "prove it would be a proper male-female relationship." Surprisingly, Iran carries out more sex change operations than any country aprart from Thailand, but this will be the first time a transsexual marriage is made legal. • 

The embryos in question came from Saddleback Memorial Hospital in Laguna Hills, where a fertility clinic was shut down in 1995 after revelations that it had repeatedly impregnated women with the wrong embryos. Anderson was the only one who stepped up to take the now-homeless embryos — he says, "I thought it was the right thing to do." That meant he was saddled with the task of tracking down the owners of each embryo, and giving them a choice: keep them frozen for a fee, donate them to medical research or to an infertile couple, or discard them.

More owners are choosing to donate to research now that stem cell issues are receiving more attention. Donating to another couple is the least popular option. Many embryos, however, remain entirely unclaimed — since Saddleback had many international clients, lots of embryo owners have been impossible to track down. Anderson says,

At some point, it just gets ridiculous. In a perfect world, when a couple is done with having all their children, they would make a decision. The farther and farther we get from that, the less likely they are to make a decision. I wish there was a way of making a disposition on a lot of these embryos that have been abandoned.

It is legal to destroy embryos abandoned for five years or more, but doing so would be "a public relations nightmare" according to bioethicist Lori Andrews. She says, "we have no agreement over the social or moral status of the embryo. We need to be more forward-looking in terms of the policies and regulation."

Dr. Anderson's quandary highlights the difficulty of knowing what to do with something that isn't a child, but that people feel deserves more consideration than a vial of blood or a clump of skin. It's fortunate that we have the technology today to create embryos like the ones Anderson is storing, but unfortunate that we haven't quite figured out how we should treat them. Also unfortunate: frozen embryos aren't the only issue to inhabit this still somewhat uncharted moral middle ground.

One of these issues is egg donation. Though women can make a fair amount of money donating their eggs to infertile couples, they couldn't be paid to give up their eggs for research — until now. New York State has decided to allow payment for research-destined eggs, opening the door for more study into cloning stem cells for individualized therapies. The move may help people with currently untreatable diseases someday get well, but due to many people's discomfort with cloning, at least one bioethicist is already predicting a backlash.

Then there's the issue of surrogacy, which is apparently becoming more popular among single men in India. The Times of India tells this story:

A 28-year old expat Gujarati, who stays in the US, met with a serious accident and was hospitalized for two years battling paraplegia. Left with a certain disability, the young man expressed his feeling that he did not want to marry as he was too conscious of his handicap but would love to become a father.

"His parents approached us and using his sperms a surrogate just delivered a boy. Fatherhood has given the young man a new purpose in life," said Dr Patel. Infertility specialist Dr Falguni Bavishi of Ahmedabad has also been approached by a single man from Canada to help him become a father. He had got his sperms frozen and will get a baby with the help of a surrogate.

The wording of the article is somewhat off-putting (the headline is, "Single men hire wombs in Gujarat to become fathers"), and it's sad that the young man's disability (it's possible that the paper is coyly referring to impotence) makes him feel he cannot marry. At the same time, it's good to be reminded that men, as well as women, sometimes want to have a child without a partner. And while surrogacy gives rise to a whole set of moral and economic questions (will it, for instance, create an underclass of poor women bearing rich people's children?), it's hard not to be happy for the man who can now realize his dream of being a father. All three stories reveal that we still have a lot to work out when it comes to reproductive technology. At the same time, one reason we have these problems is because people are able to have children who never would have before. And this, despite all the difficulties attendant on it, is exciting.

Life On Ice [Newsweek]
Single Men Hire Wombs In Gujarat To Beecome Fathers [Times of India]
New York Approves Controversial Egg Donor Payments [New Scientist]

Saletan notes that the bill's sponsor, Georgia State Senator Ralph Hudgens, and its leading advocate, Georgia Right to Life, are both busy telling everyone that the bill is strictly designed to regulate the fertility industry — because, of course, many anti-regulation Republicans think that the only thing in America that needs regulating is your uterus. Naturally, their idea of "industry" regulation involves protecting your fertilized eggs.

S.B. 169 does limit the number of embryos you can implant in an IVF patient to two or three, depending on whether the patient is younger or older than 40. But it also does several things that have nothing to do with saving tax money or protecting women from the risks of carrying multiple fetuses. It forbids the sale of eggs or sperm, bans therapeutic human cloning, and prohibits any stem-cell research involving the destruction of leftover embryos.

It also, notably, prohibits the number of eggs that can be fertilized at any given time, since, you know, the pre-born, 20-celled children shouldn't suffer. The woman, on the other hand...

If you wanted to protect the woman, you might limit the number of embryos that could be transferred to her womb, not the number that can be created in the dish. In fact, by limiting the number that can be created, you increase her risk of complications. The fewer eggs you fertilize, the lower your chances of producing an embryo healthy enough to be transferred and carried to term. That means a higher failure rate, which in turn means that women will have to undergo more treatment cycles, with the corresponding risks of ovarian hyperstimulation and advancing maternal age.

So, in fact, the bill — if passed — would actually create more risks for women undergoing the procedure in order to prevent the creation of fertilized eggs that might not be carried to term — all in the guise of preventing harm to women.

What else does the bill do? It establishes a right to individual legal counsel for any fertilized eggs at issue in a divorce; it all but bans the destruction of unused fertilized eggs; and defines fertilized eggs as human beings (of course). And, in no small bit of irony, Saletan points out that it will turn every woman that chooses to undergo IVF into Suleman.

Oh, and if you like what Suleman did, you'll love S.B. 169. By requiring doctors to "limit the number of in vitro human embryos created in a single cycle to the number to be transferred," the bill logically requires them to transfer every embryo created. That's exactly what Suleman did.

Crocktuplets [Slate]

Earlier: Georgia Pols Propose Limits On Fertility Procedures

The bill, titled the "Ethical Treatment of Human Embryos Act," is the most sweeping state legislation on fertility procedures introduced since Suleman gave birth to her octuplets in January, according to the Wall Street Journal. Republican state Senator Ralph T. Hudgens, one of the sponsors of the bill, said in an interview:

Nadya Suleman is going to cost the state of California millions of dollars over the years; the taxpayers are going to have to fund the 14 children she has ... I don't want that to happen in Georgia.

The proposed bill would limit the number of embryos implanted in a woman at one time to two, or three for women over 40. It also goes a step further, with limitations on the number of embryos created in the lab to the number being implanted. This would essentially eliminate a woman's ability to freeze her eggs, which is unsurprising, considering the bill was drafted in part by the Georgia Right to Life organization. The group's president, Daniel Becker, tells the Journal, "To us it's a human-rights issue," adding that embryos deserve legal protection "as living human beings and not as property."

Several scientific organizations are opposed to the bill because it would end embryo freezing, and because they say in some cases it's necessary to implant more than two or three embryos. Sean Tipton of the American Society for Reproductive Medicine says the lawmakers "don't understand the complicated medicine behind it." Currently, the organization urges doctors to transfer only two embryos at a time into patients under 35, and no more than five in a woman over 40, but the guidelines aren't mandatory.

Resolve, a national fertility association, also opposes the bill. Executive Director Barbara Collura says: "It's the right of the person who has gone through this procedure to decide what they can do with those embryos, not their doctor, and certainly not the government."

While up to this point, we've watched the Nadya Suleman story turn into a tabloid media circus, this legislation marks the beginning of the octuplets' birth spurring actual legal changes. Georgia lawmakers point out that other countries, such as Britain, already limit the number of embryos transferred per cycle. Other countries have found ways to reducing risky multiple births, but they've also adopted policies that don't severely limit women's rights. Hopefully in the U.S., as more states introduce limits on embryo transfers inspired by Nadya Suleman, lawmakers will consult with doctors and create legislation backed by fertility specialists that doesn't also seek to limit reproductive rights.

In-Vitro Fertilization Limit Is Sought [The Wall Street Journal]
Ethical Treatment Of Human Embryos Act [Georgia General Assembly]

In only the second live birth of octuplets in U.S. history, a woman delivered six boys and two girls on Monday at Kaiser Permanente Bellflour Medical Center by Caesarean section, according to USA Today. Doctors thought the woman was carrying seven babies, and were surprised when they found there was an eighth baby (a boy). The parent's names have not yet been released, but doctors say the babies weighed between 1 pound, 8 ounces, and 3 pounds, 4 ounces and were born nine weeks premature. Two were placed on ventilators that have now been removed, and a third needed oxygen, but they are all in stable condition.

"It's a risky decision to try to have all eight babies," said Dr. Richard Paulson, director of the fertility program at the University of Southern California, who doesn't treat the octuplets. "I would not recommend it under any circumstances, but I respect a parent's decision." The first set of octuplets born in the United States were born three months premature in 1998. The smallest died a week after birth and the surviving children turned 10 in December.

Dr. Mandhir Gupta, a neo-natologist caring for the new octuplets says the next week will be critical for the infants, who may be in incubators for six to eight weeks, and in the hospital for the next 10 weeks. "She's a very strong woman, so she probably will be able to handle all eight babies," said Dr. Gupta. But caring for eight children isn't simply a matter of a woman being strong or weak. The uterus is only capable of taking care of a certain amount of foetuses and multiples have a much higher risk of developing health problems or dying. Plus, taking care of eight babies is incredibly difficult for the parents, especially when trying to breastfeed all the babies, like the California mother says she intends to do.

Doctors usually try to get mothers who have had several embryos implanted during in vitro fertilization to reduce the number of embryos, but the number of multiple births is still high. While of course, multiples rarely do occur naturally, The Times of London reports that in 2004 alone 19,049 babies were born in multiple births of two or more, amounting to one in every 67 births.

The number of multiples born as a result of IVF may start to decline however, as doctors have developed a way to test the viability of eggs fertilization and implantation begin. Time reports that in two months, a previously childless 41-year-old British woman will give birth to the first baby who underwent the test. The main reason so many embryos are not viable during IVF procedures is that especially in older women, some eggs carry chromosomal abnormalities that make a full-term pregnancy impossible. Chromosomal testing damages the egg, but doctors have discovered that after eggs begin developing, half of the 46 chromosomes are shed and ticked into a genetic bundle called the polar body, which is safe to test.

While as with other procedures that genetically test embryos babies in the womb, the procedure could theoretically allow parents to test for genetic diseases or more trivial things. While some people are concerned the test could lead to people aborting babies with a certain hair or eye color, the test also holds the promise that a woman undergoing a costly and painful IVF procedure will be able to implant the number of embryos that she wants, rather than having to undergo several unsuccessful procedures, or implant multiple embryos and decide whether to reduce the number of embryos or deliver multiples in a risky pregnancy.

8 Babies Born To California Parents Who Expected Only 7 [USA Today]
Rising Multiple Births Carry Health Risks [The Times of London]
Building a Better Baby: A New In-Vitro Test [Time]

And that's not all! Of the 50,000 embryos currently being stored in the United States, "Forty-three percent [of the women] did not want the embryos discarded. About 66 percent said they would be likely to donate the embryos for research, but that option was available at only four of the nine clinics in the survey. Twenty percent said they were likely to keep the embryos frozen forever," the Times says.

The cost of keeping embryos frozen is about $200 a year, which isn't much when compared to the cost of IVF treatments, which usually run to tens of thousands of dollars. Someone like Celine Dion, who has candidly spoken about her frozen eggs, obviously doesn't have to concern herself with costs.

Doctors say the major problem is that patients who have their embryos frozen are not given enough options up front. Dr. Anne Lyerly, an OB/GYN at Duke, tells USA Today that the issue of what to do with extra embryos should "absolutely should be raised at the beginning" of fertility treatments, and adds that the storage bill should mention it. And the Times notes that some parents even want unconventional embryo disposals that include "holding a small ceremony during the thawing and disposal of the embryos, or having them placed in the woman’s body at a time in her cycle when she would probably not become pregnant, so that they would die naturally."

All of this is sticky business when it comes to theories of personhood and the choice ramifications that go along with it. According to EurekAlert, This study "reveals previously unexplored concerns that patients have about their embryos, and it comes at a time when several states and even the federal government are attempting to enact legislation that would either assert an embryo is a person, allow abandoned embryos to be adopted by another couple, or allow unused embryos to become 'wards of the state.'" First world problems, people. First world problems.

Parents Torn Over Fate of Frozen Embryos [NY Times]
Céline Dion Candid About Having More Kids [People]
Fertility Patients Unsure What To Do With Leftover Embryos [USA Today]
Largest Study Of Fertility Patients Shows Concerns About Embryo Disposition [EurekAlert]

Earlier: Writer, Socialite Explains Her "Mad Desire" For A Baby Through Surrogacy