Peracchio: IVF has become unremarkable

Last week, I learned from a headline that Lesley Brown, mother of the world's first "test-tube baby" had died in Bristol, England, at age 64. The news gave me an unexpected personal jolt.

Her death brought back memories of the first major story I covered as a young reporter during my 30-year career at Newsday. The paper devoted a weeklong series -- "The Laboratory Baby and the Future" -- to the birth of Brown's daughter, Louise Joy Brown, the first child ever conceived outside a woman's body. My task that long-ago summer was to explore the ethical, social and legal implications of this extraordinary and enormously controversial event, which raised hopes, fears and serious debates across the world.

Today, Lesley Brown's story is simply part of medical history, her unique experience just another milestone in the advance of reproductive technology. In vitro fertilization, or IVF, the process in which an egg is fertilized by sperm in a glass Petri dish, is routinely used now as a treatment for infertility. Barely an eyebrow is raised at its mention.

Not so 34 years ago, when little Louise was born. In that summer, the successful use of IVF gave hope for the first time to millions of childless couples.

It also ignited a moral and religious firestorm.

In reporting the controversy, I encountered visceral responses to this unprecedented event. On Long Island, ordinary couples would ask me, sometimes in desperate tones, where they could obtain IVF treatment. One woman told me this procedure was God's answer to her prayers. On the same day, a Catholic priest told me IVF was an abomination, nothing less than the devil's own work.

Bioethicists and concerned scientists across the country began to spin out nightmare "rent-a-womb" scenarios. They voiced fears about embryo manipulations leading to genetic damage. Some even speculated that in the future, dictators could amass armies of artificially created people. Legal experts worried about the rights of the scientifically made fetus.

More than three decades later, most of the controversies surrounding IVF have abated. Robert G. Edwards, the physiologist who developed the treatment and provided it to Brown and her husband, John Brown, received a Nobel Prize in Medicine for the technology in 2010.

But moral and religious objections to the procedure, which sometimes translate into political resistance, still remain. The Catholic Church continues to oppose IVF -- along with other types of reproductive choices such as artificial insemination, abortion or contraception -- because it separates the purpose of procreation from sexual unions.

Moral and religious concerns of a different sort were behind a 2008 lawsuit in California, where two physicians who opposed same-sex unions were sued after they refused to perform IVF for a lesbian couple. The California State Supreme Court ruled in favor of the couple unanimously. As more states legalize same-sex marriages, lesbian couples are expected to resort to IVF in greater numbers to conceive children.

Other novel legal issues continue to arise from the technology. In May, the Supreme Court ruled against a New Jersey woman who sought Social Security benefits for a child conceived through IVF after the father had died.

And some medical dilemmas linger. Multiple births are the major complication of IVF, the result of transferring more than one embryo into the womb to increase the chances of success. So a few countries like Britain and Belgium have adopted strict limits on the number of embryos that may be transferred. While the idea gained currency in the United States in 2009 after a California doctor transferred 12 embryos into Nadya Suleman -- resulting in the birth of eight babies to the "Octomom" -- efforts to regulate the industry here haven't gone far.

Some bioethicists are increasingly concerned that a procedure designed as a last resort for infertile couples is increasingly abused as an alternative -- and very expensive -- choice. Robert Winston, professor of infertility studies at the Imperial College in London, was quoted recently as deeming the IVF industry both "massive" and "corrupt and greedy." In the United States, a single IVF attempt costs about $15,000, with no guarantees of success, and it's rarely covered by insurance.

Even thornier ethical questions arise over what happens to embryos that aren't transferred -- some couples donate them for stem cell research, have them destroyed or release them to be "adopted" by other infertile couples. And though women nearing menopause could still be technically eligible for IVF treatment, many ethical boards in American clinics now limit the upper age for eligibility to 50 years.

By and large, however, IVF has become an accepted procedure across the developed world, where some 3 percent of all live births result from IVF.

In the United States, about 59,000 births came from this technology in 2010 -- and this country has one of the lowest rates. The highest incidence is in Israel, with nearly 1,700 IVF procedures per 1 million people (not all procedures result in pregnancies, much less births). Iceland has the second highest rate, with almost 900 procedures per million, compared with only 126 procedures per million in the United States.

There is no full account of how many births have resulted from IVF since the procedure was routinely adopted in the early 1980s.

Lesley Brown was a medical pioneer when she chose a completely unproven experimental procedure to help her become pregnant 34 years ago, and newspapers around the world breathlessly reported on her daughter's birth. Today, IVF is hardly discussed outside an obstetrician's office.

A small irony of our times is that while women's rights to reproductive choices, including abortion and contraception, became the subject of heated if retrograde talking points this political season, the practice of IVF -- at one time as contentious as human cloning is today -- wasn't mentioned once.

After all, most technological advances ultimately become uncontroversial. Lesley Brown, who had to hide from the news media for months -- would be pleased.