If I Were King

Dr Jacques Stassart runs a fertility clinic at Woodbury, Minnesota. According to Pregnancy from frozen egg is first in state in Saturday’s Star Tribune, one of his patients is now pregnant as a result of the in vitro fertilization of a previously frozen egg. I’m not sure this is a really hot idea. The unnamed patient is now 48, so by the time the kid starts learning to drive, Mom will be 65! The generation gap is bad enough when the parents are 25 years older than the kids, here we’re dealing with a generation gulf, possibly a generation abyss. Assuming she carries to term and delivers, I don’t envy her the parenting experience.

Fertilizing frozen eggs is a recent development, and apparently controversial. You can’t just take mammalian ova and shove them in with the ice cream, crystals form in the cell fluid and destroy the cell walls. By replacing some of the water with sugar or glycerol solutions and freezing either very slowly or very rapidly, lab technicians have been able to avoid that problem, and now have a 20-25% success rate - about half the rate for fertilizing fresh eggs.

In this case, the couple secured donated eggs, but when the eggs were ready it was discovered that the husband’s sperm had been mistakenly destroyed so the clinic froze the eggs until the husband was back in town and could, you know, come up with some more. Seems like a pretty sensible response to the problem.

Apparently not. The story laments that IVF clinics “operate largely without federal oversight”, although all of the procedures they use are governed by standard medical regulations and the doctors can always be sued for malpractice if it occurs. On top of that, the American Society for Reproductive Medicine recommends that the procedure be used only for cancer patients and research. (Many cancer treatments lead to sterility, or at least reduced fertility, so a young woman diagnosed with cancer could have several ova removed and frozen immediately to protect her future ability to give birth.) Dr Marc Fritz of the ASRM is quoted: “What it boils down to is a clinical investigation of an experimental procedure in patients at their expense. That is what the society feels is not appropriate.”

First, I’m not convinced that federal government oversight has helped the rest of the medical system, and it’s obvious to me that it has made it more expensive, so the lack of federal involvement doesn’t concern me in the slightest. Second, Dr Fritz is on the fritz logically here, there is no “experimental procedure in patients” going on at all. The only experimental aspect is freezing and thawing the eggs, and that happens in the lab, not in the patient. If the eggs are thawed and fertilized successfully, the procedure to transfer the resultant embryo or embryos to the mother’s uterus is exactly the same as in regular IVF.

I may not think that having a kid when you’re nearly fifty is a good idea, but I don’t have to. If there are couples out there that want it, with the scratch to pay for it all, it’s none of my flipping business. It’s fascinating, and I’m glad I can learn the technical details online, but who has it done and why is up to the prospective parents and the doctors they choose. I hope Dr Stassart makes a lot of families happy, and I hope he makes a ton of money doing it. If I Were King, the national government would leave them alone, and the American Society for Reproductive Medicine would be, uh, encouraged to get to work on solving problems, not meddling in the business of my subjects.

That’s how the press normally plays it, but to my surprise the New York Times ran a story this week headlined Efforts to Harvest Ocean’s Energy Open New Debate Front that suggests all may not be well on the green-energy front. It seems that fishermen aren’t wild about running into huge buoys that draw energy from the tides and waves.

Until now, all the press coverage of extracting energy from the tides has seemed to be instant approval. There are no greenhouse gases, no radioactive waste, no smoke in the air; the perfect answer to our energy needs. They almost say, “We love this coastline, where incredible power thrusts waves and tides against the rocks day in and day out. We love the sound of it, the shapes it has carved, the fact that the resurgence of that water keeps everything pristine. But if you want to come along with huge commercial ventures to extract some of that energy that made the coast the way it is today, and diffuse some part of the rest, well, why not? If you’re going to label it green or ecological, of course we’re in favor of it!”

Or rather, they just say they’re in favor of it, with no thought to the concept that the energy in the sea is part of what makes the coast what it is. I’m not sure that they’re wrong, but it sounds about as intelligent as the Russian engineers who built the Aswan Dam without any understanding of how important all that silt in the river was to the communities down stream, or just how rapidly their reservoir would shrink when they stopped the silt from washing to the Med.

The real killer in the debate is almost certain to be the impact on views. Here on Whidbey, the mussel rafts in Penn Cove have led to anger from homeowners who paid tens of thousands of dollars for their unspoiled views. On the Pacific coast of Oregon and Washington, most of the waterfront is public property so we won’t see quite the same fight, you can still expect a stink.

So far, I haven’t seen word one about what the impact of this sort of thing is actually going to be, particularly when scaled up to a meaningful level. And if they don’t scale it up to a meaningful level, what’s the point?

If I were king, I’d just tell them to figure it out in Finland or Korea first, mess with our Pacific coast only after we actually know what we’re doing.