After five million children, IVF is no longer controversial. Creating children in a Petri dish for infertile couples is regarded as so splendid a Good Deed that the scientist who created the technique, Robert Edwards, was awarded the Nobel Prize in Medicine in 2010.
But it deserves to be controversial. It was developed without ethical protocols; it has a higher rate of birth defects; it can destroy the marriages of couples whose treatment fails; and it skews our demographics towards older mothers and lower birth rates.
And as a disturbing case unfolding in Utah shows clearly, there is still another skeleton in the IVF closet: mum and dad cannot be 100 percent sure that they are the biological parents.
The story begins in 1992 with the birth of Annie Branum, the child of John and Pamela Branum. The parents underwent several attempts at artificial insemination at a clinic linked to the University of Utah. On their final throw of the dice, Pamela was conceived. Their daughter has grown up to be a lively, talented young woman.
Last year Mrs Branum, now living in San Antonio, Texas, followed up an interest in genealogy by getting all three to take a DNA test through the internet service 23andme . To the family's dismay, the result showed that Annie and her father were not related.
Some genetic sleuthing proved that Annie's biological father was a man named Thomas Lippert . Lippert was man with a sordid past. He had been a high-achieving graduate of Notre Dame Law School who began his career by lecturing in law at Southwestern State College, in Minnesota. But in 1977 he committed a crime so bizarre that it was reported across the United States. Together with another man, he kidnapped a co-ed at Purdue University and attempted to brainwash her into loving him by imprisoning her in a black box and administering electric shocks. He was caught and convicted and spent two years in jail.
Eventually he drifted to Salt Lake City and landed a job preparing, labelling and shipping sperm donations at a company called Reproductive Medical Technologies Inc, which was closely associated with the University of Utah hospital. He worked there from 1988 and 1993. On the side, he also made some pocket money as a "popular" sperm donor at the same clinic and his contributions were distributed throughout the US. In 1999 he passed away from alcohol-related issues.
Mrs Branum still remembers Lippert from the time that she and her husband visited the site. Behind his desk were photos of the clinic's "success stories". Mrs Branum now suspects that they could very well have been his bragging board. Why not? Mr Lippert was a very, very strange man. His widow told the Salt Lake Tribune that she was not surprised at the allegations. "I think, because Tom didn't have any kids, he wanted to have a lot of kids out there ... maybe he switched some samples so he could have more of his kids in the world."
A University of Utah investigation has been unable to determine whether the sperm switch was deliberate or accidental. Lippert is dead; his boss is dead; the records of RMTI were destroyed after the company closed its doors.
The University has apologised to the Branum family, but it refuses to contact any of the 1,500 women who received sperm donations during the years that Lippert was employed at the clinic.
On the other hand, it did offer genetic tests for anyone who asked. Five couples did - and one of them discovered yet another error. The biological father was not Lippert, but a donor for whom there are no records. So of the six couples who have been genetically tested, two were cases of misattributed paternity. The sample size is small, but it indicates a 33 percent rate of catastrophic failure - a bit higher than the 0.0006 percent estimated by the IVF industry.
Nonetheless, the University of Utah report slams the door shut on further investigation. Although there are potentially at least 1,500 families whose children may have been fathered by an alcoholic and convicted kidnapper and sex abuser, it argues that "contact from the University regarding this matter is more likely to cause harm to these families than to provide benefit". This should be a profoundly troubling case, not one which is dismissed with the-dog-ate-my-homework excuses like it happened a long time ago and things are different now, let's move on . Sex abuse cases are not treated in this cavalier fashion; why is IVF?
The ethical legitimacy of IVF is regarded as tantamount to a religious dogma nowadays. The Branums' experience reveals the self-serving, utilitarian foundation on which it rests. There could hardly be a better document to demonstrate this than the University's report, "Analysis and Recommendations in the Case of Mr. Thomas Ray Lippert". Here are some of the take-homes from this document.
1. The report barely mentions the right of a child to know his or her parent and identity, as guaranteed by the International Convention on the Rights of the Child . The desire to know where we came from is hard-wired into the human psyche. It is a fundamental right which the IVF industry has always ignored. Its only criterion for success is delivering clients a healthy baby. Its ethical justification is that the child has no right to this vital information because without IVF it would not exist at all.
2. The destruction of the RMTI records demonstrates that IVF children's genetic history has become just a disposable consumer good, not a precious link with the past. The 10,000-year-old remains of Kennewick man have been treated with more respect than children conceived in an IVF clinic. The report describes it as an unfortunate fact of commercial life.
3. IVF has always been a cowboy technology. Robert Edwards was extremely cavalier about the ethics of his experiments and one of the most popular IVF techniques, intracytoplasmic sperm injection, was first used with humans without any animal trials. The University of Utah is part of the same rodeo. Despite strong and well-founded suspicions that Lippert may have scattered his seed far and wide, it adopts the most optimistic interpretation of his employment history. If General Motors could play by rules like these, would it be in bankruptcy court now?
4. Misattributed paternity is the worst of all worst-case scenarios for an IVF clinic. But such disasters only comes to light if a child does not share the race of the parents. The clinics have no idea how often this happens at other times -- and they have no interest in finding out. How many clinics run genetic tests as part of their service? I am not aware of a single one. They put their own interests ahead of the child's and of the parents'.
5. Best practice for IVF clinics nowadays includes a multitude of safeguards to ensure that mix-ups do not happen. If a system is working smoothly, the inadvertent error rate should be minuscule. But it is quite probable that the Branum debacle was not an accident. It may have been a kinky guy's desire to become a human stud. This is a hazard inherent in assisted reproduction. In natural conception, a child is conceived in the loving embrace of a man and a woman. In IVF and other technologies, the child is manufactured by a gaggle of anonymous technicians whose ambition, at best, is to do a good job. At worst, it is to do what Lippert may have done. Technology is only as safe as the humans who use it.
6. The central argument put forward by the University is that asking embarrassing questions could have a devastating impact.
"The Committee believes that the identification of 'misattributed paternity' in cases secondary to a sample switch that occurred two to three decades before the notification is likely to have a negative impact on many families. Without question, this information would come as an enormous shock. Basic assumptions on which the family functioned for decades could be undermined. Relationships between father and child could be strained in some families. Further, it is hard to see how this information would commonly result in improved relationships between members of a family."
The report is absolutely right about this. News like that could destroy lives. It is easy to imagine emotional breakdowns, suicides, broken marriages and permanent estrangements. But it's also a "get out of jail free" card for the IVF industry because it effectively stops ruinous lawsuits. Let's reframe the University's argument: you've purchased our excellent product. We acknowledge a very, very small chance that it is not what you ordered. But if you dare to produce evidence that we made a mistake, we will destroy your life, your spouse's life and your child's life. Enjoy! That's a gangster's blackmail, not ethics.
"We are disappointed by what we perceive as a cursory, biased and incomplete investigation on the part of the University of Utah committee," the Branums have declared. They're completely right. But they shouldn't expect anyone in the IVF industry to help them. It knows how to protect itself.