Childless couples long for babies of any design

SINCE the birth in 1978 of Louise Brown, the first baby born in the UK using in vitro fertilisation, more than 68,000 children have been born using assisted conception techniques - enough to populate Orkney, Shetland, the Hebrides, and turn Balamory into a thriving metropolis.

At the risk of stating the glaringly obvious, without the scientific advances of the last 27 years, none of these children would have been conceived and tens of thousands of British couples would have remained childless. Obvious it may be, but in the current heated debate surrounding IVF and sex selection, we seem to have lost sight of what assisted conception is all about.

These are not "Frankenstein babies", "designer babies" or even "test-tube babies"; they are simply babies, much longed-for and often conceived with huge difficulty, expense and heartache. Their parents would have given a great deal to have been able to conceive them without the assistance of modern medicine.

The paradox of all the talk about choosing the sex of your baby, with its associated spectre of eugenics, is that people who need IVF do not have choices. For them there is no alternative. The reality of assisted conception techniques is that they are physically and emotionally gruelling. Few, if any, enter into it lightly. None of the couples I spoke to for The Scotsman’s series on IVF came out the other side unscathed. And they were the lucky ones - those who can either afford the 3,000 for a cycle of private treatment or who make it to the top of an NHS waiting list before they are time-barred.

The idea that there are couples who are willing to go through the physical discomfort, emotional stress, social isolation and financial expense of IVF simply to colour co-ordinate the nursery in blue or pink, is not just ludicrous - it’s grotesque. We may talk of "a much-longed-for boy" or secretly hope for a daughter, but we are unlikely to voluntarily spend months attending medical clinics, injecting ourselves with fertility drugs, having catheters inserted into our wombs and shelling out the cost of a family holiday for a 30 per cent chance of having a son rather than a daughter, or vice versa.

At present, all assisted conception in Britain is regulated, and regulated closely, by the Human Fertilisation & Embryology Authority (HFEA). The HFEA is currently undertaking a major review of the rules surrounding assisted conception techniques. Issues such as who should be eligible for IVF, how far the personal circumstances of the couple should be investigated and whether donors should be paid are all up for discussion. This consultation exercise ends on Friday.

Yet while there have been justified criticisms of the HFEA, particularly regarding the bureaucracy it entails, there is no real evidence that the current rules need a radical overhaul.

There may be a good case for paying those who donate sperm and eggs more than the 15 they currently receive, a figure unchanged since the 1970s, but there is no demand from parents currently undergoing IVF that they should be allowed to select the sex of their child. If anything, they are concerned that any new rules allowing sex selection could increase waiting lists and decrease their chances of having a baby.

Of much greater concern to them is the prohibitive cost of private treatment and the unfair postcode lottery for NHS treatment. At present a couple living in Stirling can access IVF on the NHS within six months. If they moved to Grampian they would wait five years. This is a much greater problem, in need of much more urgent discussion than the sex selection issue which has grabbed the headlines and stirred up so much controversy.

I have some reservations about routinely offering sex selection to couples undergoing IVF but they are not on the grounds that we risk creating a brave new world. Couples have to fight very hard not to give the implanted embryo an identity before they know for sure that the conception has worked. Knowing the sex is likely to make it more difficult. Those who have been on the IVF treadmill for some time know the pitfalls of naming embryos or envisaging them as babies only to suffer the utter devastation a fortnight later when the pregnancy test proves negative.

Then there is the fact that the main consideration of the medical team should be to implant the healthiest embryos and the ones most likely to develop normally, irrespective of gender. As we move towards single embryo transfer, this becomes increasingly important.

Britain has good regulation of its assisted conception services, particularly when compared with other European countries. In France, assisted conception is only available to couples who are "of an age to procreate", who are married or who have been living together for at least two years. In Germany, surrogacy and egg donation are illegal and doctors have to transfer all the embryos they create, regardless of quality. As a result, 40 per cent of all assisted conception births in Germany are multiple births, which carry added risks for mothers and babies. In Italy, surrogacy is banned as is insemination with donated sperm or eggs. The freezing of embryos has also recently been outlawed, leading to a dramatic drop in the numbers of assisted conception births.

Here, the balance between the welfare of the child and the prospective parents is reasonably well struck. Few people are turned away from fertility clinics for reasons which are not medical. It has happened in Scotland when one partner has had an alcohol problem or has a conviction for sex offences. Surrogacy, donor sperm and eggs and frozen embryos are all legal and help boost success rates. The HFEA rules may need to be modernised but they don’t need to be torn up and completely rewritten.

A greater imperative is to improve access to IVF services for couples at a younger age. Offering the chance to select the sex of their child to a couple whose chance of receiving adequate IVF on the NHS may be severely limited, is like offering a photograph of a life raft to a drowning man.