46 | NewScientist | 5 November 2011

CULTURELAB

Baby-Making: What the new reproductive treatments mean for families and society by Bart Fauser and Paul Devroey, Oxford University Press, £16.99/$29.95

THERE are few areas in medicine that strike such a chord as assisted reproduction, probably because so many of us have, at some time,

engaged in the baby-making process, either through careful planning and provision or through carefree recreation.

Baby-Making by Bart Fauser and Paul Devroey brings a fresh and accessible perspective to this modern and progressive discipline. Both authors have a long-standing reputation in the field and a wealth of peer-reviewed publications. Their international profiles rest on reputations for solid, evidence-based medicine – and also the courage to pursue and publish on novel techniques such as gentler forms of IVF and efforts to reduce the incidence of multiple pregnancy. They are ably assisted in this new project by Simon Brown, a journalist who has written in this area for many years and is renowned for his insider knowledge.

As the title suggests, Baby-Making is a succinct and comprehensive overview of our ability as a species to reproduce – both naturally and with assistance. In the first chapter (provocatively titled “How to design a baby”) the authors quantify exactly how inefficient we humans are at breeding – a basic fact often not clearly

understood by couples trying to conceive. I would like to have seen a little more exploration of whether this relative subfertility (compared with other species) gives us any biological advantage.

Subsequent chapters chronicle the fascinating history of assisted conception, as well as topics such as investigating the infertile couple, and the current treatments available for infertility. The level of detail is

not exhaustive but does provide a helpful introduction for the scientist or clinician entering this field – or the lay reader with more personal reasons for reading.

There is an entire chapter devoted to analysing why it is that in assisted conception some embryos implant into the uterus while others fail to, and how to select embryos. Cutting-edge technologies such as pre-implantation genetic screening and metabolomics are described and, importantly, realistically assessed.

There are numerous books on assisted reproduction but this one stands out from the crowd

because of its examination of the intensely private and personal tragedy of infertility in a much wider social, political and economic context.

While trying for a baby remains a deeply personal issue for most couples, this fundamental biological urge has spawned a huge global industry providing over 1.5 million cycles of IVF per year – growing by 5 per cent annually. It’s not surprising, then, that the most interesting chapters in this book are aimed at the general public and policy-makers, covering the social and political trends of declining birth rates, delayed first pregnancy, childbirth beyond age 40, and state funding of fertility treatment.

The complexities and ethical challenges of cross-border reproductive care, “saviour siblings”, and treatment for same-sex couples are thoroughly but sensitively discussed. And since both authors come from publicly funded academia, the demands of state funding and subtleties of the private sector are also carefully dissected. The book concludes with horizon-scanning for future developments – and a glossary that will be particularly helpful for lay readers.

I enjoyed Baby-Making, and I can strongly recommend it as a most readable introduction for professionals. I suspect, though, that its biggest impact will be on those involved in public health. n

Stuart Lavery is a consultant gynaecologist and the director of IVF Hammersmith in London

“Humans are inefficient at breeding – a basic fact often not clearly understood by couples”

Sperm-freezing techniques helped build an industry worth billions

So you want to have a baby?When it comes to the complexities of “reprotech”, context is everything, says Stuart Lavery

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