872 30 AUGUST 2019 • VOL 365 ISSUE 6456 sciencemag.org SCIENCEPHOTO: ISTOCK.COM/ELLENAZM
ajor academic figures admonish
“immoral experiments on the un-
born.” An advertisement in The
New York Times cautions about
the “unknowable risks to human
lives.” A government official calls
for an ethics board to investigate “attempts
to control the genetic makeup of offspring.”
No, these are not the latest outcries over
germline gene editing. The concerns raised
above came from debates in the 1970s
about a technology many of us now take for
granted: in vitro fertilization (IVF). In their
illuminating and highly readable new book,
The Pursuit of Parenthood, historian Mar-
garet Marsh and physician Wanda Ronner
tell the medical, social, and political story of
IVF from its prehistory in the mid-1900s to
the present day, sweeping in adjacent tech-
nologies toward the book’s end.
In the first half of the book, Marsh and
Ronner masterfully interweave narrative,
historical, and demographic materials in
beautiful prose to tell a compelling story
that will enlighten even those who special-
ize in this area. That story begins with John
Rock, born in 1890, who would go on to be-
come the director of the Fertility and Endo-
crine Clinic at the Free Hospital for Women
in Brookline, Massachusetts. Together with
his research assistant Miriam Menkin, in
August 1944 Rock published a report in Sci-
ence describing a procedure in which four
fully fertilized eggs from three women were
cultured in a glass dish.
While Rock, Menkin, and others made
huge progress toward realizing IVF, efforts
in the United States ultimately waned, set-
ting the stage for the United Kingdom to
bring the technology to fruition. Here, Marsh
and Ronner shift to describing the academic
odd couple of Patrick Steptoe and Rob-
ert Edwards, who enabled the birth of the
world’s first IVF baby in Oldham, England,
on 25 July 1978. Far from a dry recitation of
the medical history, the book goes deep into
each man’s background, describing their
somewhat unlikely pairing—the two were
separated by age, class, and training—andREPRODUCTIVE TECHNOLOGYBy I. Glenn CohenChanging conception
peppering the story with engaging anecdotes
along the way. (My favorite was an incident
in which Edwards was denounced by Prince-
ton theologian Paul Ramsey at a 1971 forum
on medical ethics. Edwards described his re-
sponse: “I was a Yorkshireman and I would
be blunt as Yorkshiremen are reputed to be.”)
The book then pivots to early efforts to
bring IVF to the United States. Here, the
authors describe Howard and Georgeanna
Jones’s pioneering IVF work in Norfolk, Vir-
ginia, and Richard Marrs’s establishment of
an IVF practice in California. They also pre-
sent a deep dive into the accompanying po-
litical maneuverings around federal fund-
ing of human embryo and IVF research. The
book then insightfully traces the expansion
of IVF practices and explores some of the
shadier elements of today’s reproductive
medicine—including fertility fraud and the
infamous case of Ricardo Asch, who stole
eggs and embryos from patients—before
more briefly surveying IVF-adjacent tech-
nologies, including surrogacy and egg and
embryo freezing.
Although more careful than most com-
mentators, Marsh and Ronner do buy into
the common trope that paints the United
States as the “wild west” of reproductive
technology usage. They describe, for exam-
ple, how a shift to a “consumer protection”
model facilitated what little federal legisla-
tion exists with regard to IVF—the Fertility
Clinic Success Rate and Certification Act of
1992—and correctly call out its relatively
weak enforcement mechanism. Where they
misstep slightly, however, is in focusing al-most exclusively on federal-level legislation,
and especially in their comparison to the
UK Human Fertilisation and Embryology
Authority (HFEA).
Although the United Kingdom, like many
other countries, has adopted a unitary
country-wide approach, the authors give
too short a shrift to a distinctly American
regulatory configuration that has largely
left much of IVF governance to individual
states. The result is a continuum of legal
approaches to reproductive technologies.
Regarding surrogacy, for example, in the
United States one sees everything from
criminalization of the practice to judicial ap-
proval and enforcement of contracts. Mean-
while, in states such as California, huge
reproductive technology industries thrive,
whereas in Louisiana, fertilized embryos
have been declared “juridical persons.”
Another minor disappointment of the
book was how rushed its last two chapters
felt. Although the subtitle references uterus
transplants, the book only manages three
pages on this topic. I also wished the au-
thors had taken the time to more deeply
reflect on what implications the history of
IVF might have for technologies such as
gene editing. But these are minor quibbles.
Ultimately, Marsh and Ronner have
stitched together an amazing amount of
historical, legal, medical, and quantitative
material. This book is a must-read for any-
one interested in the history of reproduc-
tive technology. j10.1126/science.aay4220A thought-provoking volume traces the medical, social,
and political histories of in vitro fertilization
In his latest science fiction thriller,
Blake Crouch imagines a world
thrown into chaos by a mysterious
condition that causes those afflicted
to experience false memories. This
week on the Science podcast, Crouch
reveals the real-life research that
inspired t he story (Science, 26 July
2013, p. 387).
10.1126/science.aay7800Recursion
A Novel
Blake Crouch
Crown, 2019. 336 pp.PODCASTINSIGHTS | BOOKSThe reviewer is at the Petrie-Flom Center for Health Law
Policy, Biotechnology, and Bioethics, Harvard Law School,
Cambridge, MA 02138, USA. Email: [email protected]The Pursuit
of Parenthood
Margaret S. Marsh
and Wanda Ronner
Johns Hopkins University
Press, 2019. 274 pp.What if you suddenly remembered details from a life you never led?Published by AAAS