Thumbs down to Monsters, Inc. (Letters).

In Shannon Brownlee's article "Designer Babies" (March 2002), we are given the impression that extensive research was done to explore the most important issues affecting fertility and biotechnology today. In fact, the article includes numerous suppositions and makes inferences that miss the mark because of inaccuracies, misunderstood information, and a lack of research. Consider, for example, the "clinic doctor" who has no idea how many embryos to transfer. In reality, recommendations for embryo transfer have been made by a number of well-respected professional organizations including both the Society for Assisted Reproductive Technology and the American Society of Reproductive Medicine. In addition, the insinuation that scientific development in the field of fertility research can only be accomplished through the work of "high-caliber, federally funded embryologists" is not only false but is an insult to those who work tirelessly to provide the best outcomes for patients. Although the federal government has banned all funding for embryo research, and has turned its back on this vital public issue, the fertility industry has made great scientific strides. While its reproductive endocrinologists are board certified by the American Board of Obstetrics and Gynecology, the fertility clinics themselves are licensed by the federal Health Care Financing Administration and College of American Pathologists as well as by state health departments. Medical standards protocols are provided by the American College of Obstetrics and Gynecology, by the American Society of Reproductive Medicine, and by the Society for Assisted Reproductive Technology. These organizations make recommendations and guidelines on important issues such as gamete donation and donor screening, and sex selection. They also report pregnancy rates, as do the Centers for Disease Control. As such, any "miraculous claims" regarding pregnancy rates may be readily verified by consumers. I would be remiss if I did not also mention that the irresponsible use of a Monsters, Inc. photograph to accompany the article is offensive to the families who seek fertility treatment and to the medical professionals who care for them. It illustrates how sensationalizing fertility issues prevents us from taking a hard look at the most challenging issues in the field.

DR. JAMES A. GRIFO
President, Society for Assisted
Reproductive Technology
Director, Division of Reproductive
Endocrinology, New York University

Shannon Brownlee replies: Dr. Grifo and I are in complete agreement that the federal government erred in turning its back on the fertility industry, which provides a vital service to many couples. But one has to wonder how much ethical guidance ASRM and SART are providing when clinics are left to decide on their own whether to proceed with germ-line-altering experiments or to provide sex selection to a given couple. Both organizations were late in issuing guidelines on how many embryos to transfer, as made clear by the rising rate of multiple births from fertility treatment in the 1990s. And all the board certifying and licensing to which Dr. Grifo refers cannot make up for the lack of basic and clinical research that is desperately needed to ensure the salty of mothers and future generations.