From the December 18, 2007 Wall Street Journal
December 18, 2007
by Ronald W. Dworkin
Marxists divide life into real events and pseudo-events. Real events, such as wars and revolutions, have sociological significance. Pseudo-events have no such significance, no matter how exciting they are, or how much of a spectacle they are on television. The Super Bowl is a pseudo-event. So is the World Series. So are most medical discoveries.
The last "real" event in medicine (perhaps the greatest "real" medical event of the 20th century) was the creation of the birth-control pill, which helped fuel a sexual revolution that changed people's entire reproductive patterns. The political consequences reverberate to this day.
Today another "real" event looms: a practical method of storing unfertilized human eggs. Until now, only fertilized eggs (embryos) and sperm have been amenable to cryopreservation. The high water content in unfertilized eggs causes crystallization under freezing conditions, rendering the eggs useless when thawed.
A couple can store embryos indefinitely. A man can store his sperm indefinitely. But until now, a woman has been unable to store her eggs. If she wants to postpone having children, she must mix some sperm with her eggs before freezing them. That means going to the sperm bank, or getting sperm the old-fashioned way: going out on blind dates or asking friends if they know someone, all while worrying about her biological clock and working on her career.
The technology permitting egg storage, called "vitrification," is still in its infancy, but success is inevitable, and when it arrives, the sociological consequences will be enormous. Right now, one in five children world-wide is born to women over 35. When mass egg storage becomes feasible, that number will likely increase dramatically, and include not just women in their late 30s and 40s, but also women in their 50s, even 60s. The hurdle for a 50-year old woman trying to get pregnant is not that she can't carry a baby -- supplemental hormones can fix that, even after menopause -- but that her 50-year old eggs, assuming she has any eggs, won't implant in her uterus. But eggs harvested when she was a 20-year-old, stored for three decades, then thawed and fertilized, will implant. A uterus is ageless.
One consequence of this new technology is a potential reversal of the declining birth rate in Western countries. Low birth rates, especially in Europe, have already caused political and cultural dislocation. Raising children while building a serious career is hard for women, and when presented with the choice, many women opt for the latter. Half of Germany's female scientists, for example, are reportedly childless. By the time a career is established, say, in a woman's 40s, it may be too late to have a baby. If women could store their eggs, they could remain fertile.
Freezing unfertilized eggs gives women a way out of a complicated cultural maze. Decades ago, the lives of men and women diverged at adolescence. Men prepared for careers while women prepared for domestic life. Today, many young men and women go through high school, college and professional school often mistakenly assuming no differences in their respective trajectories.
When I suggested to a 22-year-old female medical student that she consider a career in anesthesiology because the hours were flexible enough to raise a family, she shot back: "I went to Harvard! Now I'm going to Johns Hopkins! I'm going to be a department chairman someday! And you want to put me on the mommy track?" Seven years later, when this woman applied for a job as an anesthesiologist, the first question she asked me was: "I'm trying to have a baby. Can I go part time?"
Our culture encourages women to pursue high-powered careers. Many women must pursue at least some kind of career: With the divorce rate over 50%, women can no longer rely on the integrity of the family unit to support them. The culture paints a rosy image about career and family. Then biological truth breaks through, by which time these women have lost a decade of their best childbearing years.
Women who opt to freeze their unfertilized eggs will gain those years back -- and more -- giving them the freedom to leisurely follow the male career trajectory. No more late night panicking. No more marrying a man you don't love "just to have the baby." No more lurching from Harvard to the mommy track.
True, if these women still decide not to have children when they hit their 40s or 50s, having grown accustomed to freedom, then the population in Western countries will not rise but plummet further. Yet most middle-aged people know that many careers can be pretty dull, without much chance to create. Following rules and procedures until midnight in a law firm may seem acceptable when you're 25, but not when you're 50. Armed with this insight, money and perfect eggs -- and with an expected life span of 86 years -- many women will likely choose to create a family.
But what kind of family? Women in their 30s are reluctant to use banked sperm to get pregnant, in part because they still hope to meet someone, because they can't support themselves as single mothers, or because they fear being judged by their peers.
A woman in her 50s probably has less hope of finding a man who wants to start a family than a woman in her 30s. And so a 50-year-old woman, without serious marital options, loaded with money and eggs, and far too wizened to worry about what other people say, might just go ahead and call that sperm bank if she wants a family. Or maybe she'll marry a 70-year-old man, who thinks that if women can be mothers into their 50s and 60s, why can't he be a father too?
While Marxists divide life into real events and pseudo-events, a more accurate division is between the truths of the times and the truths of fact. Young women forsaking their careers to bear children -- this is a truth of the times. Women driven by nature to procreate but having to find a new way to do so amid today's realities -- this is a truth of fact that is likely to prevail in the end.
Ronald W. Dworkin is a practicing physician and a Senior Fellow at Hudson Institute.
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