Subscribe to the BioNews newsletter for free

Login
Advanced Search

Search for
BioNews

Like the Progress Educational Trust on Facebook


 

Issue 915 (29 August 2017)

 

Welcome to BioNews by email, published by the Progress Educational Trust, providing you with news, comment and reviews on genetics, assisted conception, embryo/stem cell research and related areas.

Visit the BioNews website at www.bionews.org.uk where you can subscribe for free to receive BioNews by email in one of three formats, and search the archive of more than 6,000 articles.

 

 

CONTENTS

Comment

News Digest

Reviews

 


 

Mitochondrial replacement therapies in Mexico and the USA - and the FDA

29 August 2017

By Dr César Palacios-González

Appeared in BioNews 915

Almost a year after the first live birth of a baby following a mitochondrial replacement technique (MRT) procedure (see BioNews 871), the US Food and Drug Administration has sent a very strongly-worded letter to the scientist and team responsible for the event.

The FDA's letter not only lists many of the violations – although it clearly states that it is not an all-inclusive list – that according to them Dr John Zhang and his team at the New Hope Fertility Centre in New York City have incurred, but also points out that Dr Zhang had continued to market MRTs in the USA, through private company Darwin Life Inc. and/or the New Hope Fertility Centre, as a way to 'to prevent the transmission of mitochondrial disease and to treat infertility', even when he had agreed not to do so. At this time Darwin Life website appears to have been pulled down. It is unclear what other actions the FDA will take following its letter. Though surprising, this is just the latest episode of a story that has been fraught with ethical and legal questions.

Before I explain why this development is important for MRTs in the US, let's briefly recap on what MRTs are. MRTs are new reproductive technologies that could help women at risk of passing mitochondrial DNA diseases to have genetically related children absent such conditions. One technique uses eggs and the other uses single cell human embryos (click here for a video explaining the difference). These techniques raise a number of important ethical questions, for example: should the egg donation be anonymous, are there moral differences between the two techniques that have been proposed, how should they be introduced into the clinic, are there important differences between the nuclear genome and the mitochondrial genome? But the ethical and legal questions that have haunted the birth last year relate more to how the experiment was carried out.

In September last year New Scientist broke the news about the first live birth following an MRT. One characteristic that stood out immediately was that, according to what was implied in the publication, the experiment happened in the city of Guadalajara, Mexico. This was of interest because the lead researcher Dr Zhang is a US-based fertility doctor. At that time Dr Zhang was quoted as saying that they went to Mexico because there there are 'no rules'.

My first reaction was that this was bad news for Mexico (see BioNews 871), given that at that time a very restrictive amendment to the General Health Law, a federal level legislation, was being discussed in Congress. My second reaction was of incredulity: are there really no laws in Mexico that apply to MRTs? María de Jesús Medina-Arellano and I wrote an academic paper where we explored the legal status of MRTs in Mexico. We concluded that, according to our interpretation of the law and the information that was publicly available at that point, Dr Zhang et al broke federal health regulations. For us it was important to write the paper because there we showed that there are indeed regulations in Mexico that apply directly to MRTs at the present time.

A month or so later, Dr Zhang and colleagues published a case report in Reproductive BioMedicine Online detailing their experiment. Their paper was accompanied with a critical editorial that contained a key piece of information for the legal assessment of this procedure: 'In the case described here, the MRT embryos were generated in New York through privately funded research, but the therapeutic part of the procedure – that is, transfer of the embryo to the patient – was done at an affiliated clinic in Mexico, thereby technically circumventing the federal statute.'

This, in the end, means that our legal assessment regarding this particular case was incorrect. Nevertheless, it is interesting that during media interviews Dr Alejandro Chavez-Badiola, medical director and founder of the New Hope Fertility Centre Mexico, did not previously clarify that the MRT procedure happened in the USA – even after a Mexican reporter for the programme Despierta con Loret explicitly said in front of Dr Chavez-Badiola that the experiment was carried out in Mexico.

Now, answering the question 'what does the FDA's letter mean for the clinical use of MRTs in the USA' seems to be straightforward at this point. First, a provision in a congressional spending bill bars the FDA from evaluating 'research in which a human embryo is intentionally created or modified to include heritable genetic modification', which according to them includes MRTs. Second, the FDA considers that MRT experiments fall within their rule and they will not turn a blind eye to them, even if the egg or zygote is intended for export. At this point we will have to wait and see if Dr Zhang decides to move all his MRT operation outside of the USA, or if this was a very short-lived stint.

Dr César Palacios-González is speaking in the session 'The Wild East and the Worried West: Pioneers or Outlaws?' at the Progress Educational Trust's upcoming public conference 'Crossing Frontiers: Moving the Boundaries of Human Reproduction'.

The conference is taking place in London on Friday 8 December 2017. Full details - including sessions, speakers and how to book your place - can be found here.

SOURCES & REFERENCES

RELATED ARTICLES FROM THE BIONEWS ARCHIVE

25 September 2017 - by Jenny Sharpe 
A campaign has been launched in Australia to overturn laws preventing couples from accessing mitochondrial donation...

14 August 2017 - by Georgia Everett 
The Food and Drug Administration has warned a US fertility doctor to stop marketing mitochondrial replacement therapy – a technique involving the creation of an embryo with DNA from three people...
19 June 2017 - by Shaoni Bhattacharya 
The fertility doctor who led the team which produced the world's first baby through mitochondrial replacement therapy is now looking to use the same technique in a commercial venture...
24 April 2017 - by Dr César Palacios-González 
It is not every day that we can examine the details of the first use of a new reproductive technology. But the first live birth of a baby following the use of a mitochondrial replacement technique (MRT) in IVF last year gives a window into just this. The case – with procedures carried out in both the US and Mexico – also raises legal questions...
28 September 2016 - by César Palacios González 
Dr John Zhang's team have opened a new door in terms of reproductive possibilities, but they may very well be instrumental in closing the assisted reproductive door for many people in Mexico...


 

Dutch sperm donor may have fathered 102 children

29 August 2017

By Jennifer Willows

Appeared in BioNews 915

A man is being investigated in the Netherlands after claims he fathered over 100 children through sperm donation.

The man has not been named but spoke to a Dutch newspaper, saying that he was not motivated by a desire to father large numbers of children. Rather, 'I just like to do it and to make people happy.' He added: 'It makes me feel helpful. The gratitude of doctors and prospective parents is great. Clinics are already happy if they have a donor who passes the screening.'

Sperm donors are supposed to be limited to 25 offspring, and sign an agreement to donate at a single clinic only. The case has brought calls for a national sperm donor registry - at the moment each clinic keeps its own records and there is no mechanism to cross check files of other establishments.

The Dutch Society of Obstetrics and Gynaecology (NVOG) have called for sperm banks to immediately stop using the man's sperm, as well as that of another man found to have donated at two separate clinics. Both men have also been offering to donate their sperm outside the clinical setting. 'We do not have information about how many children have come from these donors through this route because they are happening outside the hospital,' said the NVOG. 

The limit of 25 offspring has been in effect since 1992 and is designed to keep levels of consanguinity among donor-conceived people similar to that in the overall population. When a donor's genetic material is present in a large number of offspring, the (very small) risk that two half-siblings might form an intimate relationship is increased.

This is not the first scandal surrounding sperm donation in the Netherlands. Dr Jan Karbaat, who ran one of the Netherland's largest sperm banks, had been suspected of substituting his own sperm in procedures carried out at his fertility clinic dating back to the 1980s, but denied it and refused to provide a DNA sample for testing. After he died in April 2017, a sample was taken and found to match some children conceived at his clinic (see BioNews 903).

RELATED ARTICLES FROM THE BIONEWS ARCHIVE

05 June 2017 - by Dr Rachel Brown 
A court in the Netherlands has ruled that DNA tests can be performed on items belonging to a deceased fertility clinic director accused of using his own sperm for fertility treatments...
09 January 2017 - by Georgia Everett 
A Dutch IVF clinic is currently under investigation after it came to light that dozens of its patients might have been fertilised by the wrong sperm – half of whom are pregnant or have already given birth...
18 January 2016 - by Dr Linda Wijlaars 
A man from Luton, Bedfordshire, claims to have fathered 'in excess of 800 children' through unlicensed artificial sperm donations...
23 April 2012 - by Rosemary Paxman 
Ed Houben, a 42-year-old Dutch man has fathered at least 82 children by private sperm donation, mostly by having sex with his clients, news sources report...


 

Australia's IVF price wars may lower costs further

29 August 2017

By Shaoni Bhattacharya

Appeared in BioNews 915

Treatment costs for IVF may be coming down in Australia as a result of a price war between fertility clinics.

Two of the country's biggest IVF providers – Virtus Health and the Monash IVF Group – saw lacklustre earnings in financial reports released last week. Competition from low-cost providers and fewer Australians seeking IVF may be to blame, according to media reports.

Fertility services in Australia are overwhelming commercial enterprises - Virtus was the world's first IVF company to float on the stock market in 2013 (see BioNews 709).

Patients accessing fertility services must pay privately (see BioNews 899). They can then claim back for portions of certain costs under the country's Medicare health insurance system, or through private insurance if they have it. But they must be able to afford to pay for costs that are not subsidised by insurance – the so-called 'out-of-pocket' expenses, which may also include certain drugs as well as the remainder of the cost of the main treatments.

Due to competition, Virtus has now adjusted treatment prices at its cheaper clinic chain, The Fertility Centre, to between AU $900 and AU $1500 out-of-pocket costs, Sue Channon, group chief executive officer of Virtus, said according to newspaper the Sydney Morning Herald.

The equivalent costs at a clinic run by low-cost provider Primary Health Care are AUS $800. This provider launched in 2014, with the aim of offering low-cost IVF by bulk-billing all the associated costs covered by Medicare. According to Primary IVF's website: 'The only out of pocket expenses you will incur are those not covered by Medicare, however, these may not be applicable to all patients.'

Professor Alan Trounson at Monash University suggested prices could fall further. 'I do think the price could go lower,' he said, reported the newspaper. 'At least for younger patients, where the woman is under 38 years of age and the men are in their late 40s, their fertility is pretty strong and I think they could be treated in a much more economical manner than they are currently being treated.'

But demand for IVF in the country has also fallen. According to the Sydney Morning Herald the number of total IVF cycles in Australia were down by 1.2 percent in the year to June.

RELATED ARTICLES FROM THE BIONEWS ARCHIVE

03 November 2017 - by Georgia Everett 
Australian bioethicists have expressed concern that the country's assisted reproductive technology (ART) industry has become increasingly motivated by profit, causing a conflict of interest...
11 September 2017 - by Professor Alan Trounson and Dr Karin Hammarberg 
In Australia, almost four percent of children are born as a result of assisted reproductive technologies. The comparatively high rate of ART use is in part due to costs being covered by the taxpayer-funded health insurance scheme, Medicare...

08 May 2017 - by Dr Jane Williams 
Australia's key body for medical research released a new set of ethical guidelines last month on the use of Assisted Reproduction Technologies with a welcome and unusual surprise: a section on conflicts of interest...
08 August 2016 - by Antony Blackburn-Starza 
Fertility clinics in Australia have been warned not to offer flat fees to egg and sperm donors, reports the Sydney Morning Herald...
06 June 2016 - by Dr Mary Yarwood 
An Australian documentary has claimed that women over 40 are being misled about their chances of conceiving via IVF treatment when using their own eggs...
30 June 2014 - by Ayesha Ahmad 
An Australian fertility company has seen the price of its shares rise on the first day of its public listing on the stock market....
17 June 2013 - by Jessica Ware 
The first IVF business to be listed on the stock market enjoyed a buoyant first day of trading on the Australian exchange. Shares in Virtus Health closed 8.5 percent above their starting price, which was already set at the top end of an indicative range...


 

Surrogacy charity founder sentenced for embezzlement

29 August 2017

By Annabel Slater

Appeared in BioNews 915

A surrogacy charity founder has been convicted of embezzling £50,000.

Mrs Georgina Dodd, the first person in the UK to conceive a child using a surrogate, took money from her charity Childlessness Overcome Through Surrogacy (COTS) over a two-year period between 2005 to 2006.

Passing sentence at Tain Sheriff Court on 21 August, Sheriff Chris Dickson ordered Mrs Dodd, 69, of Lairg, Sutherland, to carry out 300 hours of unpaid community work and wear an electronic curfew tag for the next 120 days.

Mrs Dodd set up COTS in 1984 with her husband, after their son was born to a surrogate. The charity offered support and services to childless couples, in return for a membership fee and annual subscription. Mrs Dodd worked in the charity as a voluntary secretary and treasurer, and she and her husband were the two signatories to the charity's bank account.

However, Mrs Dodd also set up a secret account in the charity's name and paid COTS cheques into it. She made transfers and wrote cheques to herself and her son, and would also forge her husband's signature.

At the 2006 COTS annual general meeting, Mrs Dodd had announced that the annual membership subscription would need to be increased. Three months after this meeting, she also wrote a newsletter article requesting urgent donations to the organisation.

'[The chair of COTS] phoned the accused and spoke with her about this and the accused informed her that funds were drastically low,' said Mr David Morton, the procurator fiscal of the trial.

The chair then requested to view the charity accounts and bank statements.

'During this enquiry, [the chair] uncovered a number of discrepancies and suspected the accused had been taking the money herself. She later reported the matter to police,' said Mr Morton.

The case finally came before the Crown in January 2012. Mrs Dodd offered no dispute to the prosecution's case.

'She frittered the money away. It is as simple as that,' said defence lawyer Liam Robertson. 'I have asked her at length what happened to the money but she has been unable to provide a concrete explanation.'

Sheriff Dickson took into account Mrs Dodd's personal history and circumstances, including her age, previous good record, the length of time until trial, the fact she was a carer for both her husband and sister-in-law, and that she had repaid £15,000 of the money.

'I do not consider a custodial sentence the only appropriate way of dealing with this,' he said.

RELATED ARTICLES FROM THE BIONEWS ARCHIVE

23 May 2016 - by Daniel Malynn 
The wheels of reform in the area of surrogacy law are slowly getting in motion, a conference in London heard this month...
14 April 2008 - by MacKenna Roberts 
John Gonzalez, the founding director of a controversial UK-based online company - 'ManNotIncluded.com', which delivered fresh sperm to women for DIY-insemination - was sentenced last week at the Wood Green Crown Court in London to sixteen months incarceration for five counts of fraudulent activities. Judge Juliet May QC said...


 

Cambodia moves to permanently ban commercial surrogacy

29 August 2017

By Taqdeer Sidhu

Appeared in BioNews 915

Commercial surrogacy will be permanently banned in Cambodia if a new law drafted by the country's Women's Affairs Ministry is approved.

The proposed legislation follows a temporary ban on all surrogacy arrangements instituted in November 2016, which left many foreign couples in legal limbo, unable to obtain travel documents to take home their children born to Cambodian surrogates (see BioNews 876). It was breach of this ban which led to the imprisonment of Australian nurse Tammy Davis-Charles and two of her colleagues earlier this month (see BioNews 912).

'The main content of the law is that we absolutely ban commercial surrogacy, and any actions that get benefit or profit from surrogacy are completely banned,' said Phon Puthborey, spokesperson for the Women's Affairs Ministry, according to The Cambodian Daily.

It is hoped that the surrogacy law in Cambodia will prevent the exploitation of vulnerable women. Sam Everingham, global director of Australian non-profit organisation Families Through Surrogacy, told the newspaper: 'The key issues here are avoiding exploitation of ill-prepared, poorly screened surrogates who might later regret their decision. In a country with high levels of corruption, it may be impossible to monitor that appropriate screening and compensation are provided.'

Cambodia is the most recent country in the region to ban commercial surrogacy, or surrogacy for foreign parents. India, Nepal and Thailand have all implemented such laws in recent years, as the industry moves from one country to another (see BioNews 913, 817 and 791).

While commercial surrogacy is to be completely banned in Cambodia, the legalisation of altruistic surrogacy is already being discussed. Ros Sopheap, a spokeswoman for Gender and Development for Cambodia, told The Phnom Penh Post that she feels it is 'too early' for legalisation of altruistic surrogacy in Cambodia, adding that it could occur 'in the future, when Cambodia has more equal education between poor and rich.'

Everingham noted that 'the distinctions between commercial and altruistic surrogacy in a number of countries is not significant.' He added that in countries such as the UK, payments to cover surrogates' expenses are comparable to fees in commercial surrogacy. He told the Post: 'Altruistic surrogacy is simply a more palatable social policy.'

SOURCES & REFERENCES
Sydney Morning Herald | 23 August 2017
 
The Phnom Penh Post | 24 August 2017
 
The Cambodian Daily | 23 August 2017
 

RELATED ARTICLES FROM THE BIONEWS ARCHIVE

14 August 2017 - by Julianna Photopoulos 
A number of liberal reforms to the Surrogacy Regulation Bill 2016 have been proposed by India's parliamentary Standing Committee on Health and Family Welfare...
07 August 2017 - by Jennifer Willows 
An Australian nurse has been given a prison sentence after being found guilty of running an illegal surrogacy service in Cambodia...
07 November 2016 - by Lucas Taylor 
The Cambodian Health Minster Mam Bunheng has published a directive appearing to ban all forms of surrogacy in the country...
01 September 2015 - by Ana Ilic 
An injunction has been issued in Nepal to stop women from carrying surrogate pregnancies on behalf of foreigners...
23 February 2015 - by Julianna Photopoulos 
Thailand's parliament has passed a law banning surrogacy for foreign couples, after two scandals sparked worldwide attention last year...


 

Australian insurance inquiry to consider genetic discrimination

29 August 2017

By Rachel Siden

Appeared in BioNews 915

A parliamentary inquiry in Australia is examining the impact of life insurance discrimination based on genetic test results.

Under current law, genetic testing could result in increased life insurance premiums or exclusion from life insurance coverage altogether. This differs from rules governing health insurance which protect patients from such discrimination.

'There is a concerning lack of regulation over the use of genetic information by the Australian life insurance industry,' write Public Health Genomics scholars Jane Tiller and Dr Paul Lacaze of Monash University in Melbourne, Australia in The Conversation. 'Insurance companies are allowed to use genetic test results to discriminate against applicants for life, permanent disability, and income protection insurance (which all come under the life-insurance product category), with little independent oversight or consumer transparency.'

Whether a genetic test is obtained clinically or from a private company (also known as 'direct-to-consumer' genetic testing), life insurance applicants are obligated to disclose their genetic test results if their insurer requests it. And if the test results contain information that shows a patient possesses a genetic disease or a gene that puts them at higher risk of certain diseases, patients risk losing coverage even if they take preventive health measures.

The fear of losing coverage, according to Tiller and Dr Lacaze, is causing more Australian patients to turn down genetic testing, even in clinical settings where results could be used to treat or prevent disease.

A 2009 study conducted by 13 Australian-based researchers showed that twice as many patients with family history of bowel cancer declined genetic testing after being advised of the potential effect on their life insurance coverage, compared to the number who refused testing without being advised of the insurance risk.

Dr Louise Keogh of the University of Melbourne, lead author of the study, told the Sydney Morning Herald: 'It does put people off from getting genetic testing. It's not everybody, but there is a sub-group for whom it is a deal-breaker and they are not interested in getting genetic testing while they know that it will impact their life insurance.'

In Australia, the life insurance industry is largely self-regulated. By contrast, many other countries heavily restrict or prohibit the ability of insurance companies to discriminate based on genetic test results.

According to Tiller and Dr Lacaze, as genetic testing becomes more widespread, Australians will need greater consumer protection: 'The Australian government must take action towards an immediate ban (moratorium) on the use of genetic test results in insurance, until adequate long-term regulation is in place.'

RELATED ARTICLES FROM THE BIONEWS ARCHIVE

13 March 2017 - by Rebecca Carr 
A bill outlawing genetic discrimination has been passed by Canada's House of Commons, adding genetic characteristics as a protected ground under their Human Rights Act...
13 March 2017 - by Jennifer Willows 
A bill currently passing through the US House of Representatives may mean that employees will have to share their genetic information with their employers...
08 February 2016 - by Ryan Ross 
The parents of a child carrying genetic markers for cystic fibrosis are suing a school for alleged discrimination and unlawful disclosure of personal information...
14 July 2014 - by Rebecca Carr 
Canada's Office of the Privacy Commissioner has issued a statement urging the life and health insurance industry to refrain from asking applicants for access to existing genetic test results...
23 March 2009 - by MacKenna Roberts 
Researchers at the University of Tasmania, Australia, have conducted the world's first study to have verified incidents of genetic discrimination and warn that such incidents are likely to increase without better safeguards. The five-year study surveyed 1,000 individuals who have had genetic testing during the past ten...


 

Common flame retardant reduces IVF success

29 August 2017

By Charlott Repschlager

Appeared in BioNews 915

Lower IVF success rates have been linked to flame retardants commonly found in household items.

The findings come from the first study to look for an association between organophosphate flame retardants (PFRs) and reproductive outcomes in women.

'This carefully conducted study analysed chemicals from flame retardants in urine from women having IVF and found that the chemicals were detected in most,' said Professor Richard Anderson of the University of Edinburgh, who was not involved in the study. 'Worryingly, higher concentrations of these chemicals were associated with substantial reductions in the success of IVF, with a lower chance of having a baby.'

PFRs are considered a safer alternative to past flame retardants, which studies had linked to negative health and epidemiologic effects, and can be found in furniture, gym mats and household products. However, studies show they can migrate into the air and dust of indoor environments, and disrupt hormones and embryo development in animals.

In this most recent study, a team of researchers at the Harvard T.H. Chan School of Public Health in Boston, Massachusetts analysed urine samples from 211 women who were undergoing IVF and were enrolled in the Environment and Reproductive Health (EARTH) study, which took place from 2005 to 2015.

They looked for five urinary PFR metabolites (products of a chemical that has been metabolised), and found three were present in over 80 percent of women. Success rates for measured IVF outcomes significantly declined for women with the highest urinary levels of PFR metabolites, compared to those with the lowest levels. On average, this included a 10 percent decrease in successful fertilisation, a 31 percent decrease in implantation, a 41 percent decrease in clinical pregnancy, and a 38 percent decrease in live births.

'These findings suggest that exposure to PFRs may be one of many risk factors for lower reproductive success,' said first author Dr Courtney Carignan of Michigan State University. 'They also add to the body of evidence indicating a need to reduce the use of these flame retardants and identify safer alternatives.'

Professor Allan Pacey of the University of Sheffield cautioned that the study does not prove there is a link between PFRs and lower fertility, as 'it only describes an association' and pointed out that: 'it is not clear if this effect would be seen in couples who are not undergoing IVF'. Saying that fire safety was still important, he suggested 'before men and women undergoing IVF throw away their yoga mats, I think we need a bit more data in larger populations and in various parts of the world'.

The researchers say further research is also needed to investigate the potential impact of PFRs on male partners.

The study was published in Environmental Health Perspectives.

RELATED ARTICLES FROM THE BIONEWS ARCHIVE

05 June 2017 - by Shaoni Bhattacharya 
A common chemical found in household products could increase the risk of cancer by blocking the ability of cells to fix genetic flaws which lead to the disease...
19 May 2014 - by Dr Rosie Gilchrist 
Chemicals found in common household products can affect human sperm behaviour in the laboratory, according to a recent study...
19 November 2012 - by Holly Rogers 
A preliminary study from the National Institutes of Health (NIH), USA, suggests that environmental pollutants including industrial chemicals and pesticides may be impairing human fertility, despite being banned more than thirty years ago....
31 January 2010 - by Dr Sophie Pryor 
Exposure to chemicals found in household objects such as furniture, carpets and electronic equipment increases the time taken to become pregnant, according to a study published online in the journal Environmental Health Perspectives. Professor Kim Harley and colleagues at the University of California, Berkeley (UCB) School of Public Health found that women with a higher blood concentration of polybrominated diphenyl ethers (PBDEs), which have been used as flame retardants since the 1970s, too...


 

Theatre Review: Bodies, Royal Court Theatre

29 August 2017

By Jennifer Willows

Appeared in BioNews 915

At the opening of the play, directed by Jude Christian, couple Clem and Josh have decided to pursue surrogacy after suffering multiple miscarriages. We find out that the egg will come from a Russian donor, be fertilised with Josh's sperm, and then implanted in an Indian surrogate.

The play follows Clem and Josh during the pregnancy, including Clem's relationship with her father David, who has motor neurone disease, and her imaginary or possibly hallucinatory relationship with her future daughter, embodied as a teenager.

During the pregnancy, the ban on international surrogacy in India is passed. It is unclear how the new rules will apply to pregnancies already underway and the uncertainty adds an extra dimension of stress to an already fraught situation.

Clem sees herself as socially conscious: she's proud of her working-class background, doesn't believe in private education, and as a successful TV producer has made documentaries about female genital mutilation and teen mental health. She tries to steer a moral course between her trade-unionist father and her husband Josh, whose attitude is that if money can solve a problem, then why not use it?

But David has a keen nose for exploitation, and after discovering that surrogates in India have no legal protections, he tells Clem that he is ashamed of her. His own care is provided by shrewd and kind Oni, who has left her own daughter and husband behind in Africa. The performances were all excellent, but especially Justine Mitchell and Philip Goldacre as Clem and David, who were wonderfully moving as a father and daughter who love each other but don't know how to deal with what the other has become. 

The Daughter appears throughout the play, and it is through her that we find out the most about Lakshmi, the surrogate. As the pregnancy progresses and Clem becomes more anxious, the Daughter's reports of Lakshmi's happiness and wellbeing get progressively worse and Lakshmi begins to appear in the hallucinations herself. This culminates in Clem's wild beliefs that Lakshmi's own daughter has been abducted and that the fetus is a malevolent crow consuming Lakshmi from the inside.

The play delivers some wonderful small moments: there are hints at Clem's lost friendships, the people she has let go from her life once they became parents because it was too painful. My favourite scene takes place in the waiting room at the Delhi clinic, when Josh finds out that Clem has sneaked off for a cigarette, her first since they started trying for a baby. They laugh and tease each other, and you get an insight into the happiness they shared before infertility cast a shadow over their lives.

In the dramatic climax of the play, each of the couple in turn try to gain David's approval or at least understanding before they travel to collect the baby. Clem gives an impassioned speech to her father, about how he cannot understand her grief at her own childlessness. Later, Josh begs him to reconsider, inadvertently admitting that he would have been happy without a child, but that watching Clem's misery is more than he can bear. 

But both of these exchanges come across as heavy handed, and that comes from Vivienne Franzmann's script, rather than the performances. We can already see Clem's pain, we already know how isolated she has become, to the point where they can't even spend time with Josh's nieces and nephews. It's been subtle and believable up to this point. Clem's 'not having children makes me hate everyone who does', and Josh's 'I've taken razorblades out of her purse when her period's due…she wanted to die' seem unnecessary and detract from the feeling of authenticity.

As a viewer, I felt a great deal of sympathy for Clem, but I also worried that she was doing a disservice to other women affected by infertility. Taken together, her suicidal thoughts, conversations with an imaginary daughter, and convincing herself the child Lakshmi is carrying a parasitic crow lead inexorably to her seeming 'hysterical'.

Although I see the irony in the hysteria of a woman who feels let down by her uterus, I don't think the trope is helpful at the best of times, and I certainly don't think it is a fair reflection of the women (and men) who use surrogacy to build their families.

In addition to surrogacy, 'Bodies' touches on a number of other issues, notably the expectations placed upon women, and donor conception. Both the Daughter and David tell Clem that she will not be the mother of her baby because she is using a donor egg. The theme recurs in Clem's conversations with the Daughter as she considers the traits the child will inherit from Josh alone, and wonders if and when they will tell her the truth.

Ultimately 'Bodies' is a play that asks a lot of questions but offers no answers. I would have liked to know more about Lakshmi's real story and experiences, not just what played out in Clem's mind.

We don't get to see Josh and Clem's decision process, how they choose the agency, or the country. While I understand this probably wouldn't make good drama, I also found it unsatisfying.

Ultimately the crux of the play is how willing Clem is to overlook the potential for abuse and exploitation to get the child she wants more than anything. But to be able to have a moral view on her choices, I would want to know how they were made.

SOURCES & REFERENCES

RELATED ARTICLES FROM THE BIONEWS ARCHIVE

04 December 2017 - by Jennifer Willows 
Of Kith and Kin is a play about surrogacy that seems to have very little to say about surrogacy...
02 October 2017 - by Melissa Elsworth 
Why would a woman choose to carry a baby for another person? Should money be involved? Does surrogacy exploit vulnerable women? And what other ethical issues are involved in the surrogacy process?...

 

 

Published by the Progress Educational Trust

CROSSING FRONTIERS

Public Conference
London
8 December 2017

Speakers include

Professor Azim Surani

Professor Magdalena Zernicka-Goetz

Professor Robin Lovell-Badge

Sally Cheshire

Professor Guido Pennings

Katherine Littler

Professor Allan Pacey

Dr Sue Avery

Professor Richard Anderson

Dr Elizabeth Garner

Dr Andy Greenfield

Dr Anna Smajdor

Dr Henry Malter

Vivienne Parry

Dr Helen O'Neill

Dr César Palacios-González

Philippa Taylor

Fiona Fox

Sarah Norcross

Sandy Starr


BOOK HERE

Good Fundraising Code

Become a Friend of PET HERE and give the Progress Educational Trust a regular donation