Clone Age: Adventures in the New World of Reproductive Technology

Chapter One

Creating Life in the Lab

The year is 1985. The world's television sets are tuned to Bob Geldof's Live Aid concert at Wembley Stadium in London, but I am in another part of England. My taxi is motoring up a long, curvy driveway until it reaches a clearing. Then the Jacobean manor house, Bourn Hall, comes in view, perfectly set in the middle of a rolling green lawn, a herd of sheep to the side. Built in 1607 as the seat of Earl de la Warr, the mansion betrays nothing about its present purpose. But a few miles back, the small local store has added a new line of products. Amid the hand-knit sweaters for which this part of England is famous, there is a display of baby bottles, bibs, and gowns.

    The sitting room at Bourn Hall looks like a United Nations of women. Some are reading, others knitting, many are talking. Their bodies seem bent with grief, but there is hope in their eyes, like cripples approaching Lourdes or the Catedral de Guadalupe. They are barren women. They have come here from countries around the globe so that Robert Edwards can create a baby for them. So many have come that Edwards has erected trailers in the back of the mansion to house these women in waiting.

    I am thirty-two, about the same age as many of these women, married for four years, and childless by choice. My biological clock hasn't started ticking loudly enough to raise concerns, but I can empathize with the stories they tell me of the enormous lengths they are going to in order to create a child. I can imagine their disbelief when they stopped the Pill or threwaway their diaphragms and first learned that they could nor conceive.

    They are part of a generation of women—my generation—for whom a different set of doors had been opened. We were young at the moment that everyone else was trying to be. We were in the first group of women admitted to previously male colleges, clubs, professions. Abortion was legalized just when we first needed it.

    But it seems that a strange thing had happened while life was saying yes to us; our bodies increasingly were saying no. Women who postponed childbearing to pursue educational and career opportunities suffered the natural decline in fertility that occurs with age. Women who exercised their right to contraception, in ways such as using the Dalkon Shield intrauterine device, sometimes found their fertility permanently compromised. For many, the only hope was to use Edwards's magical new panacea, in vitro fertilization.

    Edwards, an embryologist at Cambridge, had spent two decades trying to fertilize women's eggs outside their bodies. In his early experiments, he used his own sperm and that of male lab techs in attempts to fertilize eggs recovered during hysterectomies. Later, while on a research fellowship in Chapel Hill, North Carolina, he invented a porous little cage to contain egg and sperm and persuaded women to volunteer to wear them in their uteruses.

    The British Medical Research Council denied funds to Edwards and his obstetrician collaborator, Patrick Steptoe, because of concerns about the ethics of their work. At a 1971 meeting in Washington, D.C., James Watson, the codiscoverer of DNA, chastised Robert Edwards. "You can only go ahead with your work if you accept the necessity of infanticide. There are going to be a lot of mistakes."

    Edwards's money came primarily from generous individuals (predominantly Americans), but also from a Ford Foundation grant for studying in vitro fertilization to aid in the development of contraceptives. Ironically, it was this grant for research on preventing pregnancy that led to a successful pregnancy in 1978.

    After about one hundred attempts in other women, Edwards fertilized Lesley Brown's egg in a petri dish with the sperm of her husband, John. Three days later, in the middle of the night, Edwards gingerly implanted the embryo back into Leslie and the pregnancy began. Newspapers, magazines, and television stations treated the impending birth of a baby to the Browns as an extraordinary event. When the pregnant Mrs. Brown was hospitalized, press people dressed up as boilermakers, plumbers, and window cleaners to sneak into the hospital to try to interview or photograph her. One exasperated hospital representative complained, "It seems as if you move anything, there is a reporter behind it." Someone—probably a reporter—called in a bomb scare to the maternity building, most likely in the hopes of getting a glimpse of Lesley Brown. Every woman had to be evacuated, including those who were in labor or who had surgery earlier that day.

    The newspapers even surreptitiously obtained—and printed—reports of confidential medical tests that had been performed on Lesley to monitor the development of the child within her. One day the shock of reading a newspaper report drastically raised Lesley's blood pressure. She asked her obstetrician, Patrick Steptoe, in tears, "Is it true that my baby died yesterday? Is it true? Will it happen again?"

    Steptoe assured her all was well, and, true to his word, on July 25, 1978, she delivered a little girl, Louise Brown, the world's first in vitro fertilization baby. The media breathlessly reported the birth of Louise Brown with a fervor not seen since the first moon landing.

* * *

Edwards's wife, scientist Ruth Fowler, was no stranger to controversy. Her grandfather, Ernest Rutherford, had split the atom. The same genes as Rutherford, Edwards thought when he first met Ruth, my God! But even that precedent could not prepare him for the furor that awaited.

    The church and Parliament went wild. Immoral, they said. Unnatural. Playing God. Even scientists were on edge. Some didn't believe it had occurred and demanded a peer-reviewed publication. Others criticized Edwards for going ahead before the procedure had been done in higher animals. No one had even tried it in a chimp! Still others worried about the limits that would be put in place on other scientists if one of Edwards's creations turned out to be defective and the Parliament, in horror, clamped down on all avant-garde research.

    The procedure of in vitro fertilization itself was not just some overnight sensation, having been suggested as early as 1937 in an editorial in the New England Journal of Medicine entitled "Conception in a Watch Glass." Edwards began publishing reports of his own fertilization attempts beginning in the late 1960s.

    In 1973, Floridians Doris and John Del Zio became the first couple in the United States to attempt IVF. Doris's New York City infertility specialist, Dr. William Sweeney, had tried three times to repair her fallopian tubes without success. Sweeney felt additional surgery would be of no benefit, so he asked Dr. Landrum Shettles of Manhattan's Colombia Presbyterian Medical Center to assist him in a radically new procedure.

    The hospital was on East 70th Street in New York, while Shettles's laboratory was on West 168th Street. On September 12, 1973, Sweeney surgically removed an egg from Doris Del Zio, putting it in a sterile container with protective packing. John Del Zio then carried the package across town in a taxi to Shettles's Columbia Presbyterian laboratory. There, after the addition of the husband's sperm, the culture medium containing the egg was placed in an incubator to develop for three days before an attempt at implantation.

    The day after removing the egg, Shettles was ordered to the office of his boss, Dr. Raymond Vande Wiele, the chairman of the Department of Obstetrics and Gynecology at Columbia Presbyterian Hospital and Medical Center. Vande Wiele was furious that Shettles had attempted this sort of experiment without seeking the institution's permission. Vande Wiele argued that it was unethical and immoral to carry on this work. Later, he would claim that he had been worried that the contents of the petri dish were contaminated and that he did not want to see Del Zio risk infection or even death if they were implanted in her uterus.

    As the two men spoke, Shettles noticed the Del Zio container sitting on Vande Wiele's desk. The department chairman had removed it from the incubator. He had also opened it, thus dashing completely the couple's hopes of giving birth to a child through in vitro fertilization.

    At that moment, Doris Del Zio was still hospitalized, recovering from the surgery. When the news of the chairman's action reached her, she sank into a profound depression. Sweeney had told her that her reproductive organs were so badly damaged he could not attempt to remove another egg, so she had lost her one chance to become a mother. A year later, she and her husband filed suit against Columbia Presbyterian Medical Center, Columbia University, and Raymond Vande Wiele.

    In 1974, when the suit was filed, there seemed to be little chance of its success. The whole process of IVF seemed like something out of a science fiction story, so it would be difficult to convince a jury that the Del Zios had indeed lost a realistic chance to become parents. The wheels of justice grind slowly, however, and the trial did not begin until July 17, 1978.

    Nine days later, headlines screamed the news of Louise Brown's birth in England. A defense attorney tried to prevent the jury from being influenced by the success across the ocean. He said scornfully that Shettles's procedure was as distinct from the English technique as "a Model T Ford is from a Porsche."

    The lawyers were at a loss to define the harm that had been caused to Mrs. Del Zio. It seemed crass to think of the mixture of egg and sperm as "property." She thought of it as her potential child, but the law offered no clear protections. Not knowing what to do with the case, the jury awarded Mr. Del Zio $3—far less than he could have gotten selling sperm as an anonymous donor. Mrs. Del Zio had so obviously suffered, though, that the jurors awarded her $50,000 for her mental anguish. The jury decided that the defendant's conduct was so extreme, outrageous, and shocking that it exceeded all reasonable bounds of decency.

    By the time I visited Robert Edwards in 1985, more than 1,300 doctors and scientists were quietly working on in vitro fertilization and similar reproductive technologies. Even Dr. Raymond Vande Wiele had succumbed to the allure of IVF and opened his own IVF clinic at Columbia. In the Clone Age, it would be possible for a child to have five parents: a sperm donor, egg donor, surrogate mother, and the couple who intended to raise the child.

* * *

The reason that procreation started moving so quickly from the marriage bed into the scientific laboratory in the 1970s was that infertility had become a problem for an increasing number of people. According to a study by Dr. Ralph Dougherty, professor of chemistry at Florida State University in Tallahassee, the sperm count of American males has fallen dramatically. In 1929 the median count was 90 million sperm per cubic centimeter; in 1979 it was 60 million. Men born in the 1970s had 25 percent fewer sperm than men born in the 1950s. Possibly because of environmental pollutants, nearly one quarter of all men had counts so low that some scientists consider them to be "functionally sterile."

    Women, too, were having problems. Young women had been having sex with a variety of partners and sustaining untreated low-level gynecological infections, which damaged the reproductive system. Before the 1960s and the development of the Pill, the main contraceptive devices—the condom and diaphragm—had protected against infection. According to Dr. Robert T. Francoeur, professor of human sexuality and embryology at Fairleigh Dickinson University in Rutherford, New Jersey, as many as one in four women between the ages of twenty and thirty-five are now infertile.

    I originally met Robert Edwards in 1980 at the first international meeting on in vitro fertilization, a conference in Kiel, West Germany, where I was speaking on the legal implications of surrogate motherhood. At that time, Louise Brown was the only confirmed in vitro birth. Edwards's next patient to become pregnant miscarried because the fetus had sixty-nine chromosomes instead of the normal forty-six. The patient after that miscarried at twenty and a half weeks, before the baby was mature enough to survive. Another implantation resulted in a tubal pregnancy that had to be surgically removed. Yet the hundreds of doctors at the conference were ready to plunge forward with a panoply of brave new ways to create the next generation.

    Since so little was known about the best way to fertilize an egg in vitro, two brothers, Dr. Randolph Seed, a physician, and his brother, Dr. Richard Seed, a veterinarian, thought that they would rely more closely on nature. They proposed to use a female volunteer as a human petri dish. They called it in vivo fertilization, rather than in vitro.

    When Richard Seed approached the podium in Kiel, I marveled at the irony of his name. He was wild-eyed, confident. He described a procedure developed to transfer embryos from prize cows to ordinary cattle as a way to upgrade the herd. He proposed using that same approach to flush embryos out of fertile women and put them into the infertile.

    In artificial embryonation (AE), sperm from the husband of an infertile woman would be used to inseminate a fertile woman. Then, four to five days after fertilization, the embryo would be flushed out so it could be implanted in the infertile woman, as in in vitro fertilization.

    In addition to artificial embryonation, the Seeds planned to offer embryo adoption (EA). "The technology is the same as an artificial embryonation, but donor semen is used instead of semen from the recipient's husband," said Dr. Richard Seed. "In this case, the embryo has genes from neither of these `adoptive' parents, even though the `adoptive' mother will bear the child."

    Seed told the Kiel conference how the idea came about. "It's amusing I didn't think of this myself," he recalled. "A patient called up and said he had been trying to adopt a child for five years, and asked, `Why can't I adopt an embryo?' A few months later I called him back, and that started the whole thing."

    Richard Seed confidently cited seven years of experience doing embryo transplants in cattle to justify his optimism that his procedures would succeed. "Ten thousand transfers have been done with cattle," he said, "and there are no excess abnormalities." He later added, "I see no reason why it shouldn't work with humans."

    Several doctors at the Kiel conference attacked Seed's attempts to draw conclusions about human beings from experiments done with animals. Dr. Martin Quigley said that rat eggs did not fertilize in vitro under the same circumstances in which mouse eggs were routinely fertilized. If one could not generalize in animals so closely related, how could one hope "to establish standards for human in vitro fertilization from laboratory experiments with animals?"

    Seed believed that neither AE nor EA would involve any legal procedures. "We feel the child delivered to the previously infertile mother will be her child legally," he explained, "and her previously infertile husband will be the legal father, with no necessity for actual adoption proceedings." This view was in keeping with most of the artificial insemination cases, which say that the woman who bears the child is the natural mother. But considering that in artificial insemination cases a child is not only borne by the mother but also conceived of her egg, who knew how a judge would feel if one of Seed's volunteers, who donated the egg—and thus half the genes—for the child, sued to have visitation rights?

    The idea was not as far-fetched as it may sound. In England, a British doctor had planned to help an infertile woman have children by doing an ovary transplant. The surgery was stopped, however, when British authorities informed the doctor that, although this patient could then conceive and carry a child, any offspring that might result would be considered illegitimate. In such a case the legal mother might actually turn out to be the woman who gave up the ovary and thus donated her eggs.

    The creation of embryos—whether in vitro, as Edwards did, or in vivo, as Seed did—might lead to procreation by design, with parents picking the traits they wanted in their offspring. E. S. E. Hafez predicted that it would give rise to ova and embryos being "banked" and sold for commercial purposes. He said that it would be possible to have an embryo supermarket. According to Hafez, the purchaser would be able to select an embryo knowing in advance the "color of the baby's eyes and hair, its sex, its probable size, ... maturity, and its probable IQ."

    I was the only American lawyer on the Kiel program, and as I listened to each new speaker, I thought about the legal implications of their work. If an unmarried woman used donor sperm, could she sue the donor for child support? `Could the resulting child, like adoptees in some countries, learn the identity of her donor father?

    I also relished the irony of the Seeds' address. Back in my hometown of Chicago, their medical office was in Water Tower Place, a shopping center on Michigan Avenue that houses some of the most exclusive shops in the world. There you can buy everything from eighteenth-century Chinese screens to remote-control robots. Now, in a suite marked "Reproduction and Fertility Clinic," you could buy human embryos.

* * *

For years after the Kiel meeting, the doctors in attendance called with their latest legal conundrums. One had inseminated a woman's egg with her husband's sperm to be implanted in the husband's sister as a surrogate. As he was about to put the embryo in the sister, he stopped suddenly and rushed to the phone. If he put the man's embryo in his sister, would that violate his state's ban on incest? If he decided not to go through with the implantation and terminated the embryo instead, could he be found guilty of murder?

    The law addresses any new question by relying on precedent. When cars were introduced, the wisdom from cases dealing with horses and buggies governed. But, as the Del Zio case demonstrated, it was difficult to find precedents to deal with human embryos. Were they property or people? Where could we turn to learn if they could be frozen—or "enhanced" through genetic manipulation?

    The doctors called me, they said, because the attorneys for their clinics respond to each of their questions by saying, "There is no law in this state that covers that." Which is not much comfort for a doctor with an embryo in a catheter who is trying to decide what to do.

    In 1969, when Edwards first published an article about fertilizing human eggs in Nature, William Breckon, the science correspondent for the Times, wrote, "Ultimately we could have the know-how to breed these groups of human beings—called `clones' after the Greek word for a throng—to produce a cohort of super-astronauts or dustmen, soldiers or senators, each with identical physical and mental characteristics most suited to do the job they have to do."

    Some scientists wanted to try crossing species, ape egg and human sperm, or vice versa, in the late 1960s, Chinese surgeon Ji Yongxiang reportedly fertilized a chimpanzee with human sperm to create a "near human ape" to perform simple tasks. The pregnancy was terminated when rioters destroyed his lab.

    An article in a law journal has raised the question whether hybrids would have the same legal rights as humans. If the hybrid is half human, would it have the right to vote? Half a vote? What about its offspring, who might be only a quarter human?

    Many people wanted to ban IVF to prevent us from careening down such a slippery slope. But the Chinese attempt to merge human and ape did not rely on IVF. Even if IVF with its laparoscopy component were banned, scientists could use eggs from the ovaries of women whose ovaries had been removed in the course of a complete hysterectomy. What would the opponents then propose—that hysterectomy be banned on the off chance that a scientist might decide to breed a genius hybrid with the egg?

* * *

All around the world, in vitro fertilization clinics were coming under attack. Because not all of the embryos resulted in babies, right-to-life groups protested. In Australia, priests staged a hunger strike in the lobby of Alex Lopata's clinics. His patients had to walk past this human barrier whenever they wanted to see him. The strain was palpable. In one instance, a slight young woman calmly walked into the heat of the protest. She looked a priest directly in the eye and asked quietly, "Why don't you want me to have this baby?"

    Shortly after Louise Brown's birth, right-to-life advocates persuaded Illinois lawmakers to pass an unusual law to deter doctors from doing IVF. The law said that any physician who fertilized an egg in vitro had custody of the resulting embryo and would be subject to an 1877 child abuse law. Doctors in Illinois were appropriately intimidated. They knew what it meant to provide an existing child with the food, clothing, and shelter necessary to avoid a finding of abuse, but what did it mean in terms of an eight-cell embryo? Could a prosecutor indict a doctor each time an embryo failed to develop into a child—on the grounds that the doctor should have "fed" it a more "nutritious" petri dish mixture? Would the doctor be guilty of homicide if he or she discarded an embryo that was not dividing properly?

    Another land mine was that the law granted custody to the doctor but never arranged for the parents to regain custody! If such a law had been in effect in England, Lesley and John Brown would have had no legal claim to Louise; she would have belonged to Edwards and Steptoe.

    Lois Lipton of the American Civil Liberties Union was approached by a woman who wanted to challenge the law. Her fallopian tubes had been damaged nineteen years earlier when her appendix ruptured. She underwent a number of corrective operations on her tubes, but the original damage was too great. Her doctor, Aaron Lifchez, had advised her that IVF was her only available method of conception. Lois called me and asked if I'd be willing to help in the case.

    I knew that the chances of the woman being accepted into an IVF program in another state were very slim. Clinics at that time had an age thirty-five cutoff. She was thirty-four years old when she filed suit and would be too old to qualify for some programs if she were on a waiting list for more than a year. Besides, she had confidence in her own doctor; the only reason he was unwilling to offer in vitro fertilization was his fear of being prosecuted for child abuse.

    Two other women joined the team: Frances J. Krasnow of the Chicago law firm of Fohrman, Lurie, Sklar & Simon, Ltd., and ACLU attorney Colleen Connell. We read and reread the contraceptive and abortion decisions, taking solace in the U.S. Supreme Court's language: "If the right of privacy means anything, it is the right of the individual, married or single, to be free of unwarranted governmental intrusion into matters so fundamentally affecting a person as the decision whether to bear or beget a child."

    There was no question that a married couple has a right to determine whether and when to bear a child through intercourse. But did a couple also have the right to decide how they would like to bear a child?

    "While the legislature apparently views in vitro fertilization as a crime," we wrote in our brief, "to many childless couples it is seen as a possible miracle.... Procreation is universally recognized by every culture and religion as a fundamental element of the institution of marriage. For many married couples it is the essence of family. The desire to produce one's own offspring is, for most couples, as primary as the need to eat or sleep." We argued that the Illinois law interfering with that decision should be declared unconstitutional.

    After we filed suit, the Illinois attorney general and the state's attorney for Cook County rendered an opinion that any physician who undertook the procedure would not violate the law as long as the physician refrained "from wilfully endangering or injuring" the embryo during the preimplantation period. They said that if an embryo was terminated because it was defective, that action would be interpreted as a lawful pregnancy termination on the part of the physician. The legislature passed a law allowing in vitro fertilization. But then it made any research involving embryos a crime.

    Once again, we were back in court.

    For our brief, I scoured hundreds of medical journals to demonstrate how a ban on embryo research would interfere with infertile women's chances to create a child. In vitro fertilization and reproductive technologies were so new that they were inherently experimental. Article after article described how doctors were varying every aspect of the procedure—trying new culture media, changing the shape of the petri dish—in order to improve the success rate of IVF. Randolph and Richard Seed had teamed up with a group of doctors at UCLA to offer artificial embryonation, and yet that was clearly banned by the Illinois law. So was freezing an embryo for later implantation or undertaking genetic screening on the embryo. This seemed to me clearly to violate the woman's right "to bear and beget a child."

    And the law had another fatal flaw. It violated doctors' constitutional rights by failing to give them notice about what constitutes criminal behavior. Embryo experimentation was unlawful, but experimentation was never defined. The medical articles I had consulted offered differing—and contrasting—definitions of what was an experiment. Some argued a procedure was not an experiment, even if it had never been done before, so long as the doctor "intended" it to be therapeutic. Other articles said that even a standard procedure was an experiment when it was tried on a new patient. Federal regulations considered a procedure experimental only if it was part of a larger study.

    The transcript of the Illinois legislature showed that even the men passing the bill had no idea what it meant. Some thought it made prenatal screening through chorionic villi sampling illegal; others thought it did not. It was a fundamental principle of U.S. law that if a state created a new crime, it had to be clear about what actions were forbidden. We could make a strong argument that the law should be "void for vagueness."

    We didn't want to see hundreds of human embryos lined up in rows with researchers testing drugs or cosmetics on them, but the Illinois ban was just too broad, preventing women from using legitimate fertility procedures and genetic testing.

    The right-to-life groups were up in arms. Their protestors came to court to hiss when we went by. My co-counsel, Lois Lipton, was very pregnant herself at one court hearing. A right-to-life protestor in the back row uttered a death threat against her. There was a right-to-life hotline where you could hear recorded death threats against Lois anytime, night or day.

    I was working peacefully at my office one day when a burly, angry man barged in and served me with a legal complaint. He was bringing a class action on behalf of all the unborn children in Illinois. He claimed to represent all unconceived children. He was representing my eggs—in a suit against me.

    The right-to-life groups were not our only critics. Even some feminists opposed in vitro fertilization. "What is the real meaning of a woman's `consent' in a society in which men as a social group control not just the choices open to women but also women's motivation to choose?" the feminist Gena Corea asked. She said that Lesley Brown probably chose motherhood only to escape her boring job in a cheese factory.

    Weeks, months, more than a year passed before we heard from the court. One day I got a call from the young lawyer who served as the judge's clerk. By the following day he wanted copies of the dozens of medical articles I had included in the brief. I explained how I had returned those journals to medical libraries across the city and asked what would happen if I couldn't produce them in time.

    "You'll be in contempt of court," he said.

    The federal judge, Ann Williams, was a woman—just thirty-five years old when she was appointed to the federal bench in 1985. Her opinion read: "It takes no great leap of logic to see that within the cluster of constitutionally protected choices that includes the right to have access to contraceptives, there must be included within that cluster the right to submit to a medical procedure that may bring about, rather than prevent, pregnancy."

    She threw out the whole law as unconstitutional. She also dismissed the man who claimed to be representing the state's unconceived children.

    When I read about the case the next day in an Associated Press article, the important issues of women's reproductive rights were nowhere to be seen. The story highlighted the fact that researchers could now use human embryos however they wished—including slicing them up to inject as a treatment for Parkinson's patients. It was my first legal brush with the principle of unintended consequences.

* * *

When Antonie van Leeuwenhoek first viewed sperm under a microscope in the 1670s, the biological groundwork was set for legal questions about the manipulation of reproduction. But it was not until the clinical application of in vitro fertilization three centuries later that the question took on a pressing significance. Once the embryo was isolated in the petri dish, it could be used to create a child for the progenitors, it could be donated to another couple, it could be genetically manipulated, or it could be used for other research purposes. As Clifford Grobstein has pointed out, the work that Robert Edwards was doing was "moving from unconscious cultural determination of human biological progression to a degree of conscious self-determination."

    At Bourn Hall, I was surrounded by the trappings of the past. The elegant sitting rooms and burnished wood banisters seemed an appropriate setting for a play of English manners. But as Edwards ushered me into his embryo laboratory, I was transported ahead in time, with the gleaming steel equipment and slightly antiseptic smell. This was why the law had not kept up with the changes in reproductive medicine. If a lawyer from a hundred years ago were set down in a modern courtroom, he—and, of course, it would be a he—would feel completely at home. But if a doctor from the 1800s were to find himself among Edwards's liquid nitrogen tanks, laparoscopy equipment, and ultrasound, he wouldn't have the foggiest idea of what to do.

    The laboratory gleam silenced me, commanding the respect that, in early generations, one would have given a church. Here, Edwards explained to me, he would be creating a new genesis. Edwards desired not only to facilitate fertilization, but to improve upon it. He was angry that the British government was restricting embryo research, since he wanted to undertake genetic interventions on embryos. "The dogma that has entered biology from Christian sources has done nothing but harm," he told me.

    I left Bourn Hall shortly before dusk. The women there were readying themselves to have their embryos implanted. Edwards liked to do it in the evening, perhaps out of superstition, because Lesley Brown had achieved her pregnancy when the implantation occurred at night. The same thing had happened, more recently, when he provided Louise Brown with a baby sister, Natalie. But perhaps biology played a part as well since the hormones necessary for sustaining a pregnancy are at their highest level at night. The adrenal glands, controlling the body's day-to-day activity, are least active, slowing down the body's processes and creating a more restful home for the embryo.

    As they readied themselves for their evening implantation, some of the women could not forgo the vestiges of romance. One carefully combed her long blond hair, applied makeup, and slipped into a magenta velvet gown.