The Big Three Oh

Louise Brown will be 30 in July. Doubtless she feels as ambiguous about that as the rest of us do when confronted with a significant birthday. But her big day is being noted by the likes of me because Louise Brown is a bit special - she was the world's first 'test-tube' baby.

How quaint that phrase seems now. How long since you heard anyone say it, "test-tube baby"? Technically Louise Brown was the result of a successful in vitro fertilisation (IVF). In the 30 years since she was born, IVF has been joined by a suite of other procedures. These days they are all grouped into something called Assisted Reproductive Technology (ART).

Over the last decade or so, the use of ART has become almost commonplace. So commonplace it's easy to think it's unremarkable. That would be a mistake - these technologies are remarkable, they have brought more than a million children into the lives of people who otherwise could not have had them. But the technologies aren't perfect. They are expensive, intrusive, physically uncomfortable and emotionally confronting. They often fail and that failure rate climbs quickly when the would-be parents, especially the would-be mothers, are older.

Older is a relative term. Most of us, these days, do not think of women in their late 30s as 'older'. But in fertility terms, they are. Fertility begins to drop at around 35 in most women as egg quality declines. It's inexorable and irreversible. And, with the best will in the world and enough money to go through many 'cycles' of treatment, the result can still be no baby and heartbreak*.

Who then ought to be allowed access to ART? This is the question asked and answered in Tom Frame's Children on Demand. The head of the School of Theology at Charles Sturt University is one of Australia's most prolific public intellectuals. He's cranking out books faster than many professional footballers can read them. Dr Frame is also an adoptee and the impact this has had on him affects every word. He is completely upfront about this.

Essentially Tom Frame believes that ART should not be available to a couple in which either the man or the woman isn't contributing their DNA. He argues that women should not be able to use donor sperm from a man they do not know, or even that widows be permitted to use the sperm of a man they used to know exceedingly well - their dead husband. He also believes that gay and lesbian couples should not be granted access to ART. And he's not keen on surrogacy either.

Apart from the issue of surrogacy, his motivation is a concern for the welfare and well-being of the child that may result. But if you want to know exactly why he holds these concerns, and why the ethicist Leslie Cannold disagrees with him, you'll need to listen to the show.

*This should not imply that all fertility problems are women's problems. A bit under half are men's problems and sometimes the problem seems to belong to the couple. Worst of all, about 15% of the time the infertility cannot be explained with the investigations we have now.