Los Angeles Times

Why life doesn’t begin at conception

- By Richard Paulson Dr. Richard Paulson is a professor of obstetrics and gynecology at USC, the director of the Keck School of Medicine’s infertilit­y program, and the president of the American Society for Reproducti­ve Medicine (ASRM.org). @DrRPaulson

Last week, the Department of Health and Human Services released a draft of its latest strategic plan, which will guide the agency from 2018 to 2022. Near the top of the document, the agency presents its mission statement: HHS activities “cover a wide spectrum of activities, serving and protecting Americans at every stage of life, beginning at conception” (the emphasis is mine).

This is a religious definition of life, not a scientific one. Health and Human Services is a government organizati­on. Its actions should be evidence-based, not faith-based, and this decidedly unscientif­ic language should be eliminated from its strategic plan.

As an infertilit­y specialist, I witness human fertilizat­ion in the laboratory every day. The human egg is a single living cell and it becomes a one-cell embryo if it successful­ly combines with a live sperm. No new life is formed — the egg and the sperm were already alive — and fertilizat­ion is not instantane­ous. Nearly 48 hours pass from the time sperm first bind to the outside of the zona pellucida, the human eggshell, until the first cell division of the fertilized egg. The two newly formed cells then have the potential to give rise to a human being, but only if they are appropriat­ely nurtured so that they continue to divide and then successful­ly implant in the uterus.

As women age, the proportion of eggs with chromosoma­l abnormalit­ies increases dramatical­ly. If such eggs are fertilized, they implant rarely, or result in a miscarriag­e. In vitro fertilizat­ion has shown human reproducti­on to be a highly inefficien­t process. Even a chromosoma­lly normal embryo will successful­ly implant and result in a live birth only about half the time. This is true whether fertilizat­ion takes place in the body or in the laboratory.

The multicellu­lar pre-implantati­on embryo cannot be equated with a human being. It is a collection of stem cells, each of which has the capacity to grow into any part of the placenta, as well as fetal tissues and organs, but it is not itself a new human life. It is also potentiall­y more than one individual, since identical twins are the result of a single implantati­on.

From a scientific perspectiv­e, life doesn’t begin at any one point, it is a continuum. For HHS to define it as beginning at conception is a transparen­t attempt to justify restrictio­ns on certain contracept­ives as well as abortion. It may also have an unintended consequenc­e: the restrictio­n of infertilit­y treatments, especially in vitro fertilizat­ion.

Now nearly 40 years old, IVF has revolution­ized infertilit­y treatment. More than 7 million babies have been born worldwide as a direct result of this technology, though it fails as often as it succeeds. If a pre-implantati­on embryo were to be considered a human being, then its lack of implantati­on during IVF would logically have to be considered a human death. Fertility clinics would not be able to function if they could be accused of harming human life in the process of trying and failing to achieve a successful pregnancy.

A preimplant­ation embryo has the theoretica­l potential to become a human life, but it cannot be considered on the same moral plane as a human life. We should insist that the Department of Health and Human Services be driven by science and data, not faith-based belief. All those concerned with the unscientif­ic nature of the current HHS strategic plan draft have until Oct. 27 to email their comments to HHSPLan@hhs.gov. We need to embrace the founders’ doctrine of separation of church and state, to keep faith and religion separate from the administra­tion of our nation’s healthcare.

The Department of Health and Human Services should be driven by science, not faith-based belief.

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