Sawbones: A Marital Tour of Misguided Medicine - Sawbones: IVF

Episode Date: March 5, 2024

Started in the 1930s by scientist Dr. Miriam Menkin, in vitro fertilization is a medical procedure to help with fertility that took until the 1970s to have results in humans. With some drastic misunderstandings going on in the news, Dr. Sydnee and Justin go through the long history of in vitro fertilization and its importance in fertility and contraception today.Music: "Medicines" by The Taxpayers https://taxpayers.bandcamp.com/

Saw Bones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. Alright, so I'm here to read some books. One, two, one, two, three, four.

Hello everybody and welcome to Sawbones, a marital tour of misguided medicine. I'm your co-host Justin McRoy. And I'm Sydney McRoy. Sid, I'm so excited to be here with you today. I genuinely am. I don't have any sort of, I don't have a bit, I don't have a skit or a spoof. I'm just happy to be here with you. just, I'm happy to be here with you. Well, I'm happy to be here with you too, Justin. I think it's good when,

cause we're gonna talk about something that's somewhat timely. And so I think it's good when you're talking about like current, oh, problems in the world, distress, distressing situations. I think that it is good to remember the good things too. The good things too. We're sitting here across from each other.

You're listening to the podcast. That was good. That's a good thing that's going right. Yes. Maybe you have a beverage, coffee or something. That's pretty good. I got coffee. You know, there's good stuff too.

So Sid, what's this episode about? Well, if you live in the U.S. and specifically if you live in Alabama, it's been distressing the last couple weeks a specific issue. There are many distressing things going on. We're talking about one of them. I don't want to pretend like this is the only distressing thing in the world. I will acknowledge there are many concerning things. And there are many problems that state legislatures

are causing for the people who live in their states. So I'm gonna talk a lot of smack about Alabama right now. Please no. I am not, this is not aimed at the people of Alabama because I live in West Virginia. And I think I'm okay. Yeah, it's like- But our state legislature is doing terrible things

to people at our state right now. Dumpster fire. So if you wanted to make a podcast about the awful things that are happening in the state of West Virginia, you absolutely could, and we could do that next. Yeah, sure. We've kind of covered vaccines many times. Yeah, we just got rid of it.

Yeah, our state legislators don't really believe in them. They don't think they're a big deal. We don't need them. They're bringing measles back. Florida did it, we gotta follow anyway. What are they doing in Alabama though, Justin? All said, I don't know. I mean, you know, I know, but here's my,

you all my layman understanding of it. They declared that embryos counted as humans. You know what I mean? You know what I mean? You know what I mean? You know what I mean? You know what I mean? You know what I mean? You know what I mean? You know what I mean? You know what I mean? You know what I mean? You know what I mean?

You know what I mean? You know what I mean? You know what I mean? You know what I mean? You know what I mean? You know what I mean? You know what I mean? You know what I mean?

You know what I mean? You know what I mean? You know what I mean? You know what I mean? You know what I mean? You know what I mean? You know what I mean? You know what I mean? You know what I mean? You know what I mean? It's a big problem. It's a gigantic problem. Yeah, yeah. Historically, we have not declared clusters of cells people officially, legally. Now, I know what you're thinking

hasn't a lot of the restrictions that have been placed on abortions, haven't they sort of dabbled in that area? Yes, this has been kind of the philosophical argument many are using or religious argument to justify their actions. But this is an official court ruling that an embryo is a person. And I think that this is just an important lesson in why if you don't understand science, lesson in why if you don't understand science, you probably shouldn't dabble in regulating science. You probably shouldn't try to make rules about something that you have no, I don't even mean like complex understanding of. I mean even the most basic understanding

of how babies are made, which is, I think from the interviews that followed this Supreme Court decision in Alabama, when you saw various legislators, both in Alabama and people who are in the US Congress, who were interviewed about the outcome of this and what it could mean and how do they feel about it, what it reflected is that there are a lot of people in this country, adults who are making decisions for us,

who I don't think fundamentally understand the birds and the bees. Yeah, like the basics. The basics, or at least if they do, they forgot it. I don't know. I don't know, some of them are very old. Maybe they forgot it. That sounded agist.

I don't mean that. No, well, I mean, there's more as you get older, I think we can all test to this. I mean, I'm just saying maybe they learned it a long time ago and they haven't done any refreshers on the subject. Yes. So let's talk a little bit about the result of this. The reason we're talking about declaring embryos people

is that quickly after this decision, several in vitro fertilization clinics within the state, well, all the functioning ones within the state stopped. They paused operations until they figured out what this would mean for them. And so first of all, I think we need to talk about what is in vitro fertilization? When did we start it out?

Why do we do it? How does it work? And then we can get into why would this have such a huge impact on that medical treatment in the industry around it, right? Right. Okay, so the first embryo transfer. And what this means is the first time

we took a fertilized egg. So egg and sperm combo out of, and this wasn't a human. This is a mammal. This was a rabbit. OK. The first time we did this was in 1890 by Walter Heap. Hey, Sid, what this is a diversion, but there's a, they might be a giant song that involves zygote. So I wanted to ask, what's the difference between zygote and embryo?

I want to ask what's the difference between a zygote and an embryo? We're just talking about stages in the development of the, of the, what will eventually become, you know, a fetus and then a baby and then, you know, an adult. We're just talking about different stages in the development. The first thing is the zygote. So eggs, berm, meat, zygote. And then basically what's happening at that point is the cells are dividing and at different stages along that process we have different names

until we get to embryo. Okay, got it. Right, so a zygote is like the initial thing, but the reason we're talking about embryos is that generally, and we'll get into this, in the process of in vitro fertilization, you don't just make a zygote and stop there You mature it into an embryo and stop there before you implant it. Okay, okay, so stages of development. Okay, got it

so anyway Should I take this die away from all of I don't She's having an echo of time down there She's having such fun. Okay, listeners, if you hear a small di-rattling, that is our capitol with the die. I'm sorry, but she's having a great time. She's so cute. She likes to be where I am. Yeah, we can't. I'm teaching her how to fetch. Okay. This is true. This is true. Walter Heap was, okay, I thought this was interesting. There were so many interesting characters in this story that could have been side stories on their own,

but just to give you a brief overview, Walter Heap was like a businessman who his whole family was in business and like mercantile issue, like sold goods around the world and things. And he kind of started there and then he had some sort of health issue. It's not really clear what it was,

but it inspired him to abandon the rigorous world of business in pursuit of science at the age of 24. So he just started doing science. I was trying to read like, did he like, was he always interested or did he just decide or just decided to do science? I'm gonna do science. And he wrote some books, the books themselves.

I feel like if you just look at the collection of the book titles, the breeding industry is a book he did, but it was about the importance of breeding high quality animals. I don't know, anytime I hear this, I start to get really like, oh, we're at the, I mean, we're at the end of the 1800s moving into the 1900s

as these books are being written. And this is a really, if you've listened to our show, you know that any scientist working at this time, you have to Google like, were they into eugenics? Like you have to check and see. I am not saying that Walter Heap was, but he was very into appropriate breeding of animals. He also did a book called Sex Antagonism.

Wow. Which it was about the conflicts between men and women at the time. It kind of, I haven't read the book. I found some like synopses. Sounds good though. It sounds a little bit like a men are from Mars, women are from Venus of its time.

So he did that. And then he wrote a book called Preparation for Marriage which was sponsored by the Church of England. So I think that. He wrote, and then he wrote a book called Preparation for Marriage, which was sponsored by the Church of England. So I think that we know what we need to know here. Anyway, on April 27th, 1890. So he was very interested in making sure that he could like breed rabbits successfully.

Like the breeding of a specific kind of rabbit and Gora rabbits, it was very important to him. And then I don't know, he was really into the, I was about to use the word purity of these rabbits, but then I am assuming that I don't know these things about Walter Heap. I'm just saying he was really into keeping these, the lineage of these rabbits secure. So he took some Ova, some eggs from an Angora rabbit,

and they had been fertilized at this point by an Angora buck. And he put them into a Belgian hare rabbit. A Belgian hare rabbit. A Belgian hare doe rabbit, so the one with uterus. And then basically, oh, and then also like the, he let the Belgian hair rabbit do it with another Belgian hair rabbit too. That was unrelated to the science, he was just bored

and needed to kill some time. I found this part of it confusing because so you've put, you've got a different breed of rabbit, right? And so your thought is when the rabbits are born, I can prove that it worked if they are Angora rabbits, because this isn't an Angora rabbit. And if it gives birth to Angora rabbits,

then they are from the embryo ion planet, right? So that makes sense. Like why would you do this? Cause it's going to look different. And then you know it's not a naturally fertilized Belgian hair egg that resulted in it. But then once these two rabbits do it, I feel like it introduces some confusion.

One way or another, the Belgian hair rabbit eventually gave birth to six baby rabbits. Four of them looked like Belgian hairs and two of them were definitely Angoras. So they were supporting the Walter heap. So two of these were from the implanted embryo, was what Walter heap wrote about and talked about. And it's interesting because he wrote about all this,

and it was really, I think that he was very concerned with, especially like the government of England was not aggressively pursuing the breeding of animals for like optimal animal development at the time. And I think he was really concerned with that, like animal husbandry more than he was concerned with, this could be used for humans. Like this was not, he didn't do this and say,

and now we can do it in a human and people who can't become pregnant can. And now we're going to have great rabbits. Yes. Yeah. I mean, really, like now we can have I've become master of rabbits. I really excellent rabbits. It's quite before me. But, but doctor, the, the, the extrapolations of this data are, are, are so important.

He's like, I know for rabbits, do you imagine all the rabbits we can help with this? These rabbits are gonna be incredible. It really did seem to be about that because there was no continued, I mean, there was no effort, like not that you would have at this point tried it in humans, but there was no effort to do that.

And I think as you read through like the history of in vitro fertilization, how did we develop it? You kind of see this undercurrent of people understanding that as they are doing these experiments, they are moving into an area that is going to cause controversy. I mean, right, like you know- It's like not there yet, but like we know that

it's not just about the rabbits. Well, and it's funny because I think it's this, I almost see, and I wasn't there in 1890 to know how people would have reacted to this. But I imagine that it's the kind of thing where if you're a person of a certain belief system, and I'm not implying any sort of religion, I just mean if you feel, if you're the type of person

who would think that every sperm and every egg is precious because it could be a baby. Yes, if that is sort of your mentality, I can see where you'd get outraged about this even before you really understood it. Because you feel like you probably should be. It feels bad. It must be the same way that we felt like we should... Like something about the hyper concern on husbandry felt a little bad to us who've run in the eugenics so many times on the show. Yes. So anyway, this was done and it really wasn't until 1934 that you see people starting to do,

like, to build on this. And I'm not saying nobody out there was trying anything anywhere, but like as a concerted effort that would move things forward, Gregory Pincus in 1934, again, does studies in rabbits. What? Just rough man. It's like, that name should come with wedgie insurance. It's just a tough one. Well, it's really weird.

So Gregory Pincus, who also would be working on like birth control, did these studies and rabbits and published about it, but nobody could repeat them. Like everybody, like he published his methods. And so everybody tried to, I mean, that's what you do in good science, right? Like I did this thing at work. And so then other scientists need to be able to repeat it

and see it work. And then you know that it works. Like that's really vital to good scientific research. It has to be something that you can repeat in other labs, that you can, you know, do the same thing and you get the same results. Nobody could, nobody could reproduce the experiment that he did. So it's not clear that he really did it or at least that it was successful the way he said it was successful. But it did inspire things to move forward because people like,

well, that didn't work, but there probably is something. He's doing something. He's got something over there. So there was a researcher in his lab named Miriam Minkin. And she was the one who did a lot of the IVF, like the In Vitro Fertilization kind of work in his lab. She was the hands on it. And she was the one who was really trying to refine and understand what did he do?

And maybe we can fix this and tweak this. And so there was another scientist, John Rock, who, again, if you recognize these names, if you're somebody who studies medical history, I think we've referenced these people in our show, these were big figures in the development of oral contraceptive pills. All these people that we're kind of talking about

were also working on birth control. It's interesting because they were working on both stopping people from getting pregnant and getting people pregnant because they're pretty intertwined. John Rock was like, well, okay, so Gregory Pinkas couldn't reproduce his results. He eventually ends up like losing his tenure.

Oh, really? And so Miriam's without a job. And Rock wants to do this same sort of research. And he knows that Miriam Minkin is the one who did most of the work in Pinkas's lab. So he hires her to come work in his lab and continue this research, which is exactly what she does. And she is really the one who makes the breakthrough that kind of propels the science to eventually

where it is today. I'm going to tell you about her before she we got to go to the billing department. Let's go. The medicines, the medicines that I still need my card for the mouse. Max Fun Drive 2024. Max Fun Drive? What about it? It'll be the best time for someone to support the podcasts they love. Oh yeah, Drive Exclusive Gifts, special events, and of course all the amazing bonus content. Bonus content, yeah.

So what's on your mind? Check. Well, it starts March 18th and it's only two weeks long. And check. Well, what if they miss it? Well, they should follow Max Fun on social media or sign up for the newsletter at Maxmanfun.org slash newsletter so they don't miss it. Otherwise, checkmate. Who guests on Jordan Jesse Goh?

I mean, we could just list Badnauswald, Kamell Nogiani, Maria Bamford, whatever. We couldn't remember all of them. So we asked my kids. Famous people? How famous? I don't know, pretty famous. Duh. Uh.

Really tiny celebrities who would go on this train wreck instead of a big talk show. There's just a bunch of people on your show. Jordan Jesse Goh, a comedy show for grownups. Finally, a woman is here to set things right. I mean, honestly, right? We're all waiting for it. So basically Miriam had seen what Pinkus had theorized, built on the work, I mean, frankly, built on the work of Walter Heap.

There was already this kind of body of research, like it seems like the kind of thing we could do, right? If we have an egg and a sperm and we can put it together, surely we could put it in a uterus and make it work. Surely we could do this, right? Like can we make, we can probably do this. And so building on all that she'd learned in Pinkus' lab, she starts doing these experiments in March of 1938.

So not too long after Pinkus did his work, but now in the lab of John Rock. Basically they found women who were going to undergo hysterectomies. Okay. Okay. So they're about to have a surgical procedure anyway. And they decided to schedule these right before the patient was due to ovulate.

And at the time, we're not using drugs to stimulate like egg production, which is, I mean, you know, if you're familiar at all with IVF and we'll get into that, there's a lot more that goes into it now. Back during this study, they were more just sort of trying to time things right. Or rudimentary understanding of what was happening. Like it was just one factor.

Yes, we're going to need a mature O site, which like is what is released from the ovary, you know, and goes down. Mature O site you said? O site, the egg cell. O, O. O, O site. Yes. Okay. O site. O site., you said? O-site. The egg cell. O-site. O-site. Yes. Okay.

O-site. O-site. O-site. O-C-Y-T-E. O-site. O-site. You're going to need a mature one. It's released from a mature follicle on the ovary. Okay.

It goes down the fallopian tube, into the uterus. If it's fertilized, you could get a baby. If it's not fertilized, you could, you have a period. Yeah. There you go. There's, there's. Soized. I know. You could, you have a period. Yeah, there you go. There you go. So you know. Yes. Yeah, it's not surprising.

Just a quick review, a quick review. So anyway, basically they timed it so that they could go in, and they're doing the hysterectomy, but timed it that they could collect a mature egg cell at the right moment. Okay. Anyway, they also like had the participants

have unprotected sex right before the surgery too, which I was trying to read through to like figure out like what exactly did that do? This seems another, I mean. I'm not really sure anyway. The point is, I know I was reading that part and I was like, and that did. What?

What? What was that for? Because I understand why you would need it to be at a certain point in their cycle. Right. But anyway, so basically they would collect these eggs. And this is really like what her weekly schedule was. Tuesday you collect the eggs.

Wednesday you add the sperm. Okay. So you've just got sperm in it. It's so much easier to get sperm, right? Uh, yes. You know how to get the sperm. Yes. That is no problem. Yeah.

You could figure that out all by yourself, I bet. I, I had to for fertility testing that way. So see, you know exactly how that worked. So I developed a series of techniques. So, uh, Minkin would collect the eggs on Tuesday, the sperm on Wednesday, pray on Thursday, and then look at what happened on Friday. You gotta say pray it up. So she referred to herself as the egg chaser. Because, and this is true even now, a lot, I mean like a lot of IVF, the success of it depends on timing.

You got to get the timing right of a lot of IVF, the success of it depends on timing. You gotta get the timing right of everything. It's not just the timing of when is the egg mature or when should you combine it with the sperm? It's the stuff that happens after, like as the cells divide and they're reaching different stages, what do you need to do next? And when all this timing is super important

when it comes to in vitro fertilization being successful. And so in order to do these experiments, she was kind of figuring out the timing as she went. And this is where kind of luck, and I don't know, I think this would be a great argument for why like it's so difficult to be a professional parent in this country to both have like a career. Oh, you don't mean like someone

who gets paid to be a parent. You mean like- No, be a professional and a parent. Got it. I don't want to assume, it always said, I mean, I think that like the common phrase would be like a working mom, but I don't want to assume a mom

because I think that it can affect parents, you know, no matter their gender. I think historically it has been more difficult for women to both have a job and be a parent. Yeah. But I don't want to exclude the fact that, I mean, the system hurts us all. Yes.

It just disproportionately has always affected women. Fair. Obviously. Anyway, so Minkin at this point was trying to care for her daughter at home and then also do all of these experiments, okay? So she wasn't having a ton of success so far until at one point she had obtained an egg and she, at that, the protocol that she had been using is that she would wash the egg with, or that she would put the egg in

and then she would wash the sperm sample three times and then let the egg and sperm interact for 30 minutes. That was the plan. Okay, washing the sperm sample removes like a lot of the seminal fluid, a lot of the stuff you don't need. You're trying to just get the sperm. All we eat, no chef.

And you don't want a ton of them to compete. You just want enough to get the job done. So anyway, she had been up all night with her kid. She had a newborn. She had been up all night, the night before. So she was tired. So as she was doing her work, she only washed the sperm sample once. And when she combined them, she kind of dozed and before she knew it,

an hour had elapsed instead of the 30 minutes that was the protocol. And the following Friday, she found a fertilized egg had resulted. Why? It worked because it needed to be longer. They just weren't leaving it there long enough for it to be routinely successful. So it was the decrease in how often, how much she washed the sperm sample and combined with the fact that-

So it needed more of the fluid than we thought? We needed, it needed to be more concentrated than we thought and they needed more time. Which to this day, we still, that point in the process is like one to three hour. It's not, it is not as short as it used to be. Actually, I think it's even longer now that we leave things together

because we realize that it takes longer than that. It seems like it wouldn't, right? Yeah. But it does. It takes longer. And so it was this sort of happy accident that led them to publish their findings and really like show we can make embryos in a lab. As long as we have the right ingredients,

we can make an embryo in a lab. And then the next step. Does that boil your mind just from that thing? Just from that, just from that accident. And so the net, and now I say just from that accident, just from the years and hours of research. Right, yeah, of course, right. That's what you always forget, right?

The Miriam had done, yes, leading up to this one little, little drop of luck that fell into that. Louis Pasteur just left some bread out and turned green and we have antibiotics. Exactly. It's like, okay, I lost my damn pal. Exactly. There has to be, the mind that experiences

these happy accidents has to be prepared to understand the importance of the happy accident. Right. Because in the wrong hands, it is nothing more than a mistake that is discarded and forgotten. But Miriam Minkin understood because of all the work she'd done.

So anyway, they publish, this is fantastic. The next step, of course, is gonna be, we can make an embryo, can we put it in someone else's uterus? Or, I mean, in this case, these were all people who had undergone hysterectomy, so you wouldn't put it in their uteruses, but could you take it out of somebody and then put it back

and then help somebody who was having trouble getting pregnant get pregnant? Could we do this was the next question. However, Miriam Minkin was in kind of an unhappy marriage. Her husband had a career as well and he told her it was time to move. You're gonna have to quit this work in this lab cause I've got this new job opportunity we're moving.

So the research in John Rock's lab on IVF stopped when Miriam Minkin left. Cause she was the one who knew how to do it all. I mean, he probably got a lot of the credit for it. But she was the one who knew how to do it. And so it really kind of stalled the development of IVF for quite a while because at that moment, I mean, like we're moving into the 40s and then the 50s

and birth control is the next big. Right, battle fit. Yeah, and so a lot of these scientists start studying how to make an effective oral contraceptive and abandon IVF research really. And so at that point IVF research kind of stalls. She eventually would divorce her husband, which I mean, this is a huge deal in the 40s and 50s, right? She divorces her husband, gains custody of her child as a single mother, goes back to Boston to work in Rox lab, but it's just, I think the moment where she was gonna have

that momentum to get to do that, especially somebody who was practicing without a PhD, because it would have been so difficult for her to obtain at the time. And she just wasn't able to do it. But building on that research, you see finally, like in another 10 years, there's an Ann McLaren who repeats some of this work

in mice and sees that it works. There is a Dr. Chang who does some, you know, work in rabbits, kind of repeating some of these things to take the embryos and re-implant them and shows that it can work. So we see some more animal studies, but we don't see it repeated again in humans really until the late 60s, like 1968 is when the research starts with two scientists, Steptoe and Edwards, and then they finally in 1977 are able to successfully implant an embryo into a human uterus resulting in the birth of the first baby ever conceived by IVF on July 25th of 1978 in Manchester. And her name is Louise Brown.

Anecdotally, and you researched a lot of these. So I'm asking you for an anecdote right now. But it feels like there's more women involved in the research of this for the time period than we typically would hear about on an episode, especially a research-centric one. I think you are absolutely right. And I am now just sort of hypothesizing.

So this is my- I got a hypothesis too about the same thing, but I wanna hear what you- This is my educated guess as to why moral women would be involved. Because the reason that IVF would become so important was for primarily women who had infertility and wanted to conceive a child

of their own. This was a woman's problem. That was what I was wanting. That was what I was, it felt like that. And obviously something like this would need lots more, you know, research and stuff like that, but it feels that way. Like it was treated as very much like,

well, this research can go dormant for X number of years, right? Because you don't, it's not- And if you think about like- A quote unquote, men's problem. Exactly. Because the rise of birth control is really like, on one hand, it's the sexual revolution, right?

If I can control whether or not, I mean, I am a cis woman, I have the ability to become pregnant. I, if I can control whether or not, I am going to become pregnant with birth control pills, meaning that I have that control over my body. So I can now have sex if I want to, but not become pregnant.

That is, you know, then it has always been pitched as like now I am free, that is reproductive freedom. But it also does benefit my partner, right? If you don't want me to become pregnant, this is great for you. I don't have to become pregnant now. You are not, and I mean, I think, especially if we're looking at the 50s

in a very heteronormative traditional sense, you are not now financially responsible for a kid maybe that you didn't want. So there is a benefit to kind of everybody from birth control. In vitro fertilization, I think, and I'm not saying that like a male partner of a woman would not benefit from that, of course.

I mean, there are obviously men who desperately want to have a family with a partner and benefit from this as well. But I think what you're seeing is something that would be driven more so by women who are experiencing infertility. And I mean, maybe that's just the, you know, there's so many areas of women's health

that are poorly researched. And maybe if we had more women always in the sciences, we'd be further along. Of course, things are correcting now, but we're still behind. Anyway, the point is, Edwards wins a Nobel Prize for this, by the way, in 2010, by then his co-researchers had passed away and we don't reward no bells

after you've died. So that was the only reason they didn't get them. But anyway, so now we- It's a lesson to all you scientists though, each of us has to be careful. Well, it took a long time. Like this baby was born in 1978 and he got the Nobel Prize in 2010.

So what- You gotta hang in there though. The simple thing, just briefly, the simple like explanation of what IVF is, what did they finally figure out? Is that you need to take sperm and you need to take egg and you put them together in vitro, which means in glass, but I mean, in a lab is how we,

in vitro has now come to mean in a lab, even though technically it means in glass. That is where like the, and I don't think I've ever used this term, but I keep seeing it as I'm reading articles about it. The quote test tube baby, which you've never heard them. I've heard it, but I don't I would never use that. I didn't I don't understand I really know this. It feels weird. Test tube baby. I think I only heard about it in school when people would try to like use it as a way of alienating kids. Like I don't know if I had any kids in my school, but like it was a joke, you know, that you would, you know.

Yeah, it's, well, it's quoted so often in articles about the history of IVF, like the quote unquote test tube baby and it's like, okay, I mean, I know, but. It's like, yeah, it feels weird. Anyway, it's not necessarily done in a test tube, but there is a lot. Well, actually, excuse me. And then you take, once it's matured to a certain stage,

you take this embryo and you implant it back into the person who would like to become pregnant or multiple embryos. And obviously it's more complicated than just what I sketched out in order to collect the oocytes from the person with ovaries. You have to often take multiple medications to stimulate a bunch of them, maturing all at once,

because usually it's just one at a time. Well, you need a bunch of them so that you can collect multiple, because in them, it's like any procedure, there are risks and complications that can happen. And so the idea that you can just go in, grab one egg, it's gonna be great. You got it, the sperm, it's gonna be great. You're gonna mix it up, it's all gonna go swimming late. You're gonna put it back in, grab one egg, it's gonna be great. You got the sperm, it's gonna be great.

You're gonna mix it up, it's all gonna go swimming late. You're gonna put it back in. Literally. Perfect baby. Like that is not, that is- It doesn't work that way with like typical biological concept. Like I don't know if the right term is, you know. You don't decide like we wanna have a baby, let's go have sex one time and bam.

Like that's not how anything works. So obviously- Yeah, it probably works that way for some people, but not consistent. Well, okay, not consistent. You can't rely on that. So anyway, you've got to, and you go in transvaginally, actually you kind of take a needle,

go through the vaginal wall, go up to the ovary, collect all of these mature eggs that you have created with the meds that the person has had to take for a while. Those are what you're gonna mix, of course with the sperm sample. And then there's, again, there's a ton of timing that is involved in this whole process.

I always used to see the doctor who works at our hospital who specializes in infertility. I would see him at the hospital at all hours because it's an all hours job because- You never know. Right, when certain things happen, when you're at certain stages in embryonic development, like the zygote is moving along,

there's a moment where you need to collect it and put it, you know, implant it. And so he would be at the hospital at all hours too, you know, because you gotta follow the egg. And anyway, it can take multiple cycles of this. It's extremely expensive. And during the process, stuff can go wrong and the embryos might not work right.

They might accidentally be damaged or destroyed in the process. You also could find, if you are doing this for a couple who has a history of certain genetic disorders, they may only want to implant embryos that don't carry that gene for that genetic disorder. Oh, because if you get two of the markers or something. And so maybe they're intentionally not going to implant some of the ones you create.

You're starting to see why this is going to get sticky, right? There are going to be embryos that are never implanted or that are just accidentally damaged in the process. And if those are now children, what are the implications of that for the scientists and doctors who are doing this work, as well as the people who are seeking these treatments? You know, what are the criminal implications? So anyway, the reason that this all came to a head, the reason that there was a ruling is that there was a trial, of course. So there were three couples who underwent

in vitro fertilization at a fertility clinic in Alabama. They all became pregnant. They had babies, okay? Great. However, as I said, you don't just produce the one embryo, you produce multiple. It's an expensive and also, you know, there's pain. So you don't wanna go in there every day.

And I mean, you put the patient through that constantly. You wanna collect extra, have extra, have backup, right? Right. Okay. They're also risk to the medicine. So if you have to stimulate it all over again, that's more risk to the patient. So there's a lot of reasons why you wanna do this all at once. So anyway, the additional embryos

that were not used were frozen. That's pretty standard. They're frozen, they're preserved. A lot of people do this, have frozen embryos stored different places at different facilities throughout the US. This is very common, okay? The idea is that later on, if the people who had the embryos frozen

wanted to come back and have another kid, they could have another embryo implanted, right? They could thought out and do it again. Okay. So the plaintiff's couples embryos had been in the fertility clinic frozen until in December, 2020, when a patient at the hospital

entered the fertility clinics storage area, opened up the deep freeze and stuck their hand in there and grabbed some of the embryos. Now it is so cold that they were, you know, it hurt, right? That hurts your hand to touch dry ice. Right.

So they burnt their hand, it hurt, they dropped the embryos. Okay. Why did they do this? I don't, I mean, I would, I have theories. Okay. But I don't know the, I do not know that piece of the story.

Okay. I just know this piece. So anyway, embryos were destroyed. These, the couples brought a suit against the hospital, right, for negligence for a lot. I mean, like, why was it, how did this happen? I mean, why, where's the lock? Where's the lock?

How did this happen? How did this happen? Yeah, yeah. But then they also alleged a wrongful death of a minor. That is an Alabama specific statue, which basically says this is used more often in the, I mean, I think this would be like a good representative anecdote.

Let's say that a person who is pregnant is hit by a car and they lose the pregnancy or both the person who is pregnant and the, the developing fetus dies. Losing the pregnancy regardless. The person who was pregnant and the the you know The person who hit them could be charged not just with the death of the person who was pregnant but With the developing fetus as well That is where the wrongful death of a minor comes into play. It had never been used to apply to a

An embryo to something that isn't in a uterus already. Right, right. Like it had never been used this way. And it dates back to 1872, by the way. However, now it applies to embryos as a result of this Alabama court ruling. Cause that's what it came right down to. They said, well, obviously this can't apply here

cause embryos aren't people. And the Alabama Supreme Court said, well, in Alabama, they are. So as a result, the immediate consequences were... It's wild because, and I'm ignorant of all this so excuse me, but it does seem like the Supreme Court, considering the wild law that was already there, did this was the only logical decision they could make, right? Because it's like, well, if this other wild thing's true, then I guess this wild thing, I guess, man, I guess if we're saying that embryos are people, then if that is true when the embryo is in a parent, then it's true in a test tube,

because we said this dumb thing about embryos being people. Yes, I mean, but it's all, I mean, like, you're building a house of cards, though. No, I know, I'm saying it's like the wildness, I guess what I'm saying is I thought the wildness of the decision was purely in the, like I can see how the waterfall happened. Like I can see the line, it wasn't like a absolute pivot left turn,

you know, like shocker, this is in, this is consistent with the bad decisions that have come down To this point right just a logical end point of this like very slippery slope sure well, and that is I mean if you consistently Claim that you value human life, but actually you don't value Human lives that exist at this moment just this potential for better human lives that you wish existed or want to exist or think other people should have, then I guess this is where you end up. Yeah.

So like I said, two of the major fertility clinics in Alabama paused immediately following this saying, you know, what, we don't know what the implications are for us and we don't wanna get sued and we don't wanna go to jail for the wrongful death of a minor. Right. And then there were people who were in the middle

of fertility treatment cycles. They were like, what do we? Who were left in the lurch. Like some people had to go out of state immediately to try to find somebody to continue the process because they were stuck. So because the problem is that like I said, as you're thawing out embryos,

as you're transferring them, as you're doing all this, there is stuff that can go wrong. And now all these fertility clinics could be charged with, I mean, it's a criminal charge. You know? So the result of this, and you may have seen all the interviews

of various lawmakers at various levels who clearly didn't understand because they said, well, this is great. We love this because we want more babies born. Great. Okay. But this is stopping babies from being born. So what do we do with that? So what do we do with that? So as a result, the Alabama state legislature took swift action and both chambers passed their own version of a bill that would protect people who work in IVF

from any sort of criminal prosecution. Except they each passed their own bill and- Now they have to approve the other ones. Well, now they gotta be reconciled, right? So they have to have reconciliation of the two bills. And then that final language has to be approved by both chambers. And then that has to go to the governor for signing.

So maybe sometime next week. This all, by the way, just like as I'm reporting on this, yesterday is when these two bills passed through the two chambers. So all of this happened very quickly. It's still in flux. The US Senate could have acted to protect IVF for the entire country, but they didn't

because there were lawmakers who weren't comfortable with that because there are lawmakers who are saying, well, I don't know, maybe those embryos and maybe all those frozen embryos are potential people. Well, no, it's- Maybe they're people, I shouldn't say potential, they're saying maybe they're people. They don't believe that.

This is what the thing, they don't believe that, they don't. What they think is, I don't know, I live in an ultra-conservative district and if someone comes to flank me on the right, as we've seen happen so many times in so many states, is that I don't want them to be able to say, you can well, if I've, if I'm saying that conception begin, like life begins at conception, then I have to go down all these other logical paths that make no sense. That don't, that it's, it's completely been on house cards. But if I say, well, yeah, IVF is okay, then some maniacs going to come for me on the right and say, you voted to let embryos get flushed down the toilet. Is that who you want? Like, Well, and that's, I mean, you're exactly right though,

because that's, so the question is, what do we do with all these frozen embryos? Do they all have to be implanted then? And if you don't want more children, but it's your embryo, do you have to? Do you have to store them in perpetuity? That's what these clinics are saying. So like, do we just have to pay to keep these stored

for the rest of time? For the time? I mean, or until someone else agrees to, I don't know, be a handmade and grow it for them. Please take these babies. This baby's been kicking around here for 300 years, please. Well, I mean, that's the question. And then the other thing is sometimes we don't implant

an embryo because it didn't develop in the way we expect it to. And it has fatal mutations that will result in a non-viable pregnancy, meaning this person will miscarry. But it is still technically an embryo. Yes, but it is an embryo. Do we force couples to have those? Do we force someone to have an embryo

when planted in their uterus saying, you will miscarry this, but we have to make you go through this before we can give you one that developed properly in a Petri dish? Is this what we do? And is this a pro-life, I'm using finger quotes, stance if you do this?

And so all of these questions have been brought up by this. I don't think that the actions- Would it be a killer time for those questions? Do you know an absolutely killer time for those questions would have been before? Which is exactly- Would have been a slam dunk. Because they were interviewing Governor Abbott

from Texas about all this. And he was saying- Another real demo. Yeah, exactly. And he was saying the same kind of thing. Like, well, I mean, you know, every life begins with conception. I really, you know, this is important, you know, although I'm Supreme Court. But then as he's talking about the IVS, he said, well, you know, these are things people didn't expect to happen. They didn't see this coming. They didn't see

these consequences. They didn't... Exactly. So why are you doing it? If you didn't think it through, if you don't understand, if you don't know what you're doing, don't do it. I mean, talk about the eight. this is, I know this is relevant, but are you able to talk about the test strip thing? Oh, well, yeah, I mean, I can talk about that. Cause I think it's really illustrative of the point, right? I think we've mentioned it, maybe, we did an episode about xylosing before, which is a new,

a veterinary sedative that is now infiltrating the drug supply in many parts of the US and other places certainly too. But it is very dangerous and can cause a lot of problems for people, right? It is not supposed to be used in humans. We tested it out a long time ago back in the 60s. It hurts people, but now people are unknowingly injecting it into their bodies. So we have test strips that you can use to dip into a sample of drugs and see if there is xylosine in it so that you can avoid this deadly contaminant. However, our state legislature last year, in an effort to recognize xylosine as a scheduled

substance of concern. Inadvertently wrote that all drug paraphernalia associated with xylosing would also be banned, right? Like we're naming it a drug and everything associated with it is now illegal, including test strips. So they banned xylosing test strips in our state legislature last year

because they didn't, because they don't know what they're doing. And I mean, which is like, that's a whole other conversation, right? In the war on drugs, we've never known what we're doing. We've always been doing the wrong thing, which is what got us here. But it took a whole session for us to fix it.

So now we've had to go back, wait a whole year for them to fix it so that I can once again, legally hand out these test strips, because I would never hand them out illegally. That would be wrong. I would only hand them out legally. Yup.

That's what I've been recorded as saying on this podcast is I would only ever hand them out legally. And now they're legal, so. So here we are. So here we are. Here we are. If you're curious, by the way, there've been 12 million IVF births worldwide

since it was first, you know, invented 8 million in the US. 2% of babies in the US are born using IVF. That's a fairly high. I mean, a lot of people use this medical treatment. And if you don't understand medicine, you should probably stay out of its way. Thank you, Sydney, for this important episode. Thanks to you for listening.

Thanks to the taxpayers for the use of their song medicines as the intro and outro of our program. Thanks to you for listening. We're so appreciative that you are here. But that is gonna do it for us for this week. Until next time, my name is Justin McElroy. I'm Sydney McElroy. And as always, don't drill a hole in your head. Alright! Yeah!

Maximum Fun. A work-grown network of artist-owned shows. Supported directly by you.