Do fertility doctors capitalise on patient desperation?

This week's BioNews includes the story of Pauline Lyon, the 56-year old woman who has just given birth to her second IVF child. The news of the birth has prompted a familiar debate about the rights and wrongs of post-menopausal women having children. But another theme has emerged in the discussion: that IVF patients are desperate and will do almost anything to have a child.

In the Guardian, Joan Smith commented on Pauline Lyon's apparent desperation. Besides hiding her age from her first fertility doctor, she had, in the quest for a second IVF child - advertised for an egg donor in the window of her local newsagent. She had also, according to Smith, showed scant regard for the welfare of her child.

Catherine Bennett, writing in the same newspaper, went further. For her, indulging people's desperation to have a baby is not only harmful to the resulting children, it is harmful to the patients too: '[desperation] is an expected and even useful quality, which justifies all manner of unpredictable and experimental treatments'.

Besides Bennett's unsubstantiated claims about IVF treatment, both commentators do a disservice to IVF patients. Smith and Bennett suggest that these people are either self-serving and craven or that they are hapless victims, ready and willing to be duped by scurrilous doctors.

Fertility patients are not selfish or stupid, as Smith and Bennett seem to suggest. Because of the relatively low chance of success, the emotional strain and the disruption of everyday life that IVF treatment entails, these patients tend to think long and hard about whether they want to go ahead with treatment. The financial cost of IVF alone means that prospective patients are more likely to be put off treatment than they are to be encouraged to go ahead. We all know that when a lot of money is involved, we make sure that what we are getting in return is worth the cost.

In one way, all of us are desperate when we become patients. We are desperate to get well - to have our bodies restored to their natural function. But this doesn't mean that we will allow doctors to do anything in order to cure us - quite aside from the issue of what it might cost us. If other patients can be trusted to make sensible decisions about their treatment, why can't IVF patients be afforded the same privilege?