CROSSROADS IN EMBRYOLOGICAL RESEARCH - ETHICAL CONSIDERATIONS

At the close of this year, 15,000 children will have been IVF-produced, in France, making 12,000 happy couples. However, in our opinion, this achievement is not fully satisfactory. Although we are able to control the state of the two gametes, their fertilization, the onset of segmentation, and that we put back up to 2, 3 or 4 zygotes, why have our pregnancy rates reached a 20-25% upper limit? Of the few thousands eggs kept in our freezers, only a small proportion really represent future human beings. Doubtless, this proportion will improve, but such improvement will only confirm the questions we raise. Should we continue to produce these in excess, and to whose intent? Should we destroy the ones we have been storing up? Summing up the current situation, one could say that we are able to produce too many oocytes, and that one is driven to make use of this ability - and indeed misuse it, because of one's poor command of what is being done. Therefore, the answer to these questions obviously does not lie in mere ethical or moral thinking, but depends upon technical developments as well. However, any technical improvement beyond certain rates of positive results is hard to come about, and may prove impossible, at times, without new knowledge acquirements. Can such new knowledge be obtained from eggs derived from other mammals, or must we absolutely use human eggs? Practitioners will only take out less oocytes, when they can be sure of their quality. In fact, any experience aiming at developing egg quality tests requires that fertilization and segmentation be used as reference criteria. Works performed on other mammals are too rare to help one hold back from practicing upon human eggs. Shall we be doing so, or shall we wait patiently for fundamentalists to provide their answers, and keep on filling up our freezers with human projects in the meantime? There are a number of other situations in which human eggs may appear as beeing irreplaceable (study of causes of tubal implantation, of new contraceptive methods involving fertilization). Human experimentation is often required. It never involves choosing between life and death. The same does not hold true as regards the human embryo. The more advanced its development, the greater our responsibility in terms of what this human project will become. We shall endeavour to identify some true problems, and to set reasonable scientific / deontological limits to their approach. In no way, however, can we accept that a human project be utilized for acquiring notoriety for oneself.