Dr. John Waterstone:

We have entered an anti-Darwinian situation where, as Dr. Wingfield has already outlined, the problem with a big chunk of our patients in terms of being able to have a baby naturally is the man's sperm is of very low quality and reproductive medicine now has the power to overcome that completely. We can produce a baby so long as we have a few sperm to work with and as long as the woman is fertile enough. What about the children that are the result? Because this whole area of medicine is so young the children have not grown up yet but when they do, one could predict that many of those will not be able to reproduce naturally either because they will have poor sperm, if they are boys, and therefore, we are in a sense perpetuating a problem. We are creating a generation of people who will rely on assisted reproduction to reproduce themselves. Is that good or bad? I do not know. If I have a couple in front of me in my clinic and I say that the semen is very poor but I can do intracytoplasmic sperm injection, ICSI, treatment which is a variant of IVF or we can use donor semen, what will they say? They will say do ICSI because they want their own genetic baby. You are right, Chairman, that to some extent it is anti-Darwinian if one wants to be philosophical about it.