The Elusive Embryo: How Men and Women Approach New Reproductive Technologies (review)

Gay Becker.The Elusive Embryo: How Men and Women Approach New Reproductive Technologies. Berkeley: University of California Press, 2000. 330 pp. $45.00 cloth; $17.95 paper.

"The effect of finding out about the infertility problems for me was that I felt completely useless. I felt like, basically, a piece of garbage" (39), says Marcy, a thirty-three-year-old woman interviewed for a large ethnographic study for Gay Becker's book, The Elusive Embryo. The pain in this woman's response to the loss she feels illustrates the vast and profound cultural paradigms reproduction carries for women and men in this society. Trying to understand infertility from a consumer's perspective, Becker has collected a fascinating array of feelings, from happiness to despair to anger, from 300 men and women over four years as they embark on reproductive decisions and the use of new reproductive technologies. The result is a thoughtful and insightful review of the way new technologies have been accepted as a necessary part of infertility and the problems these new technologies cause for men and women who are trying to sort out their places in a world in which reproduction and gendered roles are so deeply ingrained in society.

According to the latest available data from 1995, infertility affects 6.1 million women age fifteen to forty-four and 2.1 million married couples (National Center for Health Statistics 2001). As a result, over 9 million women have used infertility services such as the technologies Becker illustrates in her book. Because of this large number, which is only increasing as the visibility and acceptance of reproductive technologies increases, Becker works on the premise that these technologies "embody cultural phenomena and become entwined with people's lives" (5). Becker shows through research and extensive analysis that men and women, caught up in the swirl of new medical reproductive technologies, are struggling to find what is an acceptable price to pay, both economically and psychologically, for genetic offspring. What is evident in so many of the testimonies is the ambiguity about the need for genetic offspring to fulfill a cultural expectation for both men and women and how this expectation appears to be exploited by the unregulated industry of reproductive technologies. Becker methodically chronicles the growth of an industry that caters only to those couples who can afford its services and only those couples who feel compelled to conceive at all costs. The ways in which women appear to become secondary to the placement of an embryo in an acceptable uterus pushes a moral economy that maintains the ideas of patriarchy and genetic superiority as clear ideologies on which reproduction is placed. When choice is taken away from the individual and physicians are made gatekeepers of knowledge (139), children become simply a product, reducing reproduction to a win/loss column.

Becker also shows that gender messages that encourage both men and women to become parents are so strong they contribute to the growth of the industry. As she says, "cultural dialogues about gender, parenthood and family are embedded in social institutions such as biomedicine" (35). These are found in all areas of health care, from physician and patient relationships and institutional policies and laws to the worth assigned to medical research, diagnosis, and treatment. The power of infertility specialists to impose the idea of "genetic essentialism" (Nelkin and Lindee 1995), in which genetic offspring are deemed culturally superior and that biological ties equate to social ties, is very real for consumers. This message, often reinforced by health care providers and biotechnology, heavily weights a genetic choice to define a family and meaning of being a parent. It also threatens to normalize a type of eugenics, possibly creating a genetic superclass of children that, as Angela Y. Davis (1998) surmises, complicates and deepens power relations based on class and race.

A subtext to...