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One reason for the low number of births, says Silber, is that the technology is so new that few of the women who've had their eggs or tissue frozen have yet to request that it be transplanted back. Price, too, is a factor. Ovarian-tissue freezing costs $6,000 for the initial surgery and another $9,000 to have the tissue reinserted. Egg freezing comes with a price tag that can stretch higher than $50,000. Moreover, insurance rarely pays for the procedure even for women who risk losing their fertility due to cancer or illness.
"Price is definitely one of the ethical issues I have with this," says Arthur Caplan of the Center for Bioethics. "If insurance isn't paying for this, is it only the wealthy who get the opportunity to prolong their fertility?"
Dr. Battaglia, meanwhile, presents another possible moral and legal conundrum. "At what age do you tell a woman she can't have a child?" he asks. "After all, they are her eggs. Doesn't she have a right to them?"
Silber acknowledges that a woman implanted with ovarian tissue could theoretically begin ovulating again at the age of 70 or older. Just last year a woman in Spain became the world's oldest mother when, at 67, she gave birth to twins conceived through in vitro fertilization. "I think most people would say 55 should be the cutoff," says Silber. "And even that is an extreme example. Most people will want kids sooner."
Women who deliver babies late in life have an increased chance of developing diabetes and hypertension. But Silber believes babies born from the frozen eggs should suffer no inherent heath problems due to freezing. Mothers have used frozen embryos and frozen sperm to produce children for more than twenty years with no ill effects, says Silber. He believes frozen eggs will be no different.
As for ethical concerns, Silber says they're a non-issue because the procedures remain patient-driven. "There is no ethical problem provided there's an internal review board which we have and the patient's consent," he says. "What am I supposed to do, deny the patients' wishes?"
Today is not the first time Dr. Sherman Silber has upstaged the medical community. For that, you'd need to travel back to San Francisco, 1975. The American College of Surgeons is in town for its annual conference, and Silber, then a 33-year-old urology professor at University of California at San Francisco, is about to lay claim to the world's first-ever vasectomy reversal.
Most researchers might debut such an achievement in the pages of a medical journal. Not Silber. He's going to unveil the complicated procedure live via closed-circuit television in front of all 20,000 doctors gathered at the conference. The cameras are rolling when Silber looks down to see his usually steady hands trembling like a candy-jacked kid about to play Operation.
"My hands never shake!" proclaims Silber. "But now they won't stop, and the microscopic lens of the camera makes it look even worse."
So what does Silber do? He acknowledges his quivering fingers to the audience and then performs the incalculably difficult task of sewing up the damaged vas deferens a sperm duct as tiny as the period at the end of this sentence.
The next day, October 15, 1975, the New York Times splashes Silber's name across the front page in an article headlined, "Vasectomy Now Reversible with Microsurgery." All of a sudden hundreds of men are calling to ask beg, even that Silber make them fertile once more. "We're so overwhelmed the head of my department tells me, 'Look, you're going to have to stop what you're doing and open an infertility clinic.'"
Silber leaves California for his wife Joan's hometown of St. Louis, where he can better accommodate the patients flying in from all over the country to see him. He calls his clinic at St. Luke's Hospital the "Infertility Center of St. Louis." In 1978 identical twin brothers knock on his door. One of the twins is virile, the proud father of three healthy children. His twin was born without testicles. So Silber takes one of the brother's gonads and transplants it into his twin. It's the world's first-ever testicle transplant, and again Silber garners headlines. The former eunuch goes on to father three kids of his own.
Next, Silber performs the first tubal-ligation surgery in the United States that is, the procedure that restores fertility to female patients who'd willingly had their "tubes tied" to avoid pregnancy. Later he pioneers a technique for retrieving sperm from impossibly sterile men. He writes a best-selling book (400,000 copies sold to date) called How to Get Pregnant and becomes a regular on the daytime talk show circuit: Oprah, Good Morning America, The Today Show. Phil Donahue invites him on his show a record eight times.
The little Jewish kid from south Chicago is every bit as successful as his parents dreamed. Though was there ever any doubt? All his life his immigrant folks his father from Poland, his mother from Lithuania prodded him to study and become a doctor. Even when he attended University of Michigan on an academic scholarship and flirted with the idea of getting an advanced degree in English, it was his parents who called him back to medicine. They themselves hardly had grade-school educations, but this they knew: Doctors don't live in the slums of south Chicago, English professors do. "Education is the only way out of the ghetto. My parents never quit reminding me of that," he says.
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