BusinessWeek magazine: The most-read source of global business news

Advanced Search
Top NewsBW MagazineInvestingAsiaEuropeTechnologyAutosInnovationSmall BusinessB-SchoolsCareersBusinessWeek Channels : BW Magazine, Daily Briefing, Investing, Asia, Europe, Technology, Autos, Innovation, Small Business, B-Schools and Careers

Get Four
Free Issues

Subscribe to BW
Customer Service

Full Table of Contents
Cover Story
Personal Tech Special Report
Special Report
Up Front
Readers Report
Corrections & Clarifications
Technology & You
Media Centric
Business Outlook
The Business Week
Washington Outlook
Global Business
The Corporation
Science & Technology
Information Technology
Inside Wall Street
Figures of the Week
Ideas -- Books
Ideas -- The Welch Way
Ideas -- Outside Shot

FEBRUARY 27, 2006

And Baby Makes...A Market

How Money, Science, and Politics
Drive the Commerce of Conception

By Debora L. Spar
Harvard Business School Press; 298pp; $26.95
(Readers' Reviews below)
Editor's Review Star Rating
The Baby Business

The Good A provocative examination of the fertility industry in America.

The Bad Its business analysis of an unbusinesslike subject can be unnerving.

The Bottom Line A valuable, thought-provoking look at the baby-making business.

The Centers for Disease Control & Prevention reports that 12% of U.S. women between the ages of 15 and 44 -- some 7.3 million in total -- experienced infertility in 2002. In addition, an estimated 30% of adult men are infertile. That means one in every eight couples is unable to conceive children by natural means. Behind that number is a lot of heartbreak, yearning, and a huge market: Fertility clinics in the U.S. collected $2.7 billion in 2002.

It's a market unlike any other, however, because no one wants to acknowledge its existence. Baby selling may be outlawed in every nation, yet every day, in every country, money and the means for having children change hands with little government oversight. "When parents buy eggs or sperm; when they contract with surrogate [mothers]; when they choose a child to adopt or an embryo to implant, they are doing business," writes Debora L. Spar, a professor at Harvard Business School. "Over the past 30 years, advances in reproductive medicine have indeed created a market for babies."

Spar dissects this thriving industry in her provocative The Baby Business: How Money, Science, and Politics Drive the Commerce of Conception. The book, though well worth reading, is somewhat unnerving in that it brings matter-of-fact business analysis to the creation of children, surely one of the most unbusinesslike of subjects. Still, it is a valuable if occasionally dry look at a sector of the economy whose customers are usually far too emotional to clearly assess just what it is they are paying for.

Spar starts with a history of the baby-making business, going back as far as the Old Testament story of Jacob's wife. After failing to conceive she sent Jacob to sleep with her maid and adopted the resulting child. There were few other means for coping with infertility until the 1920s, when the hormone estrogen was discovered and mass-produced. By the late 1930s, most major U.S. cities had at least one fertility practice administering estrogen. After a woman using hormones gave birth to quintuplets in 1970, demand soared.

The industry really took off in 1978 with the birth of Louise Brown, the first test-tube baby. She was created by in vitro fertilization (IVF), in which an egg is extracted and combined with sperm in a test tube. The fertilized egg is then implanted in the mother's womb. An international outcry ensued, typified by the reaction at the time of biologist Leon Kass (who went on to chair President George W. Bush's Council on Bioethics): "This blind assertion of will against our bodily nature...can only lead to self-degradation and dehumanization." In the wake of Louise's birth the federal government set up a commission to figure out what to do about IVF, but it never issued any recommendations. Instead, by 1983 some 150 babies had been conceived in vitro, and the furor had disappeared.

Today, desperate couples go through round after round of IVF, at an average cost of $12,400 per try, even though the average success rate is only 25% and drops as low as 9% if the woman is over 40. High cost and poor results would be a death knell for most businesses, but in the emotional world of infertility, couples often keep paying until they run out of money; very few run out of will. Those who do give up can turn to adoption along with about 120,000 other U.S. families each year, shelling out up to $35,000 per child.

The most disquieting parts of the book are those chapters that detail some very advanced reproductive technologies. Doctors can now remove one or two cells from a two-day-old embryo in a test tube, tell the parents its gender, and test for certain genetic defects. The parents then choose which embryos they want implanted. Scientists are also only steps away from cloning a human.

Of course, the fact that couples can use such high-tech methods doesn't mean that many will. As one fertility expert says: "Most people would rather have sex." Then again, the desire to have one's own biological offspring can be insatiable. Spar quotes an infertile woman who says cloning may not be right for everyone, but "if the only way for a person to have a child of their own is to do this, and if they are willing to take a chance, then they should be able to."

Spar raises some troubling ethical issues surrounding the baby-making machinery. Science is handing us the ability to choose the method of conception and its likely results, yet there is little public debate and even less regulation surrounding these choices. "We can moralize about these developments if we desire," she concludes, "or we can plunge into the market that desire has created, imagining how we can shape our children without destroying ourselves."

By Catherine Arnst
  • Home Equity and Mortgage Loans - E-LOAN  Online Lenders Offer Home Equity Loans, Cash Out Refinancing, Mortgages, and Auto Loans at Low Rates. Approval in minutes.
  • Trade with  Sign up for a free $25,000 practice account. Advanced trading platform with real-time quotes, charts, news, research. Mini accounts from $250. No commissions - ever.
  • Chevron Energy Debate: Will You Join Us  Get information about energy and environmental issues in our world today. Chevron invites you to join an online discussion about some of the energy issues we face.
  • Credit Card Processing  Free Quotes from Multiple Vendors. Compare Prices and Options - Save time & Money
  • Try WebEx Web Conferencing Free  WebEx online meetings and web conferencing solutions: Meet colleagues online, host web events, train your staff, provide live support. Try it out free now.
Buy a link now!

Get BusinessWeek directly on your desktop with our RSS feeds.XML

Add BusinessWeek news to your Web site with our headline feed.

Click to buy an e-print or reprint of a BusinessWeek or BusinessWeek Online story or video.

To subscribe online to BusinessWeek magazine, please click here.

Learn more, go to the BusinessWeekOnline home page

Back to Top


  1. S&P Cuts Target Price on Apple
  2. Computer Sciences Goes on the Block
  3. The Alcatel Effect
  4. Citi: Back in the M&A Game?
  5. Microsoft's Wireless Watershed

Get Free RSS Feed >>
DJIA 11194.64 -9.30
S&P 500 1307.44 +1.51
Nasdaq 2347.66 +2.30

Media Kit | Special Sections | MarketPlace | Knowledge Centers
McGraw-Hill Cos.