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Already, we see early signs of this connection in states like Massachusetts, where generous insurance coverage has dramatically increased demand for fertility services. We see it as well in countries like England, Denmark, and Israel, where state funding has likewise reduced the price and expanded the demand for treatment. [95] And we see it across high-tech industries like personal computers and DVD players, where goods that were initially considered expensive luxury items migrated over time to the mass market, earning their manufacturers considerably greater reward. This is the mathematical reasoning that drives most of American capitalism, the reasoning epitomized by Henry Ford’s 1908 decision to manufacture the all-black, mass-produced Model T car. In most areas of medicine, such reasoning is clearly inapplicable: no matter how low the price falls for open heart surgery, demand for the service is unlikely to rise by very much. In fertility, by contrast, demand could well soar, driven both by the 75 percent of infertile couples who currently choose not to pursue treatment and the more amorphous pool of fertile individuals who might selectively employ the techniques of assisted reproduction.

If the market is left purely to its own devices, however, this kind of widening is unlikely to occur. Although some clinics will move aggressively into the volume market and some, like the members of the ARC Family Building Program, will begin to play with price, there is still considerable room at the top end of the market and little incentive for treatment providers either to reduce prices or to attract government intervention.

There also is little reason for any of these providers to engage with the social, medical, and ethical issues that emerge from their science. For example, should there be age limits on infertility treatment? Should new procedures be subject to testing protocols? Should multiple births be controlled or limited? Without any outside pressure, the market will tend to answer no to these questions and yes, repeatedly, to the desires of potential clients. Yes, a sixty-three-year-old woman can choose to undergo IVF treatment. Yes, a family with one daughter can choose to conceive a son. Yes, a couple can proceed with the birth of IVF-induced quintuplets. And perhaps they should. But one could also argue that these are not the kinds of questions that markets answer best. Because what happens when the sixty-three-year-old gives birth to a severely deformed child and then sues the fertility clinic for damages? What if hospitals and insurance firms balk at covering the intensive care costs for quintuplets? Without accepted guidelines, private firms and independent physicians are likely to pass along the costs of decisions they are not fully authorized to make.