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In the United States, much more so than in Europe or Canada, the private market has already pushed the social and scientific boundaries of assisted reproduction. Only in the United States can a young woman “donate” her eggs for $50,000. Only in America can two gay Britons pay tens of thousands of dollars for the privilege of conceiving “their” child in a third-party womb. Yet even in the United States the market for conception has certain limits, some of which, ironically, may work against the pursuit of profits. The market for fertility hormones, for example, would almost certainly be widened by federal guidelines mandating insurance coverage. Even if prices were capped below current levels, an increase in demand would significantly mitigate any downward pressure on profits.

Similarly, greater regulation of fertility clinics could actually expand the market for fertility services, in addition, potentially, to making it safer and more equitable. Recall that in the United States, only 1 percent of women with fertility problems employ IVF and other high-tech treatments. In Denmark, by contrast, where the state guarantees three free cycles of IVF to all infertile women under the age of forty, demand for the treatment is widespread: in 2001, 3.9 percent of all Danish babies benefited from some sort of assisted reproduction. [96] Similarly, although privately funded researchers in the United States have contributed mightily to the emerging science of assisted reproduction, so have researchers from the United Kingdom, France, Israel, and Australia—all countries where fertility clinics and access to fertility services are regulated much more tightly than in the United States. On these grounds, there is little to suggest that regulation of the fertility industry is destined in any way to diminish scientific innovation.

Finally, although most U.S. fertility practices are delighted to remain in the gray area of private regulation, history suggests that over time clarity is far more profitable than ambiguity. For as long as conception remains a furtive trade—a business cloaked in the garb of science—it will remain vulnerable to both the excesses of its fringes and the attacks of its critics, to the doctors who push science beyond what society will accept and the fundamentalists who react to the advance of reproductive technology by pushing for complete and outright bans. We will return to these issues in chapter 7.

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