Science, Faith, and Reproductive Rights

About the expert

Alexander Quaas, M.D., Ph.D.

Obstetrics and Gynecology Reproductive Endocrinology and Infertility

Alexander Quaas, M.D., Ph.D., is board certified in obstetrics and gynecology (OB/GYN) as well as reproductive endocrinology and infertility (REI). Dr. Quaas completed his residency in OB/GYN at Brigham and Women’s / Massachusetts General Hospital in the Harvard Integrated OB/GYN Residency Program. He completed his REI fellowship at the University of Southern California in Los Angeles.

Silvia

Anti-abortion activists adhere to the concept that human “life begins at conception,” when the egg cell is fertilized by the sperm. What is your take on that, and is there any scientific background?

Alexander

The concept that human “life begins at conception” is a religious, not a scientific, definition of life. As fertility doctors and specialists in assisted reproductive technology (ART), we witness and facilitate fertilization of eggs every day: a living cell, the egg, is combined with a living sperm. It takes a while from the moment of sperm binding or the moment sperm is injected into the egg, until the fertilized egg first divides. After that more cell divisions occur as the cluster of cells develops into a blastocyst. The most important aspect here is that this cluster of cells has the potential to help create a new human being under very specific circumstances - these include conditions that are favorable to the growth of the embryo, and the implantation into a receptive and welcoming uterine lining at exactly the right time. To put the cluster of cells with the potential to give rise to a baby on the same moral plane as a human being is an unscientific stretch. People are very much entitled to ethical, cultural, and religious beliefs, and if IVF is not for them, that is a choice that will always be respected. But there is no scientific base for the statement “life begins at conception”.

Silvia

How do you navigate the complex intersection between personal freedom versus religious principles? From your point of view, what would have to happen for peaceful co-existence?

Alexander

There is a simple answer to this question. Everyone has the personal freedom to have their own principles, including religious beliefs and moral or ethical standards. Every individual can decide for themselves what scientific and medical advances they would like to take advantage of. In my view, there is only a major problem when some people, including lawmakers and stakeholders, impose their moral and religious beliefs on others, thereby restricting the personal - in this case reproductive - freedom of others. Every member of society should have the freedom to decide what treatment for the disease of infertility is acceptable, and what is not.

Silvia

You practiced in Switzerland - a country with stricter embryo protection laws compared to the United States. What were the pros and cons regarding the laws there?

Alexander

Historically, restrictive reproductive legislation in Switzerland represented an obstacle to the delivery of state-of-the-art ART care to the Swiss population. Until 2017, prohibiting the cryopreservation of blastocysts impeded the evidence-based practice of reproductive medicine, with negative health consequences and treatment outcomes for patients. The favorable change in the Swiss law that was implemented in 2017 immediately had positive consequences on the practice of reproductive medicine. The percentage of single embryo transfers instantly doubled, time to pregnancy decreased, and multiple pregnancy rates with its adverse consequences for patients and the health system drastically decreased.

Silvia

What does reproductive rights legislation need at the moment from your point of view?

Alexander

The basis for adequate reproductive legislation to ensure state-of-the-art fertility care for patients is an increased understanding and increased awareness of the scientific basis for what we do. The current public debate after the Alabama ruling has uncovered appalling gaps in scientific understanding in the people that decide on reproductive laws. People need to understand that if a lawmaker says “embryos are children” and “we want to help families have more babies” in the same breath, then they do not have an understanding of the current controversy. Giving the same moral and legal status as children to embryos has negative consequences for the delivery of state-of-the-art assisted reproductive technology.
The best thing that could happen for reproductive legislation would be that the decision-makers have a scientific understanding of the matter at hand. This can only happen if legislators educate themselves appropriately with the help of experts, or if they are replaced by experts. A great start would be an increased understanding of what we do in the public - the current emerging debate leading to increased awareness is a step in the right direction.

Silvia

Alexander, thank you for your time!