Two points in this interview I'd like to address - the first is Spar's assertion that in almost all IVF cycles excess embryos are created. Many women doing IVF are not great egg producers to start with, which is why they're pursuing fertility treatment. They don't end up with many embryos to put back, let alone have many left over.

The other problem I have is the emphasis placed on multiple births due to fertility treatments. Yes, it does happen sometimes, but this angle has been so played up by the media that people seem to think anyone that has IVF is going to end up with quintuplets. In actuality it's uncommon, and most reputable IVF doctors do everything to minimize the chances of this happening. It's rare to find a doctor willing to put back 5 embryos back into a healthy young woman.

Spar seems to conclude that more government regulation is needed, but the one thing that would really make a difference is if more insurance companies offered infertility coverage. These treatments are very expensive and few couples can afford to do them more than once. Desperation drives people to do things that are not always wise.

I will never understand why couples will spend thousands of dollars to have a child that is produced by using both donor eggs and sperm. Don't they realize that the child is not genetically theirs in that situation. Wouldn't adoption be a better alternative. It amazes me that with so many unwanted children in America and around the world, the lengths people will go to in order to conceive. I can understand some people have the need to "have their own children" but again, if the children are conceived using both donor eggs and sperm, the child is not genetically related to the parents, so why not adopt.

I can't get over the parents who say they want their child back. I understand that they're grieving but how can they believe their special little pesron could be reproduced? I mean, it wouldn't be the same person, not the memories, experience or personality. At best you'd get a physical resemblence, but everytime he gave you that smile just like the first did, wouldn't you cringe knowing they weren't the same? It'd be a constant breathing reminder of your loss.

I've also seen, first hand, where this thinking leads. One of my best friends in high school had an older brother who died and her parents in their grief decided that they wanted to have another child (my friend). I can appreciate missing having a child and wanting another, but they didn't want another, they wanted a replacement. They gave her a female version of his name, told her constantly how much she was like him, how they missed him, that they couldn't have him back, but she was there instead. You have no idea how much this messed my friend up. She is a unique human being, funny and bright and very much her own person and she spent her entire childhood feeling like a new car to replace the one that was smashed up. And, no, her parents were not monsters, they were kind and loving people with huge blindspots when it came to the intrisic worth of a child.

People like that would be first in line to order a clone. No one wants to tell a grieving parent no, but it is cruel all around to pretend that getting a child "back" is possible.

As another letter pointed, the issues of multiples and excess embryos are not significant problems. Most women suffering from infertility face the problem of no children versus too many. I have gone through several infertility treatments and have never produced enough embryos to freeze and have never been pregnant.

Further, in the United States, the vast, vast majority of reproductive endocronologists (REs) no longer transfer a large number of embryos back into a woman -- women under 35 receive no more than two, women 35-40 maybe three and over 40 upto five -- unless, there is a history that indicates the need for transfering more such as repeated failures. And in countries where IVF is covered - Australia, UK - the maximum transferred is two.

What really needs to be regulated is the treatment women receive. There is no established standard of care for REs and many women are subjected to outrageous, unprofessional treatment at an outrageously high cost. Many REs have too many patients and have been allowed to get away with behavior that no other professional medical care provider would.

Regarding the judgmental, "why not adopt" reader, why is it that infertile couples have the mandate of adopting the world's children? This argument can be applied to fertile couples,i.e., with so many needy children, why create more? Are you going to adopt? If not, why not? It doesn't feel so good to have to explain your reproductive decisions, does it? Wanting a biological child is a basic human instinct that one should not be put in a position to defend. And by the way, adoption is not that easy, and also EXTREMELY costly. I know, because I have begun adoption process and it is daunting.

It's disappointing that even a Harvard professer goes for the glintzy, shocking, ripped from the headlines approach in analyzing the infertility industry. Yes, multiple births happen, but they are anecdotal and statistically insignificant. There are HUGE problems with the baby business, too bad none of them seem to be addressed in this book.

I wish there had been more discussion about the role of changing marital/fertility demographics in the discussion of the "creation" of this market. Has this market been created, in part, by the fact that people are waiting longer and longer to have children only to find that they are no longer able to or easily able to in part due to fertility issues related to aging?

I'm sure there are many couples who are infertile due to other reasons, but my intuitive vibe (which could be completely off base) is that much of IVF is done for the benefit of women between the ages of 35-45 who have never been pregnant. Fact is, fertility rates just drop of incredibly sharply.

I understand the desire of such women/couples to have children, but I'm not sure it's up to anyone else to pay for it. There are lots of things that one can't do or that become much more difficult as one ages and certainly biological realities kick in...and getting pregnant (esp. primagravid) is one of them.