Table of Contents

Part I: Introduction
1 "Take Home Baby": Reproductive dreams and journeys
2 "Not part of the parent club": Problems conceiving a healthy child

Part II: Choosing reproductive technologies
3 Becoming an infertility patient: Choosing treatment
4 Choosing eggs
5 Choosing sperm
6 Choosing embryos to avoid disease
7 "Family balancing": Choosing sex and other traits
8 "Two kids for the price of one?": Choosing twins
9 Choosing wombs
10 Choosing children

Part III: Choosing adults
11 Choosing doctors
12 "Good enough parents?": Choosing patients

Part IV: Facing and addressing stresses
13 "How much is a child worth?": Paying for treatment
14 Emotional roller-coasters: Confronting other stresses
15 Coping and Finding Support
16 "Meant to be?": Choosing religion and spirituality

Part V: Designing our future
17 Choosing education
18 Choosing policies
19 Choosing our future world

Appendices:
A. Glossary of Terms and Abbreviations
B. Methods
C. Sample Questions

Acknowledgements

About the Author

Robert Klitzman, MD, is a Professor of Psychiatry in the College of Physicians and Surgeons and the Joseph Mailman School of Public Health, and the Director of the Masters of Bioethics Program at Columbia University. He co-founded & for 5 years co-directed the Center for Bioethics. He has conducted research and written about a variety of bioethical issues, and has authored or co-authored over 130 peer-reviewed scientific articles, as well
as nine books, including Am I My Genes?, The Ethics Police?, Mortal Secrets, Being Positive, A Year-long Night, The Trembling Mountain, and In a House of Dreams and Glass: Becoming a Psychiatrist. His work has appeared in
JAMA, Science, and other scientific publications, as well as The New York Times, The Wall Street Journal, Newsweek, and The Nation. He has received several awards for his work, including fellowships from the John Simon Guggenheim Foundation, the Russell Sage Foundation, the Aaron Diamond Foundation, the Robert Wood Johnson Foundation, the Rockefeller Foundation, the Commonwealth Fund, and the Hastings Center, and is a Distinguished Fellow of the American Psychiatric Association. He has been a
member of the Research Ethics Advisory Panel of the US Department of Defense, and is a gubernatorial appointee to the NY State Stem Cell Commission.

Reviews

"Klitzman's research will be useful for bioethicists seeking better understanding of the current state of ART and PGD." -- Eric G. Swedin, Prometheus
"This book offers a reminder of the potential of new technologies to help millions more still unable to create their own biological children, while pointing out the complexities and risks these developing technologies will bring. [...] a must-read for any patient considering going abroad to avoid UK regulations that may appear to curtail freedoms but in fact aim to protect patients' safety and rights, and those of any offspring born through IVF." -- Margaret
Gilmore, Literary Review
"Professor Klitzman has created an incredibly detailed, thought-provoking book which shines a light on the dilemmas that fertility patients and medical practitioners face on a daily basis. This book will likely appeal to a wide range of individuals..." -- Bionews
"Klitzman and his interviewees lay out the real-world choices that people make DL surrogacy, in vitro fertilization, preimplantation genetic testing, adoption DL in practical detail. [...] Klitzman's book amply illustrates the supremely difficult choices that prospective parents can face, using their own voices, leavened with his review of relevant background facts. Klitzman's book is organized according to types of decisions facing prospective parents. It's a
great title to recommend to those who are contemplating or undergoing medically assisted reproduction or using adoption." -- Robert Cook-Deegan, Arizona State University, Issues in Science and Technology
"For readers with an interest in how IVF and PGT work in clinical settings, this will be a welcome contribution...Professor Klitzman understands that as genomics and assisted reproduction develop, it will become especially important to enable poor parents to afford some of the advantages that rich parents will be able to buy." -- Jonathan Anomaly, School of Arts and Sciences, University of Pennsylvania, Bioethics
"[Klitzman's] ability to scientifically explore yet vividly personalize the perspectives of many is what makes this work an important and timely read in this rapidly evolving landscape...Anyone, from a future parent suffering from infertility and considering their options to a young woman debating whether to donate her eggs to a seasoned practitioner counseling patients and providing guidance, is sure to benefit from this read." -- Chaarushi Ahuja, Yale School
of Medicine, Yale Journal of Biology and Medicine
"Designing Babies is brilliant, revelatory, engrossing, and wonderfully readable - exactly the sort of work one has come to expect from Dr. Klitzman. He has taken a subject of extraordinary complexity, presenting a labyrinth of excruciating scientific, moral, and practical dilemmas, and has charted a path through them that medical professionals, men and women struggling to become parents, and others will find invaluable." -- Louis Begley, author of
Wartime Lies and About Schmidt
"Well-researched and rigorous yet highly readable, this study of reproductive liberty will assist patients on their journey through the infertility maze and enlighten general readers about this ever-changing industry."--Library Journal
"In this meticulously researched and eloquent book, Robert Klitzman examines the brave new world of reproduction in the twenty-first century. He describes the relevant medical progress in accessible terms, tells the stories of individual families with warmth and compassion, and examines the ethical nuances that follow on evolving technologies. The book is written with the passion of a scientist and the subtlety of a novelist." -- Andrew Solomon, author of
Far from the Tree
"Reproductive technologies are radically transforming the creation of families in ways that create a host of ethical and practical questions. Klitzman takes us on a vivid tour of this new landscape and offers not only his own incisive perspectives on the moral issues, but shows how these developments affect patients and medical providers, presenting a rich tableau of their own experiences told in their own voices. This is an important and much-needed work and
there is no one who could write it better." -- Melanie Thernstrom, author of The Pain Chronicles
"It takes a seasoned psychiatrist to make it plain that conjugal reproduction is giving way to a non-conjugal counterpart. It takes a seasoned ethicist to make sense of it all. The author, straddling both disciplines, lays out a tapestry unlike any other." -- Eli Adashi, Former Dean, Brown University School of Medicine; Recipient, the first Lifetime Achievement Award, American Society for Reproductive Medicine
"A few years ago, a friend of Robert Klitzman asked 'Do you want to be the father of my child?' After much thought, he declined. Now, in Designing Babies, he has written a wonderfully well-informed, sensible, and sympathetic account of the brave new world of mechanical reproduction, reviewing the innumerable questions and choices that face parents and would-be parents today. Coming from one of this country's leading bioethicists, Designing
Babies is as valuable as it is timely." -- Jonathan Weiner, author of The Beak of the Finch and His Brother's Keeper
"Dr. Klitzman blends historical facts, modern-day anecdotes, patient and provider quotes, and technical explanations in an entertaining way that should appeal to both health care professionals and the general public." -- Anesthesia & Analgesia
"Professor Klitzman has created an incredibly detailed, thought-provoking book which shines a light on the dilemmas that fertility patients and medical practitioners face on a daily basis." -- Eleanor Taylor, BioNews
"Klitzman delivers a well-researched book that is filled with empirical data, providing a clear picture of the current state of the field. Understanding where we are now is imperative to inform our path forward. This book is therefore an important resource for anyone who is interested in predicting where we will go from here or, even better, recommending or creating policy on where we should go from here." -- Carolyn Riley Chapman, NYU Grossman School
of Medicine, The American Journal of Bioethics