It is one of the paradoxes of the age that, in the developed world, women want fewer children than ever before, but at the same time the demand for fertility treatment is ever growing. In Italy, for example, in parts of which children are now a rare sight, a woman in her sixties has been helped to become a mother.

Actually, the paradox is only partial. Female fertility declines with age, so that women who have postponed childbearing discover they are unable to conceive when they want to do so. However, this is not the whole story: men are not only reluctant nowadays to commit themselves to women and children, but their own fertility is declining. More than half the patients at American fertility clinics are men.

Treatment is more successful than ever before, but in-vitro fertilisation fails much more often than it succeeds, and in any case all forms of fertility treatment raise ethical dilemmas undreamt of before the birth of Louise Brown – the first “test-tube baby” – nearly 30 years ago. Most importantly, notions of parenthood have been overturned by new technology, and for the first time human reproduction can be dissociated completely from sex. A single spermatozoon can be removed from a testis to fertilise an ovum removed from an ovary, and the resultant embryo implanted in the womb of a woman with no genetic, physical or emotional connection to either of the donors.

The author of this book, a journalist at The Washington Post, considers the practical and moral problems to which the new means of begetting children have given rise. Who should be allowed to have children by artificial means? Who should pay and be paid in the process? Should the resultant children be told of the means by which they were conceived, and do they have the right to meet their genetic progenitors? Is there evidence that children conceived by these means are at any disadvantage, compared with children conceived normally? What should be done with the spare embryos created by IVF? Does the fact that most “owners” of these embryos regard them as special, not to be disposed of casually, have any bearing on the moral question of abortion?

Unfortunately, the author is so eager to introduce human interest into her writing, via testimony from patients who have undergone procedures, that the book becomes shapeless, long-winded and somewhat dreary. Much of the testimony is either banal or amounts to repellent emotional kitsch. For example, in a chapter called “Sperm bank helps lesbians get pregnant!”, she tells us the criteria by which a lesbian couple chose the sperm by which one of them was to become pregnant. They purchased an extended “profile” of a possible donor and were delighted to discover that he had a gap between his teeth, just like one of the lesbians. The author shows no sign of understanding just how frivolous and shallow this is.

There are many such stories in the book. They show how firmly modern Americans accept genetic determinism. And while to relay what people say verbatim may add to accuracy, it does not always add to clarity or concision. Surely the following statement from the product of a sperm donation might have been edited: “It was sort of like a you-shouldn’t-tell-them kind of thing.” This is the sort of like sentence kind of thing that should not be permitted in print. And can it really be true that 90% of modern Americans, when they report speech, begin with “I was like” or “He was like”?

The author does not ask whether the failure rate of IVF means that more misery results from it than joy, and does not seem to notice the sheer egotism and self-absorption of many of her interlocutors. Two homosexual men who wanted a child by a surrogate mother searched for one of high IQ, as well as of high “emotional intelligence”, sporty (provided it was in team and not individual sports), with a wide range of interests, who played the piano rather than the violin. This would be funny were it not mildly nauseating. And the men thought they were exercising their right of choice, and bringing about something they called “reproductive equity”.

Despite the author’s strenuous denial that her interlocutors were not self-indulgent, a picture emerges of people who are whimsical, petulant when thwarted and possessed of a profound sense of entitlement. Mostly middle-class professionals – the class to which I myself belong – they are profoundly unattractive in their self-importance. I found this unintended portrait of a class the most interesting thing in this book.

EVERYTHING CONCEIVABLE: How Assisted Reproduction Is Changing Men, Women and the World by Liza Mundy

Allen Lane £20 pp432

Buy the book here for the offer price of £18 (inc p&p)

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