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IVF versus adoption: Which is better?

Mahmoud Tawil / AP

Angelina Jolie and her son Maddox, who she adopted from Cambodia in 2002.

For couples who want children but can't conceive naturally, a personal crisis could become a defining moment, Dr. Wendy Walsh writes in this opinion piece.

By Dr. Wendy Walsh

With Hollywood luminaries like Sandra Bullock, Tom Cruise, and Brad Pitt and Angelina Jolie going the adoption route, and other late-in-life parents risking medical intervention to see their own genes replicate in a biological birth, the debate continues about what is best for the individual, our culture, and the planet.

A few months back, I was invited to appear on CNN Newsroom with Don Lemon to talk about trans-racial adoption. As the mother of two (biological) biracial children, I walk the issues every day. Recently, I was on HLN's Showbiz Tonight commenting on celebrities who spend thousands of dollars and risk complications from medical interventions while undergoing in vitro fertilization. The two subjects got me thinking. When a loving couple or single parent faces infertility, which option really is best?

Of course there is no one right answer. Adoption and in vitro fertilization both carry financial, medical, and family dynamic risks.

Dr. Wendy Walsh

Let's start with economics. The average cost of in vitro is nearly $15,000 per cycle and adoption costs anywhere from $5,000 to $40,000. But wait. Before you consider in vitro a bargain, know this: many cycles of in vitro are often required to create a pregnancy that goes full term. The success rate is 15 to 20 percent for women aged 38-40, and for women over forty, it is as low as 6 percent. Then there are the medical complications that can rack up more costs. Laparoscopy used to extract eggs carries risks related to the anesthesia. Then there are risks of infection, bleeding, damage to the bowel, bladder, or a blood vessel. Surgery to repair damage can also be costly. Bottom line: Adoption is cheaper and less physically risky.

And then there are the emotional risks and rewards. Some people believe that there is no greater joy and meaning in life than to watch one's own genes blend with a loved one’s and prosper. Others think that notion is hogwash -- a parent is the person who raises a child, not the one who throws genetic material their way. Indeed, recent studies on non-biological caregivers and adoptive parents point to hormonal changes in the adult that occur through the acts of bonding and nurturing. And with steady rates of one in five women over the age of forty being childless, a case can be made that nature's intention was for a village of caregivers to nurture any given child.

Then there's the debate about "ensuring a healthy and happy baby" by using one's own genetic material. Any mother of multiple siblings can tell you that each child is made from a unique mold. And that really good parents can sometimes give birth to really awful humans. Biology, you see, is a crap shoot.

The bigger question for me has to do with how an individual's decision can affect all of us and our children and grandchildren. I don't have to remind you that our habitat is overloaded. The planet earth will be expected to support nearly 10 billion people by the year 2040. My own children will be barely middle aged by then. "Humans are 10,000 times more common than we should be, according to the rules of the animal kingdom, and we have agriculture to thank for that," says Steve Jones, head of the biology department at University College London.

And all those little humans are causing major stress for Mother Earth. Apparently her nursery needs clean air, water, and food for these billions of babies. With the population burgeoning, parents who are facing infertility may be given a wonderful opportunity to help the planet a bit, by taking in a hungry mouth -- a baby who is already here, in a glowing package waiting for love.

I've had this conversation at many private dinner tables. The debate often gets lively. At one point or another, someone, usually aided by a few sips of wine, goes the politically incorrect route and sounds elitist. Fear does that to people. They want to protect the familiar. Among my educated friends, I've heard the uneducated argument that "intelligent" people should be able to reproduce or the world will be taken over by fools. I've heard the same plea made in terms of race or social class. All of this is nonsense. The factors that will raise our species and continue to help it evolve are good parenting, education, and prudent birth control.

I guess you know where I stand on the issue. I mean, what good does it make to drive a Prius, turn off your taps when you brush your teeth, and recycle, if you also create an army of carbon footprints? Of course, my personal opinion is a luxury and actually not worth much at all. That's because my own children are biological and were easy to conceive. My heart goes out to parents whose homes are barren through no fault of their own. For them, this crisis in fertility may be a defining moment. May the force be with you.

Dr. Wendy Walsh has a private psychotherapy practice in Los Angeles, blogs at "Dating. Mating. Relating" and is a columnist for Pregnancy Magazine. As a psychological expert, she appears regularly on television. She is the author of “The Boyfriend Test” and “The Girlfriend Test.” She is a single mother of a multiracial family.