Population and the American Future: The Report Of the Commission on Population Growth and The American Future; John D. Rockefeller 3rd, Chairman, March 27, 1972
infertility; the ability to help them is sorely limited by the same lack of information concerning basic reproductive processes that inhibits effective contraception. This knowledge is essential, not just for regulating fertility, but also for improving the outcome of pregnancy. Today, many mothers suffer the risk of serious injury, ill health or even death in pregnancy and childbirth. Too many children are born with physical and mental handicaps. We spend billions in therapy, remedial treatment, custodial care, and repair of damage that might have been prevented by a more complete understanding of the factors governing reproduction. Whether the interest is in conception or contraception, in chemical or mechanical contraception or in rhythm, in genetic counseling or mental retardation or cerebral palsy, the basic knowledge necessary is largely the same. There must be an understanding of the role and functioning of the ovary and the testes, of the egg and the sperm, of the process of fertilization itself, and the normal course of gestation. This is knowledge we do not have and must attain. Any overall strategy for the development of new agents or methods of fertility control must include not only basic research in the biology of reproduction, but also clinical trials, and related toxicological investigations, the development of new products and techniques, and the continuing evaluation of new methods with regard to both effectiveness and short-term and long-term safety. It is essential, too, that extensive, critical evaluation be made of the total effects of existing methods of contraception. The limited amount of usable knowledge of human reproduction and fertility control is the result of the lack of interest we have had in this by comparison with other scientific and technological fields. As Secretary Richardson acknowledged in the Department of Health, Education and Welfare Five-Year Plan for Family Planning Services and Population Research: in spite of its transcendent importance to human existence, reproduction has received relatively little scientific attention. Even with today’s concern for the population problem, the most talented among young investigators all too frequently seek other subjects.19 It is not difficult to understand why this has been the case. Career choices are largely shaped by the priorities that public and private institutions set when they allocate their resources. During the past two decades, as
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