Misjudging early embryo mortality in natural human reproduction

F1000Res. 2020 Jul 14;9:702. doi: 10.12688/f1000research.22655.1. eCollection 2020.

Abstract

In 2002, in a judgment relating to the use of the morning-after pill, Mr Justice Munby held that pregnancy begins with the implantation of an embryo into the uterus of a woman. The case involved a large body of expert witness evidence including medical and physiological details of human reproduction. Munby J. emphasised one particular aspect of this evidence: namely, the developmental failure rate of human embryos after fertilisation. Under natural conditions, embryo loss is approximately 10-40% before implantation, and total loss from fertilisation to birth is 40-60% (Jarvis, 2016). By contrast, and based on expert witness testimony, Munby J. stated that not much more than 25% of successfully fertilised eggs reach the implantation stage, and that fewer than 15% of fertilised eggs result in a birth, figures that do not accurately represent scientific knowledge regarding human embryo mortality and pregnancy loss under natural conditions. Rather, these figures were derived from experimental laboratory data and clinical outcomes from in vitro fertilisation treatment. Testimony provided by other expert witnesses directly contradicted these specific numerical claims. In emphasising these figures, Munby J. gave the impression that human embryo mortality is substantially higher than available scientific evidence indicated. In this critique, all the scientific expert witness evidence is presented and reviewed, and an explanation provided for why the emphasised figures are wrong. Whether there are implications of Munby J.'s scientific misjudgment on the legal outcome is for others to consider.

Keywords: Mr Justice Munby; Smeaton; early pregnancy loss; embryo mortality; morning-after pill.

MeSH terms

  • Embryo Implantation*
  • Embryo Loss*
  • Embryo, Mammalian
  • Expert Testimony
  • Female
  • Humans
  • Pregnancy
  • Pregnancy Rate

Grant support

The author(s) declared that no grants were involved in supporting this work.