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The Complexities of Human Emotion
In Vitro follows a couple longing for a baby as they navigate the quiet pressures of a prestigious fertility clinic, where medicine and emotion inevitably collide. Did a particular news story, personal experience, or ethical question inspire the novel?
After completing a residency in OB/Gyn, I did a one-year fellowship in Reproductive Endocrinology where I worked in an in vitro fertilization (IVF) clinic. I still have very vivid memories of the patients and staff members I met during this time. The clinic was filled with such optimism and hope, and on some days, such sorrow and loss. While IVF is certainly in the news these days, I had this story in my head for probably thirty years! I wanted to explore the complexities of human emotion, especially the desire to become a parent, set against the backdrop of a high-stakes fertility clinic whose success is based on deception. The current array of medical options available to couples seeking pregnancy is truly miraculous, and I wanted to make the process feel real to readers without overwhelming them with technical details.
Did writing this novel change your own perspective on reproductive medicine?
Not really. According to the CDC, about 2% of all births in the US are the result of some type of assisted reproductive technology, including IVF. There are many reasons for this such as declining fertility rates for both men and women and couples choosing to delay parenthood. Reading statistics in some report is pretty dry stuff, so bringing the story to life by following the lives of couples seeking treatment and the medical professionals caring for them struck me as a great way to help readers understand this increasingly common procedure. I haven’t been to a single author talk or book club where at least one person hasn’t come up to me afterwards and related a personal experience they or some family member had with IVF. Some stories have happy endings and some do not.
I also wished to explore some of the moral and ethical issues surrounding IVF. IVF is an extremely expensive treatment which is not covered by some health insurance companies, so one big question is who should have access. Many couples do not have the financial resources to afford this treatment if it is not a covered benefit. The existence of for-profit clinics raises concerns about commercialization that encourages high volumes and expensive add-on testing with unproven benefit. Many couples opt for pre-implantation testing to eliminate specific genetic conditions, and there is concern this practice might eventually lead to the creation of “designer” babies. And finally, most IVF cycles create a surplus of embryos, which then leads to ongoing questions about freezing (and storing) these embryos for future use, donating them for research, or discarding them. Certain religious and pro-life organizations are particularly concerned with the practice of performing research or discarding “excess” embryos on moral grounds.
The clinic itself almost feels like another character. How did you approach creating an environment where compassion and corruption could exist side by side?
What an intriguing insight! I hadn’t thought of it quite like that. I wanted readers to have enough information to form a picture in their own minds of what the McArthur Institute looks and feels like. The building itself is set on a university campus that is well known for its medical facilities, so there is a certain grandeur and gravitas to the external structure and lobby. Inside those doors, many characters, particularly the protagonist, Dr. Joyce Porter, exhibit warmth and kindness through their actions. Joyce savors the small gifts brought by grateful patients and keenly feels each unsuccessful cycle as a personal failure. The head nurse, Selena, is always ready with a box of Kleenex or a hug and cares for both patients and staff with hot coffee and chocolate chip cookies. A compassionate environment is created within the relationships between the medical professionals and their patients. I also tried to portray the “business” side of the clinic through the character of Dr. Owen Hicks, the Institute’s Director, and the university’s administration. When taken to an extreme, the focus on academic prestige and success allowed Dr. Hicks to begin a cycle of deception and corruption. Like many things in life, objects (in this case the clinic and the technologies it offers) have both a light and a dark side, or what you described as compassion and corruption, and they coexist side by side. Dr. Ajay Kumar is the character in the novel who wrestles most directly with this dichotomy, and in the end, he’s forced to make a choice.
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The calm and compassionate Dr. Joyce Porter is proud to work at McArthur Fertility Institute, where miracles happen every day. Couples determined to conceive flock to the clinic, drawn by its unmatched IVF success rate and glowing reputation.
But behind the clinic’s shining facade lies a disturbing secret. When another doctor mentions a peculiarity in the facility’s methods, Joyce investigates. What she discovers is worse than she could have imagined. Now, she must decide whether to confront the institute’s renowned director about his unscrupulous deeds or compromise her ethics by turning a blind eye. She knows staying silent could destroy people’s lives, but speaking out could destroy hers.
As the line between healing and harm blurs, Joyce must decide how far she’s willing to go to protect her patients, her integrity, and the future she still hopes to build.
In Vitro
M.J. Kuhar’s In Vitro is a medical drama built around one of the most intimate hopes a couple can carry: the hope of becoming parents. The novel opens with McArthur Fertility Institute already under investigation, then moves back two months to show how the crisis began. That structure gives the story an immediate sense of tension, but the heart of the book is personal. Evie and Leon Coleman’s longing for a baby, Joyce Porter’s devotion to her patients, and the quiet pressure inside a prestigious fertility clinic all come together in a story about trust, ambition, consent, and the emotional weight of reproductive medicine.
Joyce is the character who holds the book together. She’s smart, compassionate, anxious, ambitious, and deeply human in the way she second-guesses herself while still trying to do right by her patients. Her work at McArthur puts her in the middle of ethical questions that grow more serious with every chapter, but Kuhar also makes room for her marriage to Bill, her friendship with Sally, her attraction to Dominique, and her ongoing struggle to be heard in a workplace shaped by hierarchy and ego. The smaller domestic details, like phone calls, coffee, cats, and rushed lunches, make Joyce feel like a real person rather than just the doctor at the center of a scandal.
The strongest parts of the novel are the scenes where medicine and emotion collide. Kuhar clearly understands the procedures, the language, and the rhythms of a fertility clinic, but the book stays grounded in the people whose lives are changed by those procedures. Evie and Leon’s early tenderness gives the story its emotional anchor, especially when Leon tells her, “Evie, I love you. No matter what.” That line captures the couple’s sweetness while also foreshadowing how much their love will be tested once the clinic’s secrets begin to surface.
The darker thread of the book comes through Owen Hicks, whose obsession with reputation and success poisons the culture around him. His command to “Stay the course and keep those pregnancy rates up” says a lot about the world he’s created, one where numbers matter more than people. Kuhar builds the tension steadily as Joyce begins to understand that the problems at McArthur aren’t isolated mistakes. They’re part of a larger pattern of abuse, secrecy, and institutional self-protection. The result is a story that reads like a workplace drama, a medical mystery, and a moral reckoning all at once.
In Vitro is a compassionate and accessible novel about infertility, medical ethics, and the courage it takes to challenge powerful people. It gives readers the emotional reality of IVF from several angles: the couples who want children, the doctors who want to help, and the administrators who want the clinic’s success story to stay intact. Kuhar’s conversational style keeps the story easy to follow even when the stakes get heavy, and the ending gives the characters space to reckon with what happened and imagine a life beyond McArthur. It’s the kind of book that invites readers to care about the science because they already care about the people.
Pages: 332 | ASIN : B0G1BKZQMY
