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It’s a Wednesday morning at the National Academies of Science, Engineering and Medicine in downtown Washington, DC, and Dr. Eli Adashi is opening an unprecedented meeting: It’s titled « In Vitro Derived Human Gametes as a Reproductive Technology. »
It is the Academy’s first workshop to explore in vitro gametogenesis, or IVG, which involves the customized production of human eggs and sperm cells in the laboratory from any cell in a person’s body.
« It’s on the verge of materialization, » says Adashi, a reproductive biology specialist at Brown University. « And IVF will probably never be the same again. »
Over the next three days, dozens of scientists, bioethicists, physicians and others describe the latest scientific advances in IVG and explore the potentially vast wilderness of the emerging technology’s social, ethical, moral, legal and regulatory ramifications. Hundreds more participate in the workshop remotely.
« The implications here are huge, » he says Alana Cattapanwho studies reproductive health issues at the University of Waterloo in Canada.
Realizing progress for humans is probably still years away, but enthusiasm about it among scientists is growing.
So far, healthy IVG mice
Japanese scientists describe how they have already perfected IVG in mice. The researchers used cells from the tails of adult mice to create induced pluripotent stem (iPS) cells, and then coaxed those iPS cells into mouse sperm and eggs. They even used those sperm and eggs to create embryos and implanted the embryos into the wombs of female mice, which gave birth to seemingly healthy baby mice.
« We are on the road to translating these technologies into humans, » says Mitinori Saitou of Kyoto University, addressing the group via Zoom.
In fact, Saitou says he’s quite far along that path. He turned human blood cells into iPS cells and used those iPS cells to create very primitive human eggs. Others have created primitive human sperm this way. Neither sperm nor eggs are developed enough to produce embryos or children. But scientists around the world are working hard on this.
« I’ve been really impressed with all the data we’ve seen here and how quickly this field is evolving, » says Dr. Hugh Taylor, a reproductive health specialist at the Yale School of Medicine. « It makes me confident that it’s not about whether this will be available for clinical practice, just when. »
‘Life altering’ for infertility
Next, workshop participants, who convened in late April, explore the implications of IVG should the technology ever become a reality for humans.
« This could change people’s lives to build that family they dream of through IVG, » she says Andrea Bravemanwho studies infertility at Thomas Jefferson University in Philadelphia.
IVG would allow infertile women and men to have children with their own DNA instead of sperm and egg or donor genes. The same is true for women of any age, making the biological clock irrelevant.
But that, Braverman says, raises many questions.
« Yeah, it’s great that we can not have to worry as a woman that 40 is the cliff we fall off, » she says. « But on the other hand: What are the implications for families? For kids who have older parents? I always think of freshman moving day in your 80s. »
IVG could also allow gay and trans couples to have children genetically related to both partners.
« Even we could point to our kids and say, ‘He has your eyes and my nose,’ in a way that I think is something a lot of queer people crave, » she says. Catherine Kraschel, who studies reproductive health issues at Yale Law School.
But Kraschel also fears it could undermine gay people’s acceptance of children who aren’t genetically related to them through adoption or using other people’s sperm and eggs.
« To the extent that IVG replaces the sperm and egg markets, I think the concerns about regression are really justified, » she says.
Another theoretical possibility is « IVG only » — single people having « uni-babies » — babies with only one person’s genes, says Dr. Paula Amato, professor of obstetrics and gynecology at Oregon Health & Science University of Portland
« You could theoretically reproduce yourself. And the resulting child would be 100 percent related to you, » says Amato. « You could if you wanted to. »
He warns, however, that it could increase the risk of genetic problems in the offspring.
At the same time, the DNA for IVG could be obtained from anywhere a single cell could be found, he says Henry Greylya bioethicist at Stanford.
This raises a long list of other provocative possibilities, he says, including « 90-year-old genetic mothers, 9-year-old genetic mothers, 9-month-old fetuses becoming genetic parents, people who have been dead for three years whose cells have been saved who become parents ».
People could even potentially steal celebrities’ DNA, for example, from having their hair cut to make babies, he says.
« One law we badly need is to ensure that people cannot become genetic parents without their knowledge or consent, » says Greely.
During the meeting, the researchers and bioethicists warn that the ability to create an unlimited supply of IVG embryos – combined with new gene-editing techniques – could enhance the power to eradicate unwanted genes. This could help eradicate terrible genetic diseases, but also bring « designer children » even closer to reality.
« The desire to genetically modify the next generation in search of a supposedly perfect race, a perfect child, a perfect future generation is not science fiction, » he says. Amrita Panda, professor of sociology at the University of Cape Town in South Africa. « IVG, when used with gene-editing tools like CRISPR, should concern us all. »
IVG is probably still at least years away and may never happen, many of the participants note. There are still significant technical hurdles that would need to be overcome and questions about whether IVG can ever be done safely, several experts repeatedly warned at the seminar.
However, the Food and Drug Administration is already exploring the implications of IVG, according to Dr. Peter Marka senior FDA official.
« It’s an important technology that we’re very interested in helping advance it, » says Marks.
But Marks notes that Congress currently prohibits the FDA from even considering any proposals involving genetically engineered human embryos.
“This gives our lawyers chills,” Marks says. « It makes them feel uncomfortable in this space. »
But if IVG remains off-limits in the United States, Marks and others warn that IVG clinics could easily spring up in other countries with looser regulations, creating a new form of medical tourism that raises even more ethical concerns. This includes the exploitation of women as surrogate mothers.
« Does IVG really increase human well-being? » asks Pande. « Whose welfare does it increase? »
« The door that opens to this space is where so many things are disrupted, » he says Michele Goodwin, director of the Center for Biotechnology and Global Health Policy at the University of California, Irvine. « So many ethical issues still need to be resolved. »