Until recently, the only way to make eggs or sperm was the old-fashioned way: in the ovaries and testes. In the not-too-distant future, it may be possible to use cells from almost any part of the body to create these germ cells, also known as gametes.

This process, called in vitro gametogenesis (IVG), raises the possibility that babies could be made using muscle or liver or blood cells. While not yet ready for prospective human parents — so far it has only been accomplished successfully in mice — it raises major ethical and legal questions that we should start thinking and talking about now.

IVG works like this: Cells from almost any tissue or organ are reverse engineered into becoming induced pluripotent stem cells. These cells, which can develop into any kind of human cell, are then nudged to become egg or sperm cells.

advertisement

Why would anyone want to do this? Infertility due to cell failure or cancer treatment could cease to be the emotionally shattering issue it is for many families and individuals. It could also be a solution for women who experience premature menopause.

IVG could lead to a dizzying array of reproductive possibilities. In a female-female couple, for example, skin cells from one partner could be turned into sperm cells used to fertilize the other partner’s eggs. No man would be needed in the creation of such a baby.

We are already in an age of disruptive reproductive technologies. Babies have been born using mitochondrial replacement techniques, often known as three-parent babies. News of mice born to same-sex parents went viral last year. The eventuality of IVG is obvious to many of us watching the field.

Literacy about emerging issues in the reproductive sciences is increasing, which is a good thing. But it still isn’t getting the attention it deserves. Writing in the journal Trends in Molecular Medicine, one of us (I.G.C.), along with a complement of leading IVG experts, strongly suggest that now is the time for increased public engagement — surveys, focus groups, expert reports, op-ed debates, and the like — on this technology before embryos created by it make their way from the lab to the nursery. The group also argues that the public and regulators need to think about the ethical and legal challenges that this technology will present and get ahead of them.

As with other assisted-reproduction technologies, IVG is likely to spark heated legal and ethical questions. But some of them will be different than those arising from earlier technologies, which begin with sperm and eggs made by individuals’ testes and ovaries. This new process creates germ cells and, by that process, embryos from anyone’s existing cells.

The likelihood of prospective parents creating a large number of embryos this way and implanting only a select few may agitate many people. Should regulations limit the number of embryos a person could create using his or her own stem cells? Should embryos created through IVG be treated the same as those derived through existing fertility technologies or the old-fashioned way of making babies?

The issue becomes even more fraught with confusion when IVG is combined with preimplantation genetic screening. Couples, or even individuals, could in principle create hundreds of embryos and use genetic tools to select the “best” one. Some might see such embryo farming as a modern-day form of eugenics that puts a higher value on some lives than on others. Some bioethicists worry that such eventuality appeals to our worst instincts, which the authors of the Trends article characterize as “an untoward desire for mastery and human perfectionism in which reproduction becomes manufacture.” And what happens to all these excess embryos? We could see a commodification of embryos that resembles the current practice of selling sperm and eggs.

IVG also raises the specter of unwitting nonconsensual parenthood, also known as the celebrity scenario, in which gametes are created from cells secretly taken from an unsuspecting individual. Would such “donors” be treated as parents by the law? Whether the state can protect against the unauthorized imposition of parenthood is an open question.

The ethical, social, and legal conundrums surrounding stem-cell derived human gametes are vast and require close and careful consideration, not only by experts and scholars but by the public as well. We are all stakeholders in the future of reproduction, and should begin talking about this new technology and its implications now.

Glenn Cohen, J.D., is professor of law and faculty director of the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School. Alex Pearlman is a bioethicist, communications manager, and research associate at the Petrie-Flom Center and editor-in-chief of its Bill of Health blog.

Leave a Comment

Please enter your name.
Please enter a comment.

  • As a transgender male I try not to even let myself think about children. It’s emasculating knowing that I can’t have biological children with my wife and we both agreed that a third party wasn’t okay with us. I just hope this happens sooner rather than later. My wife and I would be great parents and I hope we get that chance.

  • I too would like to participate in future IVG as a ‘gamete donor’.

    I had no luck in becoming a sperm-donor earlier on in my life and now at 50, too old to be accepted as one. However, the prospect of gamete reproduction appears to be a lot safer than traditional assisted fertility as there is often a danger to the offspring using old sperm or eggs.

    IVG offers hope to those denied their own biological children either from illness or simply being too old. Count me in as there are many of us out there who simply refuse to miss the boat on self-preservation !

    • So the authors tried to freak us out with all kind of apocaliptic scenerios, and all they got in the comments are sad sad people, in desperate need for a solution and with great awe for the Japanis research team. Lots of support to my sisters and brothers to this path of pain. Its easy to write condescending ctastrofic theory and then go home to a full house….

  • As a young lesbian in Australia, this type of research gives me hope about the prospect of one day having a child with my girlfriend/wife that would be genetically connected to both of us. We would absolutely love our child(ren) regardless of whether we were blood-related or not, but the allure and magic of the idea of producing a life exclusively with our own genetic material is hard to deny.

    Sperm donation feels a bit iffy, because that has ethical issues of its own – what if the child wants to know who their biological father is? Will the non-biological mother still be valued the same as the biological parents? Adding a third person into the mix can be very messy and confusing for everyone involved. Some people are fine with this option and that’s totally valid, although personally I’d rather have a baby with my significant other than with a faceless stranger. It’s strange because it’s not exactly like cheating, but to me it feels like it inevitably robs one partner of the joy of making someone from theirs and their partner’s genetics, even if they decide to carry the baby through gestation. I see the creation of a child as the highest, ultimate product of love in a healthy, committed and affectionate relationship, a cherished life created from and strengthening the bond between two lovers. To me, current same-sex reproduction options constricts that because one partner is left out of the genetic creation of that child. A child should definitely be valued regardless of how they came to be born, although having the option to have biological children with the love of your life would definitely be wonderful.

  • Through hard-working I have finally established myself well in the society, after long search I finally found my Mr right, by strictly leading a good lifestyle I am very healthy (well, apart from one issue). I am as conditioned and ready as possible to be a mother, yet it turns out that I have premature ovary. Refusing to surrender, we spent all our hard-earned fortune in IVF, only ended up with failure and heart break, time and time and time again, until doctors refuse to take me anymore as it has become “inhuman” for me to go for more IVF treatments. Life in tatters. I used to be such a sunshine, now I live in desperation and denial. If were not for my supporting husband, I cannot imagine to go on. Bumping into an article about IVG on internet was such a joy! My life could have a hope again! I’ve been since then eagerly following news about it, to my distress there’s more debate about extreme scenarios where it can go wrong, how people can abuse it, rather than focusing on how much good it can do. But it’s a god sent! Think of how many people like me it can save! I don’t care about farming a million of embryos in order to select a perfect one. I don’t care about scratching a piece of DNA from a pop star so that I can have a baby like him. No, I just want to carry on a normal life, having a healthy baby with my husband, like anybody else do, let me have that hope please.

  • The celebrity scenario is so unlikely, and takes a very disturbed person and a wildly unethical scientist. It reminds me, that there was a real concern that people will get murdered for organ transplants. Well, the world found a way to control that. So, instead of focusing on fears of inevitable developments, why don’t we talk about regulating those developments and about bringing hope to millions suffering pain and agony? I suffer from infertility. This can bring so mush light and happiness to my family, this can stop the burning void in my soul, and actually change my whole life. Please don’t let some esoteric scenario take over the debate and become the focus and heart of the public discussion over this matter. For it seems this is an interesting intellectual subject for you, but for millions, including myself, it’s a ray of hope in a grim life path. Our pain is real, it is constant, and I ask you. not to shatter our deepest hope, I only hope that someday, some sweet voice, will just call me – Mum. In my country it’s impossible for me to adopt. …. Please keep my pain and agony in mind. Thank you.

  • Can we really claim that this would lead to eugenics? People already terminate pregnancies when they do early testing and determine that their child will have any number of horrible diseases. Scientists are not spending time identifying the genes which create perfect bone structure or an outgoing temperament (which would both be desirable traits to a eugenicist), they are identifying which genes lead to horrible diseases.

    If we can choose to only create children who have less chance of contracting serious illnesses, do we not have some moral obligation to do so?

Your daily dose of news in health and medicine

Privacy Policy