Discussion of ethics of new IVG technique is needed, say US experts

Three US experts say public conversation should begin now on the ethical questions raised by a new fertility technology that could reprogram any human cell into eggs and sperm.

In the future, the technology of in vitro gametogenesis (IVG) could 'reprogram' adults cells, such as skin cells, into functional gametes to produce embryos. Writing in Science Translational Medicine, the authors warn IVG could lead to unique regulatory challenges and they call for debate on its prospective use and impact on society.

'There's something troubling about an inexhaustible supply of gametes that can be fertilised into an inexhaustible supply of embryos,' said Dr Eli Adashi of Brown University, who authored the editorial with Professor Glenn Cohen of Harvard Law School and Professor George Daley of Harvard Medical School.

IVG is still far from human clinical trials, but was successfully demonstrated in mice in 2016, by Japanese scientists (see BioNews 874). The procedure holds potential benefits for fertility treatment. It could make it unnecessary to harvest eggs for IVF, which may be limited in supply, and the associated health risks such as ovarian hyperstimulation syndrome. Gametes could be grown for patients who have become infertile through medical treatment, and genome editing could be used to correct mutations in the gametes of patients with genetic infertility disorders.

Gametes would also be readily available for research. IVG could be used to produce new embryonic stem cell lines, personalised to individuals, without the need for donor eggs.

However, IVG could also result in large numbers of embryos being produced and destroyed, potentially raising ethical and religious objections. 'IVG may raise the specter of "embryo farming" on a scale currently unimagined, which might exacerbate concerns about the devaluation of human life,' caution the authors.

Parents undergoing fertility treatment could also have more 'choice' in the embryos they want to use, leading to selection for specific genetic traits.

'IVG could, depending on its ultimate financial cost, greatly increase the number of embryos from which to select, thus exacerbating concerns about parents selecting for their "ideal" future child,' said the authors.

They also questioned how to prevent 'unauthorised IVG', where gametes could be created from discarded skin cells without the individual's knowledge or consent, and the legal ramifications of any children produced from this.

The authors say it is not yet technically or legally feasible to produce a human baby via IVG, and it might never be. 'Still, with science and medicine hurtling forward at breakneck speed, the rapid transformation of reproductive and regenerative medicine may surprise us. Before the inevitable, society will be well advised to strike and maintain a vigorous public conversation on the ethical challenges of IVG.'