Event Review: The ethics and regulation of in vitro gametogenesis (IVG)

In vitro gametogenesis (IVG) involves the use of stem cells to create sperm and egg cells in vitro, which can then be used to produce embryos. It is a technique that could provide a fertility treatment option for people who currently cannot have their own genetically related children – including infertile individuals or couples, older women, and same-sex couples. There have been some promising successes in trials with mice, and some commentators believe that within decades the intervention will be available for human use, be that for research or reproductive purposes.

A symposium on IVG on 14-15 September 2017 in London, part of the Wellcome Trust funded research programme entitled 'The Donation and Transfer of Human Reproductive Materials', generated lively debate between academics, policymakers, science communicators and scientists in the field. It was organised by Dr César Palacios-González and Professor Rosamund Scott of King's College London, and Professor Stephen Wilkinson of Lancaster University.

In addition to an enlightening session on the science and development of IVG with talks from Professors Azim Surani and Robin Lovell-Badge, there were talks on the broader ethical and legal implications by experts such as Professor John Harris (who noted questions surrounding what would be considered 'safe enough' in reproductive research), Professor I Glenn Cohen (who discussed the difficulties in regulation given the possibility of circumvention tourism), and Professor Henry Greely (who considered the ethical implications of using IVG technology). Four further talks considered more specific issues, questions and concerns raised by In vitro gametogenesis (IVG).

Professor Sonia Suter discussed how IVG may be used to create vast numbers of embryos for the purpose of selective reproduction and the extent to which this raises concerns about choice overload for potential parents. Suter considered ways of dealing with this, including the use of algorithms, and noted the ethical concerns of the use of such technology for this purpose, such as possible abdication of decision-making, underlying biases, reduction in diversity, and commodification.

Dr Saskia Hendriks presented her qualitative research on public, patient, and clinician perspectives. People currently unable to have their own genetically related children would be inclined to use In vitro gametogenesis (IVG), she reported, and people would also be willing to trade-off genetic relatedness for things such as higher pregnancy rates and cheaper costs. Hendriks concluded that patients might be disinclined to pursue IVG – even at the cost of genetic relatedness – if it were risky, expensive or ineffective. Given the novelty of the technology, it was especially interesting to hear such empirical data, and this added further weight to the discussions on the value of genetic relatedness that arose several points in the symposium.

Seppe Segers explored ethical questions about 'designer babies' and . He explained that while IVG may facilitate the creation of designer babies, it is neither necessary nor sufficient for this task. He concluded that even if IVG did facilitate this endeavour, it should not be grounds for undermining the development of the technology but instead should be regulated; this would be consistent with other assisted reproduction technologies and would mean that the value of genetic relatedness would be respected as well.

Dr Birgit Beck then discussed the idea that IVG technology could be used to create children who are direct descendants of early embryos and who could therefore be considered 'orphaned at conception'. She asked whether it would be wrong to bring such children into being and explored the metaphysical and moral implications of this question and of the notion of genetic orphans in general. The view as to whether (or why) it would be wrong to create children orphaned at conception would depend on one's conceptual, ontological and ethical commitments, Beck concluded. For instance, those that hold that an embryo is not an individual human being would not consider embryos to qualify as an interim generation. For these people, it would make no sense to talk of children being orphaned at conception.

The event provided much lively and stimulating debate into ethical, legal, and practical issues relating to research into IVG, and its possible use in fertility treatment. While its possible use for non-medical trait selection provides a new context in which to examine questions about selection and selective reproduction, the topic that generated the most discussion was that the intervention would allow people who are currently unable to do so, to have genetically related children. It called into question the value of genetic relatedness, the socio-ethical implications of any such value, and indeed whether there is a need or obligation to pursue interventions like IVG that would allow people to have genetically related children.