LGBTQ+ parenthood through in vitro gametogenesis?

Scientists have recently created an egg from a male mouse (see BioNews 1182), with reports on this news highlighting its future potential for LGBTQ+ identified parents. It would be a kind of in vitro gametogenesis (IVG), that is, a technique whereby embryos are created in a lab by reprogramming adult cells of one sex only to become sperm cells or egg cells. In particular, it could potentially become a way for some same sex male couples to have a child that is genetically related to both of them.

Professor Katsuhiko Hayashi, now at Osaka University, Japan, presented his findings on creating an egg from a male mouse at the Third International Summit on Human Genome Editing in London earlier this month. Professor Hayashi reported that the eggs were of low quality and the technique could not be used safely on humans at this stage – but that he could see these current problems being overcome in ten years and that he would like to see the technique available as a fertility treatment if it is proven to be safe to use.

Previously in 2021, Professor Hayashi led a team that achieved IVG by using mouse stem cells to create egg cells that successfully developed into live mice when used in IVF (see BioNews 1104).

This follows a previous breakthrough in 2018, when healthy offspring was born to female couples of mice thanks to IVG (see BioNews 971). Even if scientists agree that it is still years away from being feasible and safe in humans, news such as this sparks the imagination, yet also opens up questions.

Firstly, what do LGBTQ+ people think about a potential possibility of becoming parents through IVG? Well, we don't really know, because it doesn't usually come up in conversations or in research on LGBTQ+ reproduction.

For example, the topic was simply not even mentioned at the roundtable on 'Current Issues for Queer and Trans Families' we held just over a year ago within the Queer Social Justice research network at the University of Cambridge, with the participation of queer and trans family activists from across the UK.

Between 2020 and 2022, I conducted a qualitative interview study with 30 families of gay men in the UK that were created through surrogacy. The study included extensive biographical interviews and conversations about different paths of potential family formation, but none of my interviewees even mentioned IVG. Personally, I have not seen such mentions either in other studies of LGBTQ+ family formation. As if the topic doesn't feature in gay people's procreative consciousness as a potential path that could be used – for now.

And yet, when I read the news, I caught myself thinking 'wow, perhaps there's a way out there for me and my partner to become parents one day – given it's still so difficult to do it otherwise as a gay couple'. I dismissed this brief thought rapidly as not such an easy option for a variety of reasons, but a glimmer of hope stirred my imagination – just like it may appeal to some other people.

If IVG could ever be translated safely and ethically to use on humans, some challenges it will present are going to be similar to those we can currently see with regard to currently available reproductive technologies. At least two issues will need to be considered, as they are being considered already now with regard to, for example, surrogacy.

The first challenge is who is able to access surrogacy, and how. Likewise, for IVG. Recently, I studied gay men's use of surrogacy in the UK and found that while there exists scarce public NHS funding for IVF for heterosexual people, medical definitions of infertility at play usually exclude gay people from such funding.

Despite the first case in 2020 of the NHS funding IVF for a gay couple in Scotland (see BioNews 1046) after a blanket ban on NHS-funding for fertility treatment in surrogate pregnancies was lifted by the Scottish Government in 2018, none of the 30 families of gay men created through surrogacy I interviewed in England received such funding.

What is more, despite the fact that the existence of altruistic and traditional surrogacy models in the UK makes surrogacy here more accessible than elsewhere, not everyone can afford the necessary expenses. For this reason, among my interviewees there wasn't anyone whose annual household income would fall beneath the UK average. Thus, achieving reproductive rights becomes a matter of social class and therefore, of social justice. Such barriers also exist for lesbian couples (see BioNews 1121), given that access to IVF through the NHS continues to be usually determined on the grounds of medical definitions of infertility.

The second challenge concerns the rights of people who would potentially be helping LGBTQ+ intended parents to complete their 'IVG journeys'. For example, male same-sex couples and singles using IVG would need a surrogate who could carry the pregnancy to term. This would raise questions similar to those that already exist in the current discussions on surrogacy, such as within the surrogacy law reform in the UK (see BioNews 1175).

That would raise questions regarding who is registered as the baby's parents at birth or how surrogates are compensated, for example. Potentially, one could imagine that 'IVG surrogacy' could just become one of the options available alongside traditional surrogacy and gestational surrogacy with egg donation, and it could be carried out with the support of surrogacy organisations that already have substantial experience in the UK. Guaranteeing rights of all parties involved would be a matter of queer reproductive justice in IVG surrogacy, just like it is in the current uses of surrogacy and reproductive technologies.