In-Vitro Gametogenesis

June 2018 Pulse

In its May 18, 2017 issue, The Straits Times reported that researchers in Japan have succeeded in creating viable eggs from the skin cells of adult female mice. Using a technique known as in-vitro gametogenesis (IVG), the team led by Professor Katsuhiko Hayashi of Kyushu University in Fukouka was able to create eggs ‘outside the mouse’ for the first time.

IVG is used to generate sperm and egg cells in a petri dish from adult or pluripotent cells that are capable of becoming any cell type in the body. This includes embryonic stem cells (in this case, induced pluripotent stem cells or IPS cells) that are found in the blastocyst or zygote. Scientists believe that these cells may have therapeutic potentials, such as treatment for Alzheimer’s disease.

Currently, scientists are able to derive sperm-like and egg-like cells from murine (mouse) embryonic stem cells (mESCs). It has been reported that a live offspring has been produced after fertilizing natural mouse eggs with sperm-like cells derived from mESCs.

Although progress in humans has been slow, scientists believe that not very far down the road, the success that they have had with mice can be replicated in humans. As Glenn Cohen, Eli Adashi and George Daley state in their paper on IVG: ‘These findings suggest that experimental refinements likely will permit derivation of functional eggs and sperm from [human stem cells] in the not too distant future’.

There are a number of foreseeable applications of IVG.

This technique would enable scientists to study human gametogenesis (that is, the formation of gametes) in vitro as well as diseases of the germline. The technique would also enable scientists to create a vast supply of gametes that can be used either for research or fertility treatment. Finally, it will enable scientists to genetically manipulate the human germline.

As Léa Suruge puts it, IVG has the potential to redefine ‘the notion of what is possible in reproductive and regenerative medicine, as it opens up the possibility of creating human sperm and eggs from induced pluripotent stem cells’.

For example, patients whose reproductive functions have been lost – for instance, because of chemotherapy – could possibly have a child through IVG. Furthermore, when used together with the rapidly advancing genome editing techniques, future scientists and physicians could root out inherited diseases even before fertilization.

However, despite these exciting prospects IVG does present scientists and ethicists with very grave ethical and social concerns. Even the seemingly positive application of IVG may prove deeply vexing for policy makers, ethicists and society.

Take the production of gametes, for instance. As Cohen, et al., have perceptively pointed out, ‘There’s something troubling about an inexhaustible supply of gametes that can be fertilised into an inexhaustible supply of embryos’.

With its potential of creating an almost unlimited supply of eggs or embryos, IVG may raise the sceptre of embryo farming and commercialisation on a scale that is hitherto unprecedented. From the standpoint of Christian ethics, this would result in the unconscionable devaluation of human life.

In addition, because of the ease with which embryos can be created by this method, parents (especially wealthy ones) could opt to generate scores of embryos from which to select the ‘best’ for implantation. ‘IVG could’, write Cohen et al., ‘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’.

The ‘rejects’ would either be destroyed or used for research (which would result in their eventual destruction).

When IVG is seen within the framework of the so-called Principal of Procreative Beneficence (PB), the outcome is nothing less that a form of disguised eugenics.

According to Hannah Bourne, Thomas Douglas and Julian Savulescu, PB ‘holds that when a couple plans to have a child, they have significant moral reason to select, of the possible children they could have, the child who is most likely to experience the greatest wellbeing – that is, the most advantaged child, the child with the best chance at the best life’.

Among the ethical objections to PB (and there are many), arguably the most serious is that it creates a eugenics mindset – an ‘arms-race’ as parents iteratively seek to ensure that their child is not placed at a competitive disadvantage.

There are also other serious ethical and social concerns surrounding IVG that must not be ignored. For instance, it could change the meaning of parenting and the received and conventional structure of the family.

IVG could result in ‘single-parent babies’ (not to be confused with single parenting). The cells from a man or a woman could be used to create both sperm and egg that could result in a baby. Such a baby would have only one genetic parent.

Although with the current state of the technology it is unclear whether this will in fact be possible, but if it were possible serious ethical and social implications are not difficult to imagine. Furthermore, it is also not clear if such single-parent babies would have the same health issues that arise from having closely related parents.

IVG would also allow older women to become a parent. Many of these women chose to delay pregnancy in order to pursue their career or find the right partner. Once the technique is perfected, IVG would be a more convenient way to achieve this than social egg freezing, which require the painful and dangerous process of egg procurement.

But there are serious ethical and social implications for women who choose to be mothers in their 40s, 50s and 60s. These issues have to do with the ability of these older mothers to properly nurture their young children and also the burdens their children may be subjected to.

Finally, because IVG enables scientists to generate egg and sperm cells from cells obtained from shed skin flakes, it might be possible for people to become parents without even knowing it. Again this raises serious and profound ethical and social concerns that must not be ignored.

As a ‘frontier biotechnology’, IVG would be accessible only to the wealthy in technologically advanced countries. This would exacerbate the already widening inequality in medicine and healthcare.

It is impossible to put a halt to this developing technology. The therapeutic potentials would spur scientists to pursue this technology to its very limits. Policy makers would be more inclined to introduce rigorous safeguards and protocols rather than imposing a ban or even a moratorium.

But, as experience has repeatedly taught us, international protocols and safeguards, important though they are, are unable to prevent transgressions and abuses that have serious social consequences.

Dr Roland Chia is Chew Hock Hin Professor of Christian Doctrine at Trinity Theological College and Theological and Research Advisor at the Ethos Institute for Public Christianity.