Improvements in IVF mean the procedure could—in theory—become the default means of human reproductionby Philip Ball / January 2, 2018 / Leave a comment
While babies have been born by in vitro fertilisation (IVF) for four decades now, this form of assisted reproduction is still in its infancy. Give it several decades more and things could look very different indeed.
At present, it remains a difficult, uncomfortable and uncertain process. A woman’s egg production must be stimulated artificially with hormones, while other drugs are needed to suppress the menstrual cycle. Egg collection is painfully invasive, and fertilisation by sperm “in a test tube” doesn’t guarantee good-quality (or indeed any) embryos. One or two embryos (in general) are then transferred to the womb in another surgical intervention, where hopefully they will implant and develop. The success rate, in terms of live births, for women under 35 is around 40 per cent, but it drops rather quickly with age.
But some commentators think that making eggs and embryos may eventually become so easy—and control of embryo characteristics so routine and dependable—that IVF will become the default means of human reproduction. We could be looking at “the end of sex.”
Speaking at a recent London meeting on the future of human reproduction, organised by the Progress Educational Trust (PET), philosopher Anna Smajdor of the University of Oslo used that arresting phrase, though she admitted that it was more of a rhetorical provocation than a prediction. Certainly there’s no reason to suppose that non-reproductive sex will go out of fashion. But in his 2016 book of that same title, law professor Henry Greely of Stanford University in California, a specialist on developments in assisted reproductive technology (ART) and their legal context, outlined a scenario in which it might indeed become the default option to make babies the “artificial” way, via IVF.
What is that scenario, and just how plausible is it? According to Greely, two technologies in particular could promote such an outcome (he neither advocates nor deplores the possibility in itself). The first would enable us to ditch the current, troublesome method for accessing eggs. That in itself wouldn’t obviously make IVF any more attractive than the traditional means of conceiving a child, when that’s an option. But what if IVF embryos could be quickly and cheaply screened to produce a predictive profile of their genetic inheritance? Then you could not only avoid embryos with susceptibilities to genetic disease but pick out those with genetic advantages. To go even further, what if such defects or enhancements could be edited out of or into the respective genomes?