In-vitro derived gametes and embryos
Published November 2016
New reproductive technologies allowing the creation of rudimentary embryos and the possibility of generating gametes in-vitro have the potential to overhaul how we conceptualise reproduction and parenthood.
Are there recent scientific, legal or social developments?
Creating in-vitro or ‘artificial gametes’ refers to the idea of making germ cells from embryonic stem cells or induced pluripotent stem cells. Researchers have been able to derive haploid mouse spermatid-like cells by stepwise differentiation of embryonic stem cells and these male gametes have gone on to produce viable and fertile offspring. In a recent breakthrough published in October 2016 scientists in Japan were able to create in-vitro mouse oocytes and have been able to use these eggs to produce fertile pups. The technique has been partway successful with human cells and in 2015 scientists from the UK and Israel reported creating artificial primordial germ cells (which are precursors to gametes) from embryonic stem cells and induced pluripotent stem cells.
Recent studies have shown that under the right conditions mouse and human pluripotent stem cells can form structures that have some resemblance to embryos during gastrulation, which is a critical point in development shortly after implantation during which the primary germ layers are formed. These structures have been called ‘gastruloids’ and although they do not currently resemble the human post-implantation embryo, they may one day, thus creating ‘embryos in a dish’, without the need for distinct gametes.
Are there complex ethical issues?
Such technology could potentially allow for a vast widening of reproductive choices and a redefinition of concepts of infertility. In principle the process could be used to derive egg cells from a man’s body and maybe even sperm cells from a woman’s body making reproduction for same-sex couples possible. In this way new genetic connections which were not previously possible may become a reality, providing same-sex couples with reproductive options that do not rely on donor material. On the other hand, there is the possibility of a de-geneticisation of human reproduction in which the genetic link between father, mother and offspring may no longer exist: for example, if a child is created with genetic material from just one person. Although donor conception and surrogacy already separate out the genetic link to a parent from the idea of parental responsibility, they both still fundamentally involve two distinct genetic origins. With this new technology the level of interference with so-called ‘natural’ reproduction is likely to invoke strong intuitive reactions perhaps because we attach some particular importance to a new human identity being derived from a traditionally human process. The impact on any children born as a result of this technology is also a subject of concern.
One broader ethical question might be whether there is a meaningful distinction between treating infertility as opposed to enhancing fertility. Some uses of these technologies would be to treat fertility pathologies, whereas others would extend fertility to those who would not ordinarily have it. Many existing reproductive treatments do not necessarily treat disease-related problems however. Even if these technologies would not be funded by public health systems there may be the potential for use in the private sector which would still require a regulatory response. Whilst still in the research stage, there may be concerns around appropriate informed consent for donors of biological material for research.
Many of the ethical questions surrounding artificial gametes are brought out in the Council’s commissioned background paper by Dr Anna Smajdor.
Is there a potential policy impact?
If these technologies continue to advance, there will be a need for regulatory decision as to whether to permit their use for human reproduction. There may be a question as to whether the HFEA has the moral authority to license the use of in-vitro derived gametes for treatment, given that when the HFEA was created this technology was not envisioned. Another issue will be how parenthood is defined and ascribed. The regulatory status of gastruloids, including whether they should be subject to the ‘14-day rule‘, is currently unclear due to varying definitions of what constitutes a human embryo, and will need further attention.
Is it a subject of public concern?
Previous public consultations have shown that the overall attitudes towards fertility treatments are largely positive but with many people concerned about unknown consequences. In a similar vein to the public outcry surrounding cloning, creating new life using such techniques is bound to attract significant public interest, and likely opposition.
Is consideration timely?
Members of the HFEA‘s Scientific and Clinical Advances Advisory Committee thought in 2008 that the timescale for deriving artificial gametes for treatment was between 5-10 years.
Can the Council offer a distinctive contribution?
Artificial gametes were already addressed in the February 2016 Forward Look meeting and some of this topic is likely to overlap with the upcoming workshop looking at the 14-day rule. The Council may be able to offer a project alongside work on the 14-day rule which could investigate a number of ethical issues that would need to be addressed in a more consistent regulatory framework that could accommodate in-vitro derived gametes and gastruloids.
Possible future work topics
This is one of the topics that have been suggested as possible project areas for further investigation by the Council. These topic summaries do not aim for comprehensiveness; rather, they are intended to sign-post some of the key considerations and to provide a starting point for discussion. Each summary includes links to relevant publications on the topic.