Here are fertility options that can curb ‘baby factories’

Although new revolutions in fertility solutions are sprouting up through transformative technologies, child trade seems to be thriving under the radar through the use of deceit, undue influence, kidnapping, and abduction by agents of the illicit trade.

There are fertility options that can effectively trump these activities, especially with the falling cost of in vitro fertilisation (IVF) technologies – the ability to fertilise an egg outside of a woman’s body, in a laboratory.

While much of the groundwork for future developments has been laid through IVF, more groundbreaking advances would allow large new groups of previously infertile or sterile couples to become parents.

Some advances will allow for an age-independent and limitless supply of sperm and egg cells, Princess Therese, an investment director in the biotech fund of M Ventures, said in an analysis of the future of fertility.

“We may soon be able to make sperm and eggs from patients’ skin or other somatic (non-reproductive) cells, by reprogramming them into stem cells and then into egg and sperm cells. This technique is termed in vitro gametogenesis (IVG) and has already been successful in mice and is being tested in human cells in the lab. This is particularly important for people who cannot produce egg or sperm due to genetics or cancer treatment, or for older women,” she said.

Another technology that would be less controversial and could tackle a woman’s finite pool of eggs is in vitro maturation (IVM) of immature egg cells, known as follicles.

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Currently, patients receive uncomfortable hormonal treatment to mature eggs, so that they can be harvested for IVF. With IVM, one could circumvent this stressful and expensive process. The more significant impact, however, would be to enable lifelong fertility by taking an ovarian biopsy with follicles at a young age, freezing them, and maturing them for IVF later, she said.

An alternative could be the development of egg-producing artificial ovaries, for which preliminary models in mouse studies have already been published by research groups but are still far away from use in humans.

IVM and artificial ovaries could also address premature infertility caused by cancer treatments. For such patients, fertility could be preserved by isolating the patient’s follicles from the ovarian tissue before cancer treatment, subsequently transferring them to transplantable artificial ovaries, bioengineered using the patient’s ovarian cells. After cancer treatment and recovery, the artificial ovary could be transferred to the patient.

However, there are ethical concerns that society and lawmakers must consider along with the regulatory requirements for the development of cell and gene therapy products, Therese noted.

Some of these concerns are that research may require the generation and destruction of large numbers of embryos and the fear of embryo farming and devaluation of human life. There may also be a greater potential for human enhancement by being able to select from a larger pool of embryos than currently possible with IVF, especially if combined with gene editing technologies.

An easy supply of egg and sperm cells could lead to their unauthorised use, resulting in questions about who the legal parents are and whether genetic parents have the “right not to be a parent.”

Ultimately, IVG has the potential to change the concept of parentage and to create a need to completely separate the statuses of genetic, gestational, and legal parents. For these reasons, the impact of IVG in the near future will likely be limited to enabling research until we have solved the technical, safety, ethical, and law challenges.