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Lately, there seems to have been a lot of talk about the possibility of ‘lab-grown babies’. Proper research into this area kicked off around a decade ago, and is still largely experimental in humans. But the technique used to potentially develop lab-grown babies could hold the power to provide a novel treatment option for human infertility. It does, however, also come with possible ethical and social implications. When we refer to ‘lab-grown babies’ here, what we are really talking about is growing human eggs or sperm in the lab using a field of biomedical research called in vitro gametogenesis (IVG). But what exactly is IVG, and how does it work? “In vitro gametogenesis, or IVG, is making gametes – eggs or sperm – in the lab. Scientists create induced pluripotent stem cells starting with a somatic cell (e.g. skin or blood cell), and are working to figure out how to direct those cells to develop into mature gametes that could potentially be used for reproduction. They have accomplished this in mice, resulting in mice being born from lab-made gametes, but have not done so for humans,” explained Katie Hasson, associate director of the Center for Genetics and Society (CGS) in Berkeley, in the U.S.. IVG shows promise in mice As Hasson pointed out, IVG has already been accomplished in mice; and it is Japanese scientists who are leading the way in this particular area. In 2012, Japanese reproductive biologists reported taking skin cells down the pathway towards eggs, reprogramming them to embryonic-like stem cells, and then into primordial germ cells, which are early cells that emerge as an embryo develops, later giving rise to sperm or eggs. Then, in 2016, the Japanese scientists announced that they had taken skin cells from the tip of a mouse’s tail, reprogrammed them into stem cells, and made those stem cells into egg cells. Then, once fertilized, the eggs were transferred to the uteruses of female mice, who gave birth to pups, some of which even went on to have babies of their own. This was the first conclusive evidence that IVG was possible in mammals. More recently, it was announced that Japanese researchers had also created mice with two biologically male parents for the first time. Here, the team generated eggs from the skin cells of male mice that went on to produce healthy pups when implanted in female mice. All of these advancements are considered a significant milestone in reproductive biology, as it could expand the possibilities for people who are unable to reproduce naturally, including for same-sex couples. California startup’s ambitious plan to make lab-grown babies The research by Japanese scientists surrounding IVG has now led to a crop of biotech startups wanting to transform human reproduction. One of those companies is California-based Conception, and, in an audacious effort to take this research one step further, they are working on turning stem cells into human eggs in order to give women the opportunity to have children even as they get older, eliminate the barriers for couples suffering from infertility, and potentially allow same-sex male couples to have biological children. Additionally, it could also allow same-sex female couples to have babies with genes from both women, and provide transgender couples with the opportunity to have biologically related babies. The company also says that, if proven safe, IVG could be a critical platform, allowing for widespread genetic screening of embryos, and could even eliminate and reduce the risk of devastating diseases for future generations, such as Alzheimer’s disease, heart disease and many different types of cancers. In its lab, Conception essentially reconstitutes the process in which egg cells would normally develop in the human body, generating pluripotent stem cells from blood samples, before taking them through the various steps required to turn them into viable eggs. These steps involve: differentiation, progression, follicle formation, follicle growth, and egg maturation. What potentially sets Conception apart from other biotech startups attempting the same goal, is that the company claimed in a recent report that - to their knowledge - they have gotten closer than anyone else to making IVG a reality by creating structures found in ovaries, known as follicles, which are vital for maturing eggs. Lab-grown babies on the horizon: when could it become a reality? Japanese scientist, Katsuhiko Hayashi - who was involved in creating the aforementioned lab-grown mice, and is a pioneer in the field - recently said that he believes humanity is only five years away from creating the first lab-grown babies. Dorothée Caminiti, director of the Bioethics program with the Markkula Center for Applied Ethics at Santa Clara University, agreed that we could see lab-grown babies become a reality within this timeframe: “There are still many safety issues and experiments that need to be run to call it a success, but I would not be surprised if, in the next five years, we are able to manage those risks and be ready, from a technical standpoint, to create babies using IVG.” But Hasson believes that, due to the fact the science around IVG is still technically in its infancy, it is a long way from being ready to be used for human reproduction. Plus, she added, there are also safety concerns to think about. “The process of transforming skin or blood cells into gametes could lead to genetic or other changes in the cells that could be harmful to a child born from lab-made gametes. The science here is very early, and there’s a lot that scientists don’t know – including how they will test whether lab-made eggs or sperm can safely and effectively be used for reproduction. Are there ethical ways to conduct these kinds of experiments – including health risks to women who would carry these pregnancies? Ultimately, we have to remember that the results of these risky experiments would be babies, human beings,” said Hasson. IVG raises ethical concerns IVG could help people unable to have children become a parent, and supporters of the technology say that this can only be a positive thing. But some experts have also raised ethical concerns over the technology. “Because IVG could potentially help anyone become a parent, a part of me wants to believe it is beneficial. Everyone of us has a deep desire to have genetically-related children (if and when we decide to have children). This is a very natural and understandable aspiration. “What is the price we are ready to pay for satisfying such a desire”, is the true question. And I am not talking about the financial price – even if the costs will certainly be so high that other inequalities and social justice issues will arise from this new business, for sure,” said Caminiti. One of the main risks of using IVG for reproduction, explained Hasson, is the fact that it could be used to generate large numbers of embryos that could be genetically tested and ranked using proprietary algorithms to identify the ‘best’ ones. “This takes us in the direction of attempts at creating people who are supposedly biologically superior to others and could lead to a new eugenics, in a Gattaca-type world of even more intense inequalities,” said Hasson. For this reason, there would need to be extremely clear regulations in place to keep heritable genome editing off limits. Hasson also said there are other ethical and social concerns to take into consideration when it comes to IVG, such as whether it will reinforce the idea that families are solely defined by genetic connections. This could potentially erase a lot of the progress made towards inclusion and support for diverse forms of families. “In any case, it is very clear to me that IVG could very easily spiral out of control,” stressed Caminiti. “Beyond the unforeseen physiological consequences that might come from this technology, there are huge consequences for our society. This asks us to deeply analyze and potentially reconsider what being a parent is, what being a child is, what being a family is, and how sacred this is.” “I don’t trust that the race towards scientific achievement should prevent us from asking these important questions, and debating them in order to find the right answers for us, as a society.” The question around whether IVG will benefit people by helping them to become parents, or whether it will instead lead to additional social and reproductive issues, is a debate that is likely to be ongoing until IVG actually becomes a reality for humans. But, for now, research surrounding IVG will continue, in an attempt to make it a viable technology that could transform human reproduction…for better or worse.