Can society and the judicial system keep pace with the technologies of in vitro fertilization (IVF), stem cell biology, artificial wombs, and in vitro gestation?
On a Friday evening in late September, there was an obvious energy in the IQ Building atrium as faculty, staff, and researchers gathered for the first in-person Brews and Views event in well over two years. Chris Contag, Director of the Institute for Quantitative Health Science and Engineering, noted this significance as he introduced the session on “Human Reproduction in a Dish: The Science and Ethics of IVF & Artificial Wombs.”
A panel of experts sat facing the audience, ready to share their perspectives on innovations to the science of human reproduction that could dramatically impact reproductive health. These experts were Jennifer Carter-Johnson, PhD, JD, associate professor, College of Law; Leonard Fleck, PhD, professor, Center for Bioethics and Social Justice, College of Human Medicine; Richard Leach, MD, professor and chair, Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine; and Margaret Petroff, PhD, professor, Department of Pathobiology & Diagnostic Investigation, College of Veterinary Medicine.
Dr. Leach, reproductive endocrinologist and infertility specialist, explained new developments in human gamete derivation or in vitro gametogenesis (IVG) for IVF. Citing research on this process that has been successful in mice, he explained a future where it could be possible to create human embryos by taking an adult’s cells and reprogramming them into egg and sperm cells. Asking attendees to consider this possible future, he noted that there are already three companies in the U.S. and Japan related to IVG.
How far are we from this type of assisted reproductive technology (ART) existing? Dr. Margaret Petroff shared that there currently are 2.5 million IVF cycles per year—more than 500,000 babies born each year globally. Dr. Petroff stressed that there is still much to learn about long-term health effects of ART, and that long-term epidemiological studies are needed to learn about impacts of all types of ART.
What is it that makes us human? Dr. Jennifer Carter-Johnson, who is an associate professor of law with a background in microbiology, asked attendees to think about how life is defined—ethically, scientifically, legally. She noted that there is no good definition, that discussing human life is legally ambiguous. In contrast, there is legal precedent about when human life ends. Dr. Carter-Johnson discussed the complexities and unknowns related to the June 2022 Dobbs decision that overturned Roe v. Wade. Individual U.S. states are now making different decisions about access to abortion, and about how a person is defined. If life were to be legally defined as beginning at conception, that would greatly impact the current and future use of IVF and ART.
Philosopher and medical ethicist Dr. Leonard Fleck introduced the idea of an artificial womb and what medical purpose it would serve were it to exist. In theory an artificial womb might be used to save a fetus that was going to be born before viability, or by someone without a uterus. He characterized it as a micro version of a neonatal intensive care unit. The idea of an artificial womb brought up a wide variety of ethical questions related to abortion, who has the right to make decisions about a fetus in an artificial womb, and the high cost of the use of such technology creating access barriers and utilizing limited healthcare resources.
One message from the panelists in the discussion that followed was the importance of thinking about guidelines for this technology now, rather than waiting. The complexity of the topic continued to be apparent—legal, ethical, scientific, safety, health policy, and societal implications.
The question and answer portion brought forth more unique perspectives, demonstrated with both passion and vulnerability from panelists and attendees.
“We can only see a limited distance into the future when trying to assess new technologies,” stated Dr. Fleck. The event generated more questions than answers, but that is the very nature of the mission of Brews and Views. Though the event had officially ended, the room remained abuzz with conversation.
While Brews and Views continued virtually during 2020 and 2021, this event was not only the first in-person offering is years, but also the first that explored a non-COVID topic since the pandemic began. The series is an ongoing collaboration between the Institute for Quantitative Health Science and Engineering (IQ) and the Center for Bioethics and Social Justice, and aims to hold moderated discussions addressing fascinating and provocative areas of bioscience and engineering.