The Viability of In Vitro Gametogenesis for Social and Situational Infertility

In vitro gametogenesis (“IVG”), a process through which scientists may induce any human cell to become either an egg or sperm cell, might eliminate the need for injections and painful egg retrieval procedures associated with in vitro fertilization (“IVF”). Though IVG has proven successful only in mice, hypothetical applications to human reproductive therapy may also extend to socially or situationally infertile non-heteronormative couples. This could enable gay and lesbian couples to have children genetically related to both partners.

Though some individuals feel unsettled by the implications of lab-created human life, a biotech start-up by the name of Conception opened research to human applications of IVG in 2023. As of this year, Conception scientists remain focused on their aim to create a ‘proof of concept human egg.’ Chief Scientific Officer Pablo Hurtado and Chief Executive Officer Matt Krisiloff both expressed hope that IVG would allow them to produce children genetically related to both parents in their respective partnerships.

Amid the flurry of research surrounding IVG in humans, bioethical literature entered a debate regarding the ethical hurdles should IVG become an approved Assisted Reproductive Therapy (“ART”). Such debates center around who might be precluded from IVG. If IVG, like IVF, emerges solely as an ART method, this could mean that IVG would only be accessible for those who would have the capacity to conceive but for egg and sperm count/quality challenges (heteronormative couples).

However, situational infertility also plays a role in IVG’s use as an ART. For example, should a man and a woman who knew prior to their union that neither had the ability to conceive with one another decide to marry in spite of this, their choice to pursue union would render them situationally infertile (i.e., but for their choice to be together, either party possess the potential to conceive). By the same parameters, non-heteronormative couples could be considered situationally infertile and, as such, eligible to use IVG as an ART. Despite this, questions of ART access stretch beyond the degree of infertility status.

Currently, IVF is the ideal predecessor to which one could compare IVG’s eligibility for insurance coverage (should human applications come to fruition). The National Infertility Association advertises that only eleven states and the District of Columbia have passed broadly accessible fertility preservation coverage. Of these, only the Colorado Revised Statutes and the Illinois Compiled Statutes define ‘infertility’ in a flexible manner such that it could include situationally infertile non-heteronormative couples. These definitions indicate that IVG, like IVF, will not be available through insurance for non-heteronormative couples except within Colorado and Illinois. Even within Colorado and Illinois, degree of insurance coverage will heavily depend on the policy and coverage qualifications, which will not be measured uniformly among candidates. Because of this, IVG will become the next headliner in boutique baby making, accessible to very few individuals.

This predictable inaccessibility of IVG strikes a chord among reproductive justice advocates. Those who experience infertility often feel grief, depression, anxiety, and loss of self-esteem. Those who experience situational infertility within both heteronormative and non-heteronormative couplings experience a sense of social dissonance and distress. Lack of access to IVG may also propagate the harmful societal notion that adoptive children are inferior alternatives to genetic children. As reproduction is an inherently human function, reproductive justice advocates argue that equal access to all available reproductive therapy, regardless of one’s choice in partner, is a human right.

Nevertheless, amidst the current tumultuous battleground in Alabama over the ethical implications of IVF, many wonder whether some states will begin to block ARTs such as IVF and IVG altogether. From a practical perspective, issues concerning legal accessibility and insurance coverage (espoused above) will likely block such a high percentage of otherwise eligible couples as to render the restrictive implications of the Alabama IVF ruling obsolete where IVG is concerned. Should Conception and/or similar laboratories successfully patent a reproducible methodology for IVG in humans, such a patent would likely be sold to consumers in other nations whose healthcare and legal systems better cater to cellular inducement ARTs.

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