Lab-grown babies from stem cells: What does this new reproductive tool mean for next generation Indians?

Why are ‘designer’ babies a real possibility?

If this “designer” baby seems too unreal, scientists at Kyushu University in Japan have already “given birth” to mice using stem cells converted to eggs and sperm (gametes). In fact, UK’s fertility watchdog, Human Fertilisation and Embryo Authority, says a human experiment could be likely in the next three years. In India, there are mixed reactions among specialists of In-Vitro Fertilisation (IVF), a procedure which involves extracting an egg and sperm from a couple, fertilising them outside the body and implanting the embryo in the woman’s uterus.

Can IVG hold out hope for Indians in the future?

Dr Kshitiz Murdia, CEO of the Indira IVF group, says the technology will be a boon for infertile couples. “A study says that the reproductive age (ovarian function) of Indian women is now six years older than their Western counterparts. The sperm count of men has declined in the last 50 years and at this rate, men will be left with minimal to no sperm count in about four decades. The Indian population has gone below the replacement level of 2.1 and we know how other countries are suffering from this crisis of an ageing population without a younger generation to replace them. We need advanced assisted reproductive technologies and make them affordable too,” he says.

Can IVG give better results than IVF?

According to Dr Manish Banker, Director of Banker IVF in Ahmedabad and former president of the Indian Society for Assisted Reproduction (ISAR), the average success rate of IVF is about 60 per cent.

With couples harvesting eggs and sperm at 35, when both their quality and quantity are compromised, he has no option but to suggest donors. “But they want their own genes in the child, not an outsider’s. IVG will give them reproductive autonomy,” he says. “Besides, they would not have to fight against the biological clock to decide when to become parents,” he adds.

In-vitro gametogenesis (IVG)

Why women could choose the timing of motherhood

A woman is born with a finite number of eggs, which dips as she ages. So does the quality. “If I harvest eggs of an under-32 woman for an IVF procedure, roughly 60 per cent of the embryos will have a normal chromosome level. But if I harvest eggs from the same woman at age 42 and beyond and I produce 10 embryos, 7-8 will have an abnormal chromosome number, leading to potential birth defects,” says Dr Murdia.

Getting 10 embryos is not possible in one or two IVF cycles because the woman’s egg reserve has gone down. “But with IVG, I can get any number of competent eggs. The woman will not have to undergo multiple stimulation cycles or repeated operative procedures,” he adds.

What are ethical complexities?

Some doctors say first human trials need to be monitored to see how normal the child is. Besides, says Dr Nayana H Patel, Medical Director, Akanksha Hospital and IVF Centre in Anand, Gujarat, “Once lab-grown babies become real, people may stop going for natural conception altogether.”

She doesn’t rule out the abuse or overuse of this technology, one which allows ageing people in their 50s and 60s to birth children without considering their ability to raise a child. “We need to think about what kind of progeny we want in this world. Compassion and love are removed from the process of creating life and instead become something available over the kiosk,” she says of the commodification of “designer” babies.

Also, with multiple embryos becoming viable with IVG technology, which ones will be selected and developed as embryos? While IVG can be used to avoid those containing harmful genetic conditions, it could potentially be used to select those with specific traits. “The possibility of genetic manipulation for traits beyond medical necessity could lead to a loss of diversity. If people can have a ‘made-to-order’ child, it will be a very scary situation,” says Dr Patel, not ruling out manipulation for military applications.

This problem, says Dr Murdia, can be solved with regulation prohibiting unethical genetic modifications while allowing IVG for medical benefits.

IVG vs law

The Assisted Reproduction Technology (Regulation) Act 2021, limits the age (50 for women, 55 for men), reasons and gender of people seeking to use IVF. It has no provision for IVG, drafted as it was before it was developed. “However, there is no ban on new research or technology. Even in IVG, you are taking the stem cells of the intending parents, so I don’t think there should be a problem,” says Dr Manish Banker, who was a member in an early committee that drafted parts of the Assisted Reproduction Technology (Regulation) Act.

On the rights of same-sex intending parents to avail IVG, Dr Banker says the law currently applies to married heterosexual couples. “This can change only when the government changes the definition of marriage in India,” he says.

It’s not going to be cheap

Even if IVG is rolled out in the near future, initial costs will be high. “But once it is scaled up and gets volume, it will be cheaper. The chemicals and technology used in the conversion of cells are not so expensive,” says Dr Murdia. The market potential is huge considering 25-30 million couples of reproductive age are suffering from infertility and only two per cent of them come forward for treatment.