Egg-Freezing, Uterine Transplants, and In Vitro Gametogenesis: Disruptive or Normalizing Reproductive Technologies?
Egg-Freezing, Uterine Transplants, and In Vitro Gametogenesis: Disruptive or Normalizing Reproductive Technologies?, 22
Hous. J. Health L. & Pol'y
Available at: https://repository.uclawsf.edu/faculty_scholarship/1954
In the last year, headlines have heralded the introduction of several radical new technologies that promise to revolutionize procreation and transform our understanding of reproduction. In March 2021, for example, scientists revealed that mouse embryos had been grown in" artificial wombs" for 11 days, roughly half the animal's natural gestation period. According to Jacob Hanna, the biologist at the Weizmann Institute of Science in Israel who led the research team: "This sets the stage for other species. I hope that it will allow scientists to grow human embryos until week five." At the same time, two groups of researchers reported the creation of synthetic human embryos generated from skin and stern cells, which they term "blastoids" to differentiate them from blastocysts created through the joinder of sperm and egg. These technological breakthroughs have already provoked regulatory reform. In May 2021, the International Society for Stern Cell Research (ISSCR) relaxed the famous 14-day rule for embryo research and replaced it with a recommendation for case-by-case consideration, which would entail scientific review and a public approval process. However, previous experience with assisted reproductive technology suggests that techniques that once began as experimental, such as IVF, have often been translated to clinical practice with little or no regulatory oversight. For example, once the "experimental" label on egg-freezing was dropped, use of this technology has become widespread, with egg-freezing rates rising by dramatic percentages over the last decade, despite scant evidence regarding safety or efficacy. Indeed, the data indicates that the rate of egg-freezing increased even more during the pandemic, contrary to the expectations of fertility clinics and physicians. Similarly, in the wake of the first successful womb transplant in Sweden, the practice seems to have proliferated widely across the world, even though early trials demonstrated limited success. These developments suggest that technological breakthroughs in assisted reproductive technology often trigger the relaxation of regulatory restrictions, and that once experimental techniques rapidly become prevailing practices. The potentially speedy progression from scientific discovery to commercial process raises a number of questions regarding revolutionary new reproductive technologies. What will be the impact of these seemingly radical new reproductive technologies? Should they be regarded as "disruptive reproductive technologies" with the potential to transform existing social structures, or should they be normalized as simply providing new methods to engage in age-old practices? And will they actually enhance autonomy and expand opportunities for disadvantaged individuals and groups, or will they reinforce and perpetuate existing inequalities? This paper will attempt to explore some of these questions, focusing upon three relatively new types of assisted reproductive technology: egg-freezing, uterine transplants, and in vitro gametogenesis (IVG). All three of these technologies promise to liberate individuals from the limits of biology by supplying them with the biological resources necessary to create children who are the product of their own genes and gestation. This enables individuals to keep reproduction all in the family, free from the need to procure gametes or gestational services from third parties, who could trigger concerns about the possibility of coercion or exploitation, or become entangled in relationships and assert claims to the resulting children. In so doing, these technologies offer hope for a scientific solution to the complex ethical, legal, and social problems posed by prior methods of assisted reproduction, such as gamete donation and surrogacy. Yet in reality, each of these technologies merely substitutes one set of complications for another, and all of them present new perils.
Houston Journal of Health Law & Policy