The Future of Human Reproduction (Part 3)

9 min readJul 26, 2022

Introduction

In Part 1, we tackled the present and future of birth control and abortion. Part 2 had us discussing Assisted Reproductive Technologies (ART), as well as the impact genetic technology is having on matchmaking and reproduction. For this segment, we will have a look at emerging trends and technologies, including some that aren’t possible (yet). And then we will look at various works of fiction that deal with a significant change in human reproduction, and judge how probable each of them are.

The Rise of Designer Babies?

Briefly mentioned in the last part, CRISPR-Cas9 (clustered regularly interspaced short palindromic repeat and CRISPR-associated protein 9), or just CRISPR for short, happens to be the latest and most promising of the gene editing technologies available at the moment. Made public in 2012, what makes CRISPR stand out compared to other genetic engineering technologies is cost and accuracy, along with the ease of use. In layman’s terms, CRISPR utilizes a natural process involving bacteria to modify DNA. It can be used to insert genes as well as delete them and has shown great promise in the treatment of diseases such as a sickle cell (also mentioned in Part 2) as has the potential to cure a range of genetic diseases including cancer, as well as blood, ocular and neurodegenerative disorders. However, there is tremendous controversy regarding utilization for reproductive purposes.

Source: https://www.cambridge.org/core/journals/mrs-bulletin/news/crispr-implications-for-materials-science

In 2015, the first experiments on human embryos were performed. A few years later, in 2017, an international coalition led by the US National Academies of Sciences, Engineering, and Medicine released a report that outlined the conditions that should be met before editing a human embryo that is destined for implantation into a human body. One of the criteria was that the DNA sequence created by the CRISPR edit must be common in the population, and carry no known risk of disease.

In 2018, a Chinese scientist announced that they had utilized CRISPR technology on two human embryos that were eventually implanted into the wombs of 2 women. Even though he said his team had made the children less susceptible to HIV, they were met by scorn and ridicule in the scientific community, and were subsequently sentenced to 3 years in prison by the Chinese government for an “illegal medical practice.” So far, the most recent regulated experiments have produced outcomes that have heightened safety concerns. Not only were the results unpredictable, but unintended consequences were usually the case. I believe it will be some time before we have safe, replicable CRISPR-related reproductive techniques, but in the meantime there is another technology that can produce a lot of the same results, without the downsides.

This technology, known as Preimplantation Genetic Diagnosis (PGD), involves testing IVF embryos to screen for specific genetic functions before they are transferred and implanted inside human bodies. According to bioethicist Henry Greely of Stanford University in California, “Almost everything you can accomplish by gene editing, you can accomplish by embryo selection.” PGD is already utilized by couples that are carriers for specific inherited diseases to identify which embryos didn’t inherit those unwanted genes. In the USA, PGD is performed on 5% of IVF cycles, and usually on 3- 5 day embryos. In the United Kingdom, embryos are screened for 250 diseases.

Source: https://www.shecares.com/pregnancy/preimplantation-genetic-diagnosis-pgd

Due to the difficulty of the limitations of egg harvesting, PGD is limited to disease prevention. But as both genetic and reproductive technologies improve, it seems inevitable that the scope will expand from focusing on traits that parents don’t want, to traits that they do want, potentially including cosmetic (eye and hair color, etc), as well as functional ones (height, intelligence). In 2009, it cost $50,000 to sequence a whole human genome. Today, it’s less than $2,000. What will it cost in 10 years? And what will be the societal implications of such technology being widespread?

Artificial Wombs

Ecogenesis, better known as artificial wombs, are a theoretical technology that allows for a pregnancy to develop outside of the human body. They have been a staple in science fiction since 1924, but are on their way to becoming science fact. In the mid 1990s, Japanese scientists were able to maintain goat fetuses for weeks in a machine that used artificial amniotic fluid. In 2017, researchers at the Children’s Hospital of Philadelphia demonstrated how they had grown premature lamb fetuses for 4 weeks in an artificial womb. Regarding human beings, with our present medical technology, it’s now possible for a fetus to survive outside of its mother’s womb as early as 22 weeks, which is a bit more than halfway through the pregnancy. In 2016 published two studies showing human embryos developing for 13 days in artificial wombs, one day short of the 14 day limit that is law in 12 countries, and a guideline in 5.

There are several applications for this emerging technology. Globally, premature birth (before 37 weeks) is the leading cause of death amongst newborns. As of 2018, an estimated 15 million babies are born premature every year. And of these 15 million, 1 million die each year because of complications from being born too early. Those that survive are usually disabled physically and mentally. According to the World Health Organization, the rate of children born prematurely is increasing every year. However, they also state that 75% of these deaths (which mostly occur in developing countries) could be prevented through current, cost-effective interventions. Artificial wombs could function as much better incubators for premature babies than the present neonatal intensive care units (NICU) and save millions of lives.

Other applications include fetal surgery at early stages, as well as an alternative for surrogacy. The latter of course would be a game-changer for non traditional (i.e same sex and so forth) couples. However, I believe that in developed nations, artificial wombs will serve as alternatives to abortions. As talked about extensively in Part 1, a lot has been changing lately when it comes to abortion laws. Over the years, there has been a shift from using trimesters as a standard to viability. Artificial wombs would clearly extend the viability of fetuses, and as the technologies develop, the laws will also have to change. Will artificial wombs make abortion as we know it obsolete? Will we ever get to a point where women will choose to utilize artificial wombs for portions if not their entire pregnancies?

Science Fiction Becoming Reality?

We now will look at examples in science fiction of many of the topics we have discussed, and assess the likelihood of the scenarios in each work of fiction.

“The One”

This Netflix original series involves a company that offers a DNA service to find people’s genetic “love” match. The show provides a clear example of the DNA Dating service that I mentioned in the previous part. It goes without saying that within the show, the service is extremely controversial, and also causes a spike in divorces as people seek to find true love in a very unorthodox, but technologically driven way. What is the probability of this happening?

The DNA companies today rely on consent. If people believed that giving their genetic information would give them an advantage in the dating market, a significant amount would do so. I would actually be surprised if this didn’t happen before the end of the decade.

“The Expanse”

James Holden, who is one of the central characters of Amazon Prime’s science fiction series “The Expanse”, also happens to have multiple biological parents; 8 to be exact. What is the chance of this becoming reality?

If three-parent children are possible now, it naturally follows that with improvements in technology, more genetic material from more people would be available for donation for Assisted Reproductive Technologies. The number of genetic parents may not be as high as James Holden’s, but our family trees will certainly become more complicated in the future.

“Star Trek”

The Eugenics War of the very popular science fiction franchise “Star Trek”, centered around genetically engineered human beings, called Augments. These “supermen” as they were called, were twice as smart, stronger, and more durable than unaltered humans. However their “superior genetics” had defects, and thus they also had superior ambition as a byproduct. It was not long before these Augments took over various nations and subsequently fought amongst themselves. Upon their defeat, genetic alteration of life forms was outlawed. What is the possibility of any of this becoming reality?

In any society that legalizes genetic modification of fetuses, it goes without saying that anyone who can pay for it, will likely do so, even if it’s as simple as removing negative genes. If parents believed that this would give their children an advantage in life, the vast majority of them would opt to do so, if they had the means. And because I can’t imagine such technology being as affordable to the masses of people anytime soon, it seems inevitable that a genetically enhanced elite would soon follow, and likely have enormous advantages over the un-enhanced. In human history, humans who have significant advantages over others usually take that advantage, and I don’t have many reasons to suspect that this scenario would be any different. With that said, conflicts would certainly emerge, and restrictions would soon follow, depending on which side wins.

“Demolition Man”

This classic from the 1990s centers on a utopian society where super virulent sexually transmitted diseases have made sex totally unsafe. As a result, human reproduction is done totally via IVF, while couples who want to enjoy sex do so via a virtual reality. What is the chance of this becoming reality?

While I do predict that human sexuality will drive Virtual Reality development the same way it drove VHS, World Wide Web and streaming technologies, I do not predict that it will outright replace sexual intercourse anytime soon, if ever. The same applies to IVF.

“Gattaca”

This movie from 1997 involves a caste society where your DNA is indeed your destiny. hose who are conceived via eugenics are classified as “Valids” and qualify for professional jobs, while those conceived naturally are labeled as “Invalids”and are restricted to menial labor. What is the possibility of this happening?

The technology that makes the entire premise possible is biometrics and I do see that becoming the primary means of identification in the near future. With that being said, I believe that a Gattaca future society is only possible if the “Valids” win the “Eugenics War” that was mentioned earlier. However, I can see religious sects and cults attempting small scale variations of what we see in the film.

“Children of Men”

The premise of this movie is a world where women have stopped giving birth and the chaos that ensues. The central plot is around protecting the first baby that had been born in years. What is the possibility of this happening?

This movie was based on the book of the same name. Published in the early 90s, when IVF was still in its infancy. With the various A.R.T available, the chance of global Infertility is low.