In Vitro Gametogenesis (IVG) – What Issues Does It Raise? Video recording and transcript

Posted on by Zindzi Cresswell

AI generated futuristic egg cell with pipette

Video Recording and Transcript of The Future of Human Reproduction team’s first Research Showcase Webinar:

1. In Vitro Gametogenesis (IVG) – What Issues Does It Raise?

Discussed by Stephen Wilkinson and Sarah Norcross

Facilitated by Nicola Williams and Laura O’Donovan

Organised by Zindzi Cresswell

Held on Tuesday, 28th January 2025

This work has been supported by the Future of Human Reproduction Programme, which has been funded by the Wellcome Trust under grant reference 222858/Z/21/Z.

Please note that this transcript has been edited for clarity and structure, while maintaining the tone and language of the original auto-generated content from the Teams webinar. It can be read alongside the related recording: Access the video recording here.

Section 1: Welcome and outline

Section 2: Intro to The Future of Human Reproduction project

Section 3: Progress Educational Trust

Section 4: How might IVG be used?

Section 5: Are the many research applications?

Section 6: When might IVG be available for clinical use?

Section 7: Key ethical and policy issues

Section 8: Ethical concerns

Section 9: Do the ethical and regulatory questions raised by IVG mirror those associated with existing reproductive technologies?

Section 10: Which uses of IVG do you think are likely to generate the most public interest or the most controversy?

Section 11: Has much public attitudes research been undertaken regarding in vitro gametogenesis?

Section 12: Open Questions:

  • Given the problems with NHS funding, is this technology going to be something for the wealthy in society? What problems could this create?
  • Is IVG more economically feasible than current practices?
  • Is more work needed to establish public attitudes and what do you think that should involve if it is needed, what should that look like?
  • What about the views of potential UK users?
  • If this technology could potentially make gamete donation obsolete, what implications might that have for existing families through donor conception and donor conceived people?
  • Issues of transparency
  • The impact of reproductive technologies on each other.

· The UK has the HFEA, but not everywhere has such robust regulation. What concerns do the speakers have about the unregulated use of reproductive technologies?

Close, thanks, and weblinks.

Section 1: Welcome and outline

Nicola Williams:

Welcome, everyone. My name's Dr Nicola Williams and I’m a lecturer in the ethics of human reproduction at Lancaster University. It’s my absolute pleasure to introduce you to today’s webinar, brought to you by the Wellcome-funded Future of Human Reproduction Project.

This is the first in a series of webinars, where different members of our team, along with some special guests, will share the work we've been undertaking and the questions we've been tackling over the last three years as part of our Wellcome-funded Research Development Award.

Now, today’s topic is particularly timely, given the HFEA statement on IVG published yesterday, and the importance placed on public engagement regarding IVG. The topic is In Vitro Gametogenesis (IVG): What issues does it raise? I’m joined today by Professor Stephen Wilkinson, Distinguished Professor of Bioethics at Lancaster University and Principal Investigator of the Future of Human Reproduction project, and Sarah Norcross, the Director of the Progress Educational Trust—an independent charity that aims to educate and promote debate on the responsible application of reproductive and genomic science.

Before we hear from Steve and Sarah, however, I’d like to go over a few housekeeping points. First, this webinar is being recorded and will be shared online at a later date. Second, let me walk you through the format for today’s session.

We’ll begin shortly with an introduction from Steve on the research topic and the Future of Human Reproduction project. Steve and Sarah will then spend around 15 to 20 minutes discussing some of the key ethical, legal, and social questions and concerns raised by in vitro gametogenesis. After that, we’ll open the floor to a Q&A session.

If you’d like to ask a question, please post it in the chat section. I’ll be moderating the Q&A alongside my colleagues Zindzi Cresswell and Laura O'Donovan, and we’ll try to ask as many of your questions as possible during this part of the session.

So, without further ado, I’d like to hand over to Steve to introduce the topic and The Future of Human Reproduction project. Thanks.

Section 2: Intro to The Future of Human Reproduction project

Stephen Wilkinson:

Thank you very much, and thanks to everyone for being here. Nicola mentioned, the Future of Human Reproduction project, I’ll say a little bit about that first.

This is a Wellcome-funded research project that explores bioethical issues from a very multidisciplinary and interdisciplinary perspective. We bring together colleagues from bioethics, design, English literature, law, linguistics, and psychology to approach these topics from different angles. The project focuses on three key technologies, which we’ve been examining to varying extents.

The first is what's sometimes called ectogenesis, or artificial wombs, which refers to technologies that allow us to gestate fetuses—and eventually babies—outside the human body. We’re not talking about that today, but it is one of our topics. The second technology we explore is genome editing in a reproductive context. And the third one, which we’ll be discussing today, is in vitro gametogenesis—or IVG.

What is IVG? I’ll just say a little bit about what that is. This will be a non-technical explanation—largely because I am non-technical myself.

In vitro gametogenesis (IVG) refers to a set of technologies that allow us to create sperm or eggs from cells that are not reproductive organs. In the standard case for animals, sperm comes from the testes and eggs come from the ovaries. IVG enables us to create either sperm or eggs from other bodily cells.

If it works—when it works—you could, for example, take a skin cell from an animal or a human and create sperm or an egg from it using stem cell technology. I won’t get into the details, but this opens up a number of possibilities that you might already be considering.

Firstly, it could be a very useful reproductive treatment for people who have reproductive organs that have been damaged or lost, so it could be used in that context. It could also enable other possibilities, which we might discuss later, such as creating sperm from a female body or creating eggs from a male body. So, in the future, it could potentially open up those possibilities.

So, that’s IVG. We’re using it as a term to cover all the technologies that enable us to create sperm or eggs in this non-standard way from other bodily cells.

That’s probably all you need to know from me for now. I’d like to hand over to my colleague, Sarah Norcross. It’s very, very nice to have you here, Sarah. Perhaps you’d like to say a few words about yourself and PET.

Section 3: Progress Educational Trust

Sarah Norcross:

Thanks very much, Steve.

So, yes, I’m Sarah Norcross, and I’m the Director of PET (Progress Educational Trust), which, as Nicola mentioned, is an independent charity. We focus on the cutting-edge scientific developments affecting reproduction and genomics. IVG is something we’ve been looking at and thinking about for quite some time.

What’s really interesting is that, looking back at my preparation for this webinar, my rather poor memory—shall we say—was jogged, and I realised that we’d actually worked on what we were then calling artificial gametes back in 2008 in Newcastle. Some work was being done there at the time, and it was also when the Human Fertilisation and Embryology Act was being updated.

It’s interesting to note that these discussions about these technologies have been ongoing for quite a while. Every so often, due to scientific developments, we get a little more excited about them, and the public and the press get more excited as well. I think that’s why it’s really timely that we’re having this discussion today, especially considering that this issue was in The Guardian yesterday and was also on BBC Radio Four’s flagship news programme, The Today Programme, just this morning [the HFEA statement]

So, perfect timing, Steve! I don’t know how your team managed that, but great work!

Stephen Wilkinson: Alright, thanks very much, Sarah!

Section 4: How might IVG be used?

Nicola Williams:

I suppose what we’ve covered so far is that you’ve given us a little bit of an introduction to what IVG is and how it’s been in the news in the last few days, particularly with the HFEA report. So, I was just wondering, could you tell me more about IVG and how it might differ from—or be similar to—currently available reproductive technologies? And, if so, who would use IVG and why might they choose it over other available options?

Stephen Wilkinson: Who's going to go first? Do you want to go first, Sarah?

Sarah Norcross: I think you go first, Stephen, then I'll chip in at the end.

Stephen Wilkinson: Ok, yes, well, in very general terms, there are probably three types of use for IVG:

1.

One use would be to replace or complement things which are already happening. For example, if IVG became very safe, effective, and cheap, you might imagine it replacing some of the processes used in regular IVF. Specifically, egg extraction could potentially be replaced by IVG, as it might be easier and safer to use IVG rather than remove an egg from a woman. With IVG, you could take a skin cell and create eggs that way.

Now, I should say that this is probably a long way down the road technically, but it's something that’s already being discussed. For instance, Sarah and I attended a meeting in the Netherlands earlier this year where some of the more technical people put forward the idea that this could become a possibility.

So, this could replace current practices, such as egg donation or sperm donation, allowing people to have children who are genetically related to them without needing a donor.

2.

The second type of practice is enabling new types of family structures. One example often discussed is the possibility of same-sex biological or genetic parents. For example, if two women could produce both a sperm and an egg between them, and one of them carries the pregnancy, they could create their own child without needing any donors. Similarly, this could happen for two men, though they would need a surrogate for gestation.

IVG could thus help enable more diverse family structures, offering same-sex couples the possibility of having biologically related children.

3.

Lastly, IVG could be used to facilitate more extensive selection of embryos. Henry Greely, the American bioethicist who wrote The End of Sex and the Future of Human Reproduction, has spoken about what he calls "easy PGD." This refers to the idea that IVG could allow the creation of a large number of embryos, making it easier to select embryos with specific characteristics. This could allow for more nuanced selection, although this raises ethical concerns, as Greely himself acknowledges.

So to summarise, IVG could be used in a fairly conservative way to support existing practices, it could enable new family forms, such as same-sex, biologically related families, or it could lead to more extensive embryo selection, as Greely suggests. These are some of the possible uses of IVG.

Sarah Norcross:

And on that point, I suppose it opens the possibility for women who are post-menopausal to have a genetically related child, even if they haven’t chosen to freeze their eggs. It may even remove the need for egg freezing altogether. Additionally, there are the different family forms that Steve has mentioned. This includes what is sometimes referred to as multiplex parenting, where more genetically related people are involved, rather than just two. It also includes what we at PET call auto-reproduction, where both the sperm and the egg are created from just one person.

I think, as people on this call can imagine, some of these possibilities garner more press attention and topical discussion than others. And, as you asked Nicola, when we look at the similarities – there's a striking resemblance between what is being done now and what might be done in the future if IVG is implemented in the UK, but within a licensed clinic. However, before we get anywhere near using in vitro-derived gametes for fertilisation, there would need to be a change in the law.

But there is another potential use that might not require a law change. If in vitro gametes are created in the lab and then transplanted back into a person’s ovaries or testes, and they go on to have a child naturally, that wouldn’t fall under the Human Fertilisation and Embryology Act. Instead, it would likely fall under the remit of the Human Tissue Authority for oversight.

Section 5: Are the many research applications?

Nicola Williams:

Super. So you've spoken quite a lot about the potential treatment uses of in-vitro derived gametes, but are there many research applications for which they could be used?

Sarah Norcross:

Well there are various research applications that could be explored. For example, IVG could be used to further our understanding of gametes and meiosis. It could also help us investigate how certain drugs might affect gametes. For instance, we could study the impact of medications taken by a mother or a father on their gametes. These are just a few examples of the research possibilities that come to mind.

Steve, perhaps you have additional thoughts on this?

Stephen Wilkinson:

No, I don’t have much to add on that, really. I think IVG could be a very useful research tool. Particularly for eggs, it could allow for research without needing to source gametes from an actual person, which involves costs and risks. This makes it a valuable resource. However, it’s likely that research applications will come into play long before clinical applications in humans, which, as we know, could be a long way off.

Section 6: When might IVG be available for clinical use?

Nicola Williams:

So it seems like from what you're saying that the potential of IVG is that it could essentially prove transformative when it comes to reproductive practises. So it could obviate the need to use gamete donors. It could transform kind of the procurement practises that we currently use. So when do you think that it might become available for clinical use?

Sarah Norcross:

I think if I knew that, Nicola, I’d also be able to predict the winning lottery numbers! It’s very difficult to forecast, as there first needs to be proof of concept. The safety and efficacy aspects will require a huge amount of work and testing. If we think about something like mitochondrial donation, it took a long time to go from proof of concept to clinical application. Even once the law changed to permit it, it wasn’t a matter of just opening clinics the next week.

If this technology does move forward, I’d expect it to be introduced in phases. While we’ve been discussing a range of possibilities, some are far more scientifically complex than others. For example, creating sperm from a woman won’t happen at the same time as producing an egg from a man. So, it’s likely to be a long and carefully phased process.

Nicola Williams:

OK. So we think that perhaps some of the more kind of rosy predictions about time frames are a little premature.

Sarah Norcross: That's my view.

Wilkinson, Stephen:

I could just chip in, my answer is going to be fundamentally like Sarah's, which is that I don’t know either! But Sarah and I have probably both been to meetings where people from the science side do make predictions. For example, the Guardian report from 2023 – when the headline about the mice with two fathers came out – quoted scientists, including some from Japan, saying it could be ready for clinical application in humans within 10 years.

We've also been to meetings where people are even more optimistic than that, although I would say most of the experts I’ve heard, especially from the science community, are more sceptical. There are significant differences between mice and humans, and, more importantly, the safety requirements in human reproduction are rightly very rigorous, especially in the UK and similar countries. It’s going to take a lot of preclinical research before we can even think about clinical use.

One thing to note is that the world is a pretty diverse place when it comes to the regulation of reproductive technologies. Some people, especially those with the resources, might want to use this technology – whether to overcome infertility or to have a same-sex biological family. And in countries with less regulation, they might go ahead with it. So, while it might happen sooner rather than later in certain places, I think for the UK, in a regulated environment, it’s probably quite a long way off.

Sarah Norcross:

And actually, Nicola, going back to what I was saying about the PET event in 2008 – the reason we held that event was because at the time, it was thought to be just around the corner. Efforts were even being made, led by Dr Evan Harris, who was an MP back then, to introduce an amendment to allow this once it became possible. And that was more than 10 years ago now.

Section 7: Key ethical and policy issues

Nicola Williams:

That's super. So what do you both think are the key ethical and policy issues that are associated with developing and using IVG for human reproduction?

Sarah Norcross:

The overarching ones have got to be demonstrating safety and efficacy because if it doesn't work and if it's not safe, then the other ethical issues fall away because we aren't going to do it.

Stephen Wilkinson:

Yes I agree. You're right that there's a baseline ethical question around safety, but as you say, it's really complex when we consider what we’re comparing it to. It's not just about safety in the traditional sense but also about the purpose of IVG, which, in many cases, is to provide people with the ability to have a genetic connection with their child that they wouldn't otherwise have, like with egg donation or adoption. How much weight we give to that relationship when assessing the risks and benefits adds another layer of complexity to the ethical debate.

The example of older women being able to have children using their own genetically created eggs is a really compelling one from an equality perspective, especially when we consider the longstanding ability of men to father children much later in life. This raises a really important conversation about whether this technology could potentially equalise reproductive opportunities between the sexes. Of course, people might find this problematic in various ways, but from an equality standpoint, I think it makes a strong case.

The idea of novel family forms is equally interesting. There are certainly positive arguments for enabling same-sex couples and others to have biological ties to their children, which could be seen as a step forward in reproductive equality. That said, these possibilities also come with huge caveats, especially regarding safety, as you rightly pointed out.

As for whether IVG should be publicly funded, I think that’s a really important question. Should we view it as a treatment for infertility, in which case it might be more appropriate for public funding, or should we see it as a more elective procedure for creating non-traditional family structures? There’s a case to be made for both, but I imagine the debate would be complex and nuanced. I’d be really interested to hear Sarah’s thoughts on how these different applications of IVG – particularly in creating novel family forms – might influence public attitudes and policy.

Sarah Norcross:

I think we have to go back to thinking about the welfare of the child and the family, which is already embedded in the Human Fertilisation and Embryology Act (HFEA), and how new developments like IVG might impact that. It’s important to consider what responsibilities these individuals—who may be involved in a child's life through IVG—would have.

At the moment, our legal system is set up with a more traditional family structure in mind, typically revolving around one or two parents, or a blended family. But with IVG, there’s a possibility that more people might be involved—perhaps four individuals—each playing a role in decision-making throughout the child’s life. This raises questions about how we allocate responsibility, particularly when it comes to decision-making.

For example, what happens if there’s a disagreement between these parties? It could be something relatively simple, like when a child should get their first mobile phone, or more significant matters, like how the child should be raised, which religion they should follow, or even which football team they should support—these are the kinds of issues that often spark debate in families.

The more people involved in a child's life, the more likely it is that disagreements will occur. And when you look at cases where similar situations have played out informally—without IVG, but involving sperm or egg donation, for instance—many of these have ended up in court. They highlight the complexities of managing these types of relationships and responsibilities.

When we consider the potential for more people to be involved through IVG, it becomes clear that these situations could get quite messy. If the system isn’t carefully thought through, it could lead to complications that are hard to untangle, especially if there are legal disputes about parental rights or responsibilities. That’s a scenario that’s a bit concerning, and we really need to think about it carefully before making any leaps forward.

Section 8: Ethical concerns

Nicola Williams:

And are there any other ethical concerns, particularly around consent? For example, there has been some talk about issues like 'gamete theft' and concerns regarding posthumous conception. What are your thoughts on these?

Stephen Wilkinson:

Well yes, this technology, as you've mentioned, does carry the risk of being used to create sperm or eggs from people without their consent. Essentially, the concern is that if it becomes relatively easy to create sperm or eggs from a small tissue sample, someone could potentially obtain your tissue and use it to create a child without your permission. In a way, this is not ethically complicated; it just seems wrong because of the lack of consent. However, there could be issues around how to prevent this from happening. If the process becomes very easy, would we need a regulatory or policing system specifically designed to criminalise and prevent this behaviour? These would be more practical questions regarding how to stop such events from occurring.

The ethics of it seem fairly straightforward in that sense. But there could be ethical issues that mirror those seen in donor conception. For instance, in the case of 'Multiplex parenting,' if one of the contributors is similar to a donor—making some contribution but not intending to be part of the social family—how much information and access should the child have? For example, if the contributor made only 25% or 12.5% of the genetic contribution, should the child have the same rights to information as a donor-conceived child? It’s a question worth considering. So, there are these additional factors to think about, and people do worry about the possibility of 'gamete theft,' which this technology could, in a future scenario, facilitate.

Sarah Norcross:

I think, as Steve has quite rightly said, a lot of the issues around gamete theft could be addressed through regulation and treatment in a licensed clinic. It’s not as though you’re going to be able to just get this done on the High Street. Scientifically, I think it’s going to be incredibly difficult to make it happen.

But when it comes to posthumous conception, we already tie ourselves in knots over those situations. For instance, when a couple is going through fertility treatment and one of them dies unexpectedly, and they haven’t signed the right consent forms with the HFEA, that becomes a real issue. So, I think that PET would hope, anyway, that when the HFEA comes before Parliament next, these issues around posthumous conception can be tidied up. This way, we don’t see so many of these cases ending up in court, which doesn’t seem like the right way forward in such often very tragic circumstances. So, I think part of the conversation around this could be part of the broader law reform.

Section 9: Do the ethical and regulatory questions raised by IVG mirror those associated with existing reproductive technologies?

Nicola Williams:

So, to what extent do you both think that the ethical and regulatory questions raised by IVG essentially mirror those that already exist around existing reproductive technologies, or are they more distinctive?

Stephen Wilkinson:

I think it's a mixture. Most of the issues raised by IVG are not fundamentally different from issues we've had with other reproductive technologies. The questions about what it takes for consent to be adequate and valid, how much information people should receive, the welfare of families, the welfare of the child, and safety – these are crucially important issues that come up every time a new reproductive technology is introduced.

This is not to say that they don't need to be revisited, refreshed, and contextualised for each new technology, but I don’t think they’re fundamentally different in form.

The new aspect with IVG, however, is the possibility of biological family forms that haven't been possible before. Do they raise any special issues? Should they be permitted, encouraged, facilitated, or funded? These are the questions that are quite specific to IVG.

For example, the concept of multiple-parent families or auto-reproduction – I quite like the term auto-reproduction,actually. Sometimes it's referred to as cyano-reproduction, where one person provides both the sperm and the egg. There are technical and safety concerns that suggest this may not be a good idea, but it remains a theoretical possibility.

There are also new scenarios like the potential for women to have their own genetic children at a much older age. This could, in time, require significant social change. So I’m very interested to see how this develops.

There are, of course, a lot of familiar issues that we know from other contexts, which is a good thing because we can learn from past models and the mistakes made then.

Sarah Norcross:

And I think, also, the ethical issues arise if it's possible to create IVG from a single person at scale, and therefore make embryos at scale. This opens up ethical questions about how many embryos should be created for these people to have enough viable embryos to complete their family, or enough viable embryos that can be tested for genetic conditions. How far should we go with those sorts of things if it becomes a possibility?

I think it's always worth reflecting on this and thinking about some of the things that might make us feel a bit uncomfortable now. People’s views on these matters do tend to change over time. Take IVF, for example – in 1978, before Louise Brown was born, people felt very differently about it.

Section 10: Which uses of IVG do you think are likely to generate the most public interest or the most controversy?

Nicola Williams:

So that brings me on quite nicely to my next question, which is which uses of IVG do you think are likely to generate the most public interest or the most controversy?

Sarah Norcross:

Now, the tabloids love to have a go at older women having babies. A lot of female columnists love to write about it. I've seen many such columns over the years, especially when social egg freezing was introduced, and you could store eggs for up to 55 years. That generated masses of media coverage.

So, I can see that this would really get people talking, along with the concepts of multiplex parenting and auto reproduction. I think these would be the three things that people would really be up in arms about

Stephen Wilkinson:

Yes, I agree with that. I mean, I think same-sex biological reproduction probably won't attract that level of hostility. I wonder if it could be presented, as it should be, as a good news story—if it can be done safely and effectively—as part of the equality journey we've been on.

So, I think that would definitely attract interest, but hopefully not the kind of hostility on that scale. However, yeah, I think the other things Sarah talked about will definitely attract significant negative attention from the media.

Section 11: Has much public attitudes research been undertaken regarding in vitro gametogenesis?

Nicola Williams: And has much public attitudes research been undertaken regarding in vitro gametogenesis?

Sarah Norcross:

Last year, PET had a little exhibition at the Science Museum in London as part of their Science Late programme, and we asked people there what they thought about the potential uses of IVGs. We received about 100 responses, and the thing people were most in favour of—no surprise—was using it to help people with total infertility.

People were also very strongly in support of its potential to reduce the burden of IVF on women, and its use in same-sex female and same-sex male couples.

However, they were less supportive of its use for women of post-menopausal age or beyond normal menopause, and they were most against auto reproduction. That said, about one-third of the respondents did support auto reproduction, which really surprised us.

It was quite interesting to see the shift in public opinion. Looking back to 2008, we actually asked the audience at that event some questions as well. We had traffic light cards, I believe. Back then, 6% of the audience (and that was 86 people, so the percentages are not entirely accurate) voted for a total ban. 53% said artificial gametes should be banned for now, but that regulatory powers should be included in the Act for future use, while 41% thought there should be no specific ban.

So, it was interesting to see that even back then, there was quite a bit of positive support, or at least an open-minded approach. It’s also worth noting that large-scale public engagement on this in the UK hasn’t really been done, as far as I’m aware.

Stephen Wilkinson:

Yes, we were all at a meeting in the middle of last year where some scientific research from the US was presented. This research particularly focused on the use of IVG to facilitate same-sex biological families, examining people in same-sex relationships to see how keen they were to use it.

I think the findings showed that there was significant enthusiasm amongst a portion of those people. However, there was also some pushback, particularly concerning the idea that this technology might lead to a very conservative, genetic-biological model of the family, which some people found objectionable.

But yes, I think more research of that kind would be very welcome. It would help us understand who wants to use IVG, why they want to use it, and what the public views on it might be. Those findings were particularly interesting, especially regarding what you mentioned about auto-reproduction.

Nicola Williams:

Ok, super, well, I think that at this point, given that there are quite a lot of questions in the Q&A section, we should probably move over to answering some of those. So I'd like to hand over to my colleague, Dr Laura O'Donovan.

Open Questions

1. Given the problems with NHS funding, is this technology going to be something for the wealthy in society? What problems could this create?

2. Is IVG more economically feasible than current practices?

Laura O'Donovan:

Thanks, Nicola. So, we've got two questions in the chat that relate to funding. I’m going to ask them both because I think they cover related aspects.

The first one is: 'Given the problems with NHS funding, is this technology going to be something for the wealthy in society? What problems could this create?' And the other question, again about funding, is: 'Is IVG more economically feasible than current practices? So, is it only going to be available for the wealthy, or is it more economically feasible than what we currently have?

Sarah Norcross:

Now, I don't know about you, Steve, but I'm not sure how much this is going to cost by the time it gets to the clinic and the end user. Usually, when new technology comes along, it’s more expensive at first, and then the price might plateau or even go down. So it’s difficult to predict what the cost will be, and of course, that will impact whether it could be made available on the NHS.

We have to remember that in 1978 we had the first IVF baby in the UK, and in 2004 we had the NICE guidelines setting out the access criteria, etc. And yet, we still haven’t managed to achieve (unknown) in 2025. So, I think it’s going to be a big ask, particularly in the current climate with the NHS. If it’s going to be used instead of IVF, it would have to demonstrate some sort of cost-saving. And at the moment, the access for female or male couples to fertility treatment on the NHS is very poor indeed in the UK

Stephen Wilkinson:

Yeah, I mean, from an ethics point of view, I suppose it should just be subject to the same cost-effectiveness and safety criteria as other treatments in this field. So, as Sarah indicated, we assume it’s going to be phenomenally expensive for quite a while, and then hopefully the price will drop as it becomes more mainstream and more efficient.

And, as we mentioned earlier, it could even be used as part of regular IVF, potentially creating a cheaper, safer, and better way of producing eggs. That’s a theoretical possibility. But yes, I’m sure it will be very expensive to begin with, and outside the context of research studies, it may not be something that is publicly funded initially—not because of any principle-based objection to it, but simply because of the cost.

3. Is more work needed to establish public attitudes and what do you think that should involve if it is needed, what should that look like?

Laura O'Donovan:

Ok, that’s great. To go back to public attitudes then, I think there’s another question here. You've covered most of those aspects regarding what the public might—or what a cross-section of the public might—think about some of these potential uses. But the second part of that question is about whether more work to establish public attitudes is needed. And I’d add to that: What do you think that should involve, if it is needed? What should that look like?

Sarah Norcross:

I think more public engagement work is definitely needed. Whether that’s through specific focus groups, public dialogue workshops, or something else, I think a whole range of methods would be useful to gauge public attitudes towards these issues. So, there’s room for both surveys and smaller, in-depth focus groups. I don’t know what you think about that, Steve?

Stephen Wilkinson:

Yes, I agree. Given the relatively complex and unfamiliar nature of technologies like IVG, I think a public dialogue approach would be very welcome. It's quite resource-intensive, but I think it’s important. If you can sit people down with scenarios, provide them with information, offer different perspectives, and allow them to take their time absorbing everything and discussing in small groups and then with the larger group, that could be really valuable.

A really in-depth public dialogue is a great approach to these kinds of issues. If you just conduct a survey, the majority of people might not have heard of IVG. If they're only engaging with short written or video materials, they might not fully grasp it. Given the complexity—not only of the science but also of the social and ethical issues—some form of in-depth public dialogue seems like the best way forward.

Sarah Norcross:

I’d also be really fascinated if, alongside general representative public attitudes work, there was a specific focus on what fertility patients think about this. Whether they are in favour or not, just because they need treatment doesn’t necessarily mean they’re automatically pro cutting-edge science. I think that would be very interesting to explore, personally. It would be really valuable to hear their views.

4. What about the views of potential UK users?

Laura O'Donovan:

Yeah, thanks for that. I think that links to a question that we've got here from Suzanne. It says you discussed public attitudes research, albeit limited. But what about the views from potential future users in the UK? [Noting Steve], you mentioned some research on this in the US can or should we move forward spending resources on the potential use of this technology in the UK before we know that this desire exists or can we take desire for this technology from such user user groups as a given, given the possibilities that it opens up.

Stephen Wilkinson:

Well, it'd good to have that information about user groups and possibly and potentially, maybe, that is easier to extract than the public dialogue. I mean, public dialogue could be a way of doing it. But I mean maybe you can ask people, you can say, you know, would you consider using this if it was an option? So, perhaps it isn't so complicated. So yeah, it'd be good to have that information about what demand there is for it. Absolutely. I don't know, what you think Sarah?

Sarah Norcross:

I think, yeah, you've done some work on this, Steve, but given people's overwhelming desire for genetic relatedness to their children that seems quite hard to get to the bottom of that overriding desire. I think it, you know, it's sort of wouldn't be surprising if they were in favour of that. And I think for people who go through fertility treatment unsuccessful and realise that donation is the way forward. They often find that difficult to move to donor gamete because of that. So I think there will be, and I wouldn't be surprised that there'll be a strong desire from the from the patients.

Stephen Wilkinson: I think there is clearly a large number of people who would prefer to be genetically related to their own children. Certainly. I mean, you can question that whether that's a good preference to have, but clearly, lots people do have it. And so absolutely, I think IVG would be, in principle, wanted by those people, though again, it's going to depend on things like safety cost and so on, but in the more distant future, if it became well established, I think it would be an attractive option for a lot of people.

Sarah Norcross: And I suppose that gives rise to the problems with accessibility and the false hope that potentially this technology may give to people and actually cause more upset if it is something that they're never going to be able to afford or have available to them.

If this technology could potentially make gamete donation obsolete, what implications might that have for existing families through donor conception and donor conceived people?

  1. If this technology could potentially make gamete donation obsolete, what implications might that have for existing families through donor conception and donor conceived people?

Laura O'Donovan:

That's great. Thanks. We've got some questions now. Moving on to sort of look at this comparison with other methods for donor conception. So, if this technology could potentially make gamete donation obsolete, what implications might that have for existing families through donor conception and donor conceived people?

Sarah Norcross:

I'm not sure that we'd ever completely get rid of gamete donation. Fundamentally, I think this is due to the difficulties in creating sperm from a woman, for example—which is something that has already been mentioned in the discussion. Some of these biological processes are incredibly complex.

Additionally, if a single woman wants to have a child, she would still need a donor. That might simply be a sperm donor, which could be a more affordable option than using IVG.

Some individuals may also prefer not to go through a licensed clinic, as not everyone chooses that route. Because of this, I believe gamete donation will always exist in some form.

In terms of what this means for donor-conceived families and the donors themselves, I think they will continue to have the strong communities they currently do, supported by organisations such as the Donor Conception Network. So, I don’t foresee any significant changes in that regard

Stephen Wilkinson:

I completely agree with what Sarah said. That being said, you can imagine a much more distant future scenario where IVG becomes very mainstream—very easy and very affordable. In that case, the number of donor-conceived offspring could drop dramatically. If that were to happen, and donor conception became more unusual, there might be concerns about that community becoming more marginalised.

However, I think that’s a very distant possibility. For now, the pragmatic reasons for surrogacy and gamete donation remain.

7. Issues of transparency

Laura O'Donovan:

So, we've got another comment here about donor conception. It's more of a comment than a question, but I do wonder if you have any reflections on it.

This is from Natalie, and she says:

"Initially, when using donor gametes, recipient parents were advised to keep quiet about it. However, research now suggests the opposite—that children fare better when they know they are donor-conceived. If IVG babies become common many years in the future, there will need to be a whole new narrative about 'the birds and the bees' for children in schools, or even for the general public to understand it. Presumably, the same issue of transparency would apply here, just as it does with donor-conceived children."

Do you have any thoughts on that?

Sarah Norcross:

Yes, Natalie, I think it is the same. We can certainly learn lessons from the past.

However, depending on the family setup, there may not be a big reveal where a child learns that one of their parents is not a genetic parent. In this case, the aim is for the child to be genetically related to both—or even all four—of their parents. So, while it’s slightly different, the principle remains the same.

From my experience, people often find it easier to tell children about their conception when there isn’t that additional layer of complexity. This might be more comparable to telling a child they were conceived through IVF, rather than having to explain donor conception and its implications. It’s essentially IVF—but more advanced. That additional complexity is what changes, rather than there being a moment where the child receives significant new information at a certain age. That whole aspect would no longer be an issue.

Stephen Wilkinson:

Yeah, I think that’s a great point. The comparison with IVF works really well because, in cases where IVG is used to reinforce the biological family—so that the social family is also the genetic family—it’s quite different from revealing that someone outside that group provided the genetic material.

In that sense, it’s more about explaining a technical aspect of the reproductive process, which the child might not be particularly concerned about. That said, while this isn’t my area of research, everything I’ve heard from those who do study this suggests that openness, transparency, and honesty from an early age lead to better outcomes and overall well-being.

So, given that, I absolutely think parents should be open about IVG.

8. The impact of reproductive technologies on each other.

Laura O'Donovan: Yeah, and I wonder if, rather than discussions about the right to know your genetic origins, we’ll actually move towards a broader conversation about the right to know how you came to be—the method by which you were created.

We’ve now got some questions about the introduction and regulation of these technologies.

Vicky asks:

"Do you have any concerns about the impact that developing reproductive technologies may have on each other? For example, people may be in favour of IVG, but when combined with something like artificial placentas, it could be seen as too much and tip the scale against the technology. Do you think each technology should be introduced slowly and separately, or could a combined introduction actually garner more support?"

Stephen Wilkinson:

Well, I suppose if you’re simultaneously using two experimental or very new technologies on the same future person or embryo, that would presumably magnify the risk and introduce a great deal of complexity.

From a safety and research methodology perspective, I would have thought—though this isn’t my area of expertise—that keeping them separate would be a good idea. That way, you’re not compounding the risk or causing interference between the two research programmes. So, probably yes, introducing them separately makes sense.

But that’s just my view—I’m not speaking from any methodological expertise on this. What do you think, Sarah?

Sarah Norcross:

I’d be speaking from the same lack of expertise, but it does seem more sensible to keep things separate and allow each technology to be tested and proven before combining them.

Trying to introduce everything at once, as outlined in the question, would likely be quite problematic.

Stephen Wilkinson:

I suppose the question is more about regulation, which is slightly different. In that case, it might actually be a good idea to have a wide-ranging, comprehensive set of regulatory and legal reforms, rather than tackling each technology one at a time.

That’s a different consideration—rather than separating the technologies themselves, we’d want a coherent regulatory system that can handle all these developments as they emerge. It should be consistent, based on similar underlying principles, and capable of addressing advancements from different areas in a structured way.

So, if the question is more about regulation, then yes, we should take a broader approach. We should be looking ahead, scanning the horizon for what’s coming, and developing a framework that can effectively accommodate these new technologies as they arrive.

Sarah Norcross: Absolutely.

9. The UK has the HFEA, but not everywhere has such robust regulation. What concerns do the speakers have about the unregulated use of reproductive technologies?

Laura O'Donovan:

I was just going to say, thanks for that, Steve. That actually leads us into the final question we have here, which is:

The UK has the HFEA, but not everywhere has such robust regulation. What concerns do the speakers have about the unregulated use of reproductive technologies?

So, that’s our final question—worries about the unregulated use of this technology, given that not every country has a strong regulatory authority overseeing activities in this area, like the HFEA in the UK.

Sarah Norcross:

For me, the biggest concern would be patient safety and the outcomes of the pregnancy, if one is achieved. There’s also the possibility that people could be, in effect, mis-sold this technology.

I think that, for me, is the main issue. As we’ve seen with some areas of stem cell research and rogue treatments in various countries, there’s a real risk of unregulated use leading to harmful outcomes. That would be my primary concern.

Stephen Wilkinson: Yes, I totally agree. This is one of those issues where we do have experience and models from other technologies. There’s been a lot written and researched about cross-border reproductive travel, including the pros, cons, and the risks it can bring.

So, yes, there are certainly risks with unregulated use—whether it involves UK residents travelling abroad or just situations in other countries. As we mentioned earlier, the first clinical use of this technology could well occur outside a regulated context, especially if someone is particularly keen to make it happen. I’m somewhat worried about it, to some extent, yes.

Close, thanks and weblinks

Nicola Williams: OK, so in order to finish on time today, I just want to thank the speakers for today’s session. It’s been really interesting to hear about the ethical, social, and legal questions that in vitro gametogenesis raises. I’d also like to thank those who participated and asked some really fascinating questions.

So, thank you, everyone. We look forward to seeing you at our next webinar.

If you’d like to find out more about the work we’ve been doing as part of the Future of Human Reproduction grant, you can visit our website or check out our LinkedIn page

Thanks again.

Related Blogs

Disclaimer

The opinions expressed by our bloggers and those providing comments are personal, and may not necessarily reflect the opinions of Lancaster University. Responsibility for the accuracy of any of the information contained within blog posts belongs to the blogger.

Back to blog listing