Recent breakthroughs in stem cell differentiation and reprogramming suggest that functional human gametes could soon be created in vitro. While the ethical debate on the uses of in vitro generated gametes (IVG) was originally constrained by the fact that they could be derived only from embryonic stem cell lines, the advent of somatic cell reprogramming, with the possibility to easily derive human induced pluripotent stem cells from any individual, affords now a major leap in the feasibility of IVG derivation and (...) in the scope of their potential applications. In this paper we develop an ethical framework, rooted in recent scientific evidence, to support a robust experimental pipeline that could enable the first-in-human use of IVG. We then apply this framework to the following objectives: (1) a clarification of the genetic parenting options afforded by IVG, along with their ethical underpinnings; (2) a defence of the use of IVG to remedy infertility, broadening their scope to same-sex couples; (3) an assessment of the most far-reaching implications of IVG for multiplex parenting. These include, first, the liberation of parenting roles from the constraints of biological generations in vivo, allowing multiple individuals to engage in genetic parenting together, thus blurring the distinction between biological and social generations. Second, we discuss the conflation of IVG with sequencing technology and its implications for the possibility that prospective parents may choose among a hitherto unprecedented number of potential children. In view of these perspectives, we argue that, contrary to the exhausted paradigm according to which society lags behind science, IVG may represent instead a salient and most visible instance where biotechnological ingenuity could be used in pursuit of social experimentation. (shrink)

An exciting development in the field of assisted reproductive technologies is In Vitro Gametogenesis (IVG) that enables production of functional gametes from stem cells in the laboratory. Currently, development of this technology is still at an early stage and has demonstrated to work only in rodents. Upon critically examining the ethical dimensions of various possible IVG applications in human fertility treatment from a Sunni Islamic perspective, together with benefit-harm (maslahah-mafsadah) assessment; it is concluded that utilization of IVG, once its efficacy (...) and safety are guaranteed, could be permissible by strictly adhering to Islamic ethical principles related to marriage, biological/genetic relatedness, sexual intercourse, and moral status of the embryo/fetus versus that of the gamete. As a result, IVG will be acceptable for treating primary infertility, age-related infertility, and preventing genetic diseases. However, it will be unacceptable for application in posthumous reproduction, donor gametes, genetic enhancement, and procreation in same-sex couples. (shrink)

Lors des entretiens pré- IVG chez les mineures dans le cadre du Centre de planification, la conseillère conjugale se pose la question de ce qu’il est nécessaire de connaître pour que cet entretien aide la jeune fille à vivre son interruption de grossesse et à affronter éventuellement ses parents. Comment poser des limites à cet entretien bien particulier? Que transmettre dans le dossier de la patiente et dans la synthèse avec les autres partenaires?

Résumé En 1975, la loi inscrit l’IVG dans la juridiction de la médecine, investie comme instrument du contrôle social dans la régulation des naissances. La demande d’IVG demeurait pensée comme phénomène relevant de la pathologie. Cependant, une normalisation de cette activité s’opère dans le système de soins avec l’évolution de l’encadrement réglementaire et des techniques de prise en charge. Notamment, les sages-femmes sont enrôlées dans le réagencement des formes de l’action publique en la matière. Leur champ de compétence est élargi. (...) Ces nouvelles définitions de l’expertise médicale en santé sexuelle et reproductive donnent lieu à des délibérations sur les conceptions de la pratique abortive. L’association nationale des sages-femmes orthogénistes (ANSFO) se saisit de cette opportunité pour renforcer la légitimité du groupe professionnel, en opérant un travail cognitif de « physiologisation » de l’IVG. (shrink)

Voici un livre important. Ne nous laissons pas abuser par son titre discret et son illustration de couverture idyllique. Mine de rien, il montre, avec une maîtrise exceptionnelle, comment et pourquoi l’histoire des femmes est un moteur puissant de l’histoire tout court. On pourrait croire que l’accouchement sans douleur concerne seulement le confort des parturientes. On découvre ici que cette « révolution oubliée » a bouleversé non seulement l’histoire du corps, de la santé, de la douleur, ma...

ABSTRACT Recent developments in generating gametes via in vitro gametogenesis (IVG) from induced pluripotent stem cells (iPSCs) and their successful use for reproductive purposes in animals strongly suggest that soon these methods could also be used in human reproduction. At least two questions emerge in this context: (a) if a legislator should permit their use and (b) if ethical claims emerge that support their provision, e.g., by public health care systems. This urges an ethical reflection of the new reproductive options (...) this technique might offer. Since the concept of reproductive freedom is a key aspect for the ethical evaluation of artificial reproductive technologies (ARTs), it is necessary to analyze if the new possibilities emerging from IVG fall within the scope of this concept. The results may constitute a morally relevant difference between different imaginable applications of IVG and potentially justify differences in claims to access this technology. (shrink)

This paper explores whether egg donation could still be ethically justified if in vitro gametogenesis (IVG) became reliable and safe. In order to do this, issues and concerns that might inform a patient’s reasoning in choosing to use donor eggs instead of IVG are explored and assessed. It is concluded that egg donation would only be ethically justified in a narrow range of special cases given the (hypothetical) availability of IVG treatment and, further, that egg donation could itself be replaced (...) by donation through IVG techniques. Two possible criticisms of this position are then considered: Ones based on respect for patient wishes, and on loss of donor benefit. It is concluded that whilst neither argument constitutes a strong enough reason to continue with programmes of egg donation, egg‐sharing programmes could still be permitted come the advent of IVG; these could then provide a morally acceptable source of “natural” donor eggs. (shrink)

In vitro gametogenesis (IVG) might offer numerous research and clinical benefits. Some potential clinical applications of IVG, such as allowing opposite‐sex couples experiencing infertility to have genetically related children, have attracted support. Others, such as enabling same‐sex reproduction and solo reproduction, have attracted significantly more criticism. In this paper, we examine how different ethical principles might help us to draw lines and distinguish between ethically desirable and undesirable uses of IVG. We discuss the alleged distinction between therapeutic and non‐therapeutic uses (...) of assisted reproduction in the context of IVG, and show how it is both problematic to apply in practice and theoretically dubious. We then discuss how the ethical principles of reproductive justice and beneficence apply to IVG for opposite‐sex reproduction, same‐sex reproduction, and solo reproduction. We suggest that these principles generate strong reasons for the use of IVG for opposite‐sex and same‐sex reproduction, but not for solo reproduction. (shrink)

In vitro gametogenesis (IVG) is believed to be the next big breakthrough in reproductive medicine. The prima facie acceptance of this possible future technology is notable when compared to the general prohibition on human reproductive cloning. After all, if safety is the main reason for not allowing reproductive cloning, one might expect a similar conclusion for the reproductive application of IVG, since both technologies hold considerable and comparable risks. However, safety concerns may be overcome, and are presumably not the sole (...) reason why cloning is being condemned. We therefore assess the non‐safety arguments against reproductive cloning, yet most of these can also be held against IVG. The few arguments that cannot be used against IVG are defective. We conclude from this that it will be hard to defend a ban on reproductive cloning while accepting the reproductive use of IVG. (shrink)

The Principle of Procreative Beneficence (PB) holds that when a couple plans to have a child, they have significant moral reason to select, of the possible children they could have, the child who is most likely to experience the greatest wellbeing – that is, the most advantaged child, the child with the best chance at the best life.1 PB captures the common sense intuitions of many about reproductive decisions. PB does not posit an absolute moral obligation – it does not (...) dictate what people must do. Instead it holds that there is a significant moral reason to select the best child, but one that must be weighed against other reasons.Recent research suggests that it may become possible to derive gametes (eggs and sperm) from human stem cells in vitro, a process which we will term in vitro gametogenesis (IVG). The ability to create large numbers of eggs or sperm through IVG greatly increases our capacity to select the best child possible. (shrink)

Recent advances in stem cell research suggest that in the future it may be possible to create eggs and sperm from human stem cells through a process that we term in vitro gametogenesis (IVG). IVG would allow treatment of some currently untreatable forms of infertility. It may also allow same-sex couples to have genetically-related children. For example, cells taken from one man could potentially be used to create an egg, which could then be fertilised using naturally produced sperm from another (...) man to create a genetically-related child with half of its DNA from each of the men. In this chapter, we consider whether this technology could justifiably be denied to same-sex couples if it were made available as a fertility treatment to different-sex couples. We argue that it could not. (shrink)

The Vatican’s position on in vitro fertilization (IVG), found in the ’Instruction on Bioethics’ (1987), is that all IVF is immoral, for it violates the normative procreative act of married spouses. The dilemma created is, if all instances of IVF are immoral, then God’s act in the Incarnation (granting the traditional doctrine) must also have been immoral. Conversely, if God’s act in the Incarnation was not immoral, then at least some cases of human IVF are not immoral either. A resolution (...) is offered. Two diagrams are employed. (shrink)

In this work I have tried to fill the gap left by the bioethical discussion on in vitro gametogenesis with regard to the contextual factors of the development of this technology. Starting from the understanding of IVG within the sociotechnical system of assisted reproductive technologies, I tray to explain, from a co-production point of view, the role played by agents and contextual factors in the configuration of the IVG. To do this, I use semi-structured interviews with specialist in embryology, as (...) well as scientific and philosophical bibliographic sources on IVG. Finally, I examine the disruptive capacity of IVG withn this context. (shrink)

Scientists are developing a technique called in vitro gametogenesis or IVG to generate synthetic gametes for research and, potentially, for treating infertility. What would it mean for feminist concerns over the future of reproductive practice and biotechnological development if egg and sperm cells could be produced in laboratory conditions? In this article, I take on the question by discussing the emerging technique of IVG through the speculative feminist analysis of ambiguous reproductive futures. Feminist cultural and science studies scholars have explored (...) the transformative effects of biomedicine on reproduction through science fiction novels and other cultural products. I theorise the speculative and visionary in biomedicine in the context of ethnographic methodology by drawing on ‘thought experiments’ conducted with stem cell scientists as shared acts of future-oriented contemplation. I develop the figure of SF proposed by Donna Haraway to investigate how science facts and speculative fabulation together shape futurities of reproduction. I propose including shifting frontiers in feminist thinking of the SFs in bioscience. Biomedical research aims to shift the borders between what is known and not known in reproductive biology, subsequently raising new technical, ethical and political issues in terms of stratified reproduction. The article shows that synthetic gametes are anticipated to intensify selective procreation. Simultaneously, IVG is seen to forge new biogenetic relationships and possibilities for non-normative reproduction and kin-making. Following Haraway, I argue that by ‘staying with the trouble’ of these biotechnological visions, feminist speculative analytics on technoscience offers a valuable tool to envision more hopeful and equal futures together with scientists. (shrink)

In vitro gametogenesis is the process of deriving gametes from embryonic stem cells or induced pluripotent stem cells. While not as well-known as in vitro fertilization, IVG could lead to more moral issues that would require corresponding responses from the Magisterium. Because IVG remains at the experimental stage, mainly using mice, the Magisterium has not issued any such responses in a document along the lines of Donum vitae and Dignitas personae. This essay situates IVG within Catholic moral teachings for those (...) who are unfamiliar with the teachings of the Church but who are interested in forming their consciences and those of others on what is undoubtedly a peculiar medical technique with many moral ramifications. (shrink)

Ces dernières années, l’avortement et l’accès à l’interruption volontaire de grossesse (IVG) ont de nouveau été au centre du débat public et politique. Si la proximité temporelle de ces changements rend difficile l’élaboration de leurs chronologies, certains événements marquants peuvent déjà être soulignés. Pensons par exemple aux attaques des droites populistes contre les droits reproductifs des femmes en Europe et aux États-Unis, telles que les tentatives d’affaiblir la loi sur l’IVG en Pol...

L'histoire du MLAC (1973-1975) est replacée dans la « bataille de l'avortement » en considérant les différentes expériences sociales et militantes des femmes comme des hommes, en province comme à Paris et en resituant l'action du MLAC illégale, mais considérée comme légitime, dans le cadre du mouvement de contestation des « années 68 » avec l'implication « d'intellectuels spécifiques », médecins et avocats. Compromis et retour à l'ordre, la loi de 1975 sur l'IVG, difficilement acquise, signe la fin du mouvement.

Abstract:Research into the development of stem cell-derived (SCD) gametes in humans, otherwise known asin vitrogametogenesis (IVG), is largely motivated by reproductive aims. Especially, the goal of establishing genetic parenthood by means of SCD-gametes is considered an important aim. However, like other applications in the field of assisted reproduction, this technology evokes worries about the possibility of creating so-called ‘designer babies.’ In this paper, we investigate various ways in which SCD-gametes could be used to create such preference-matched offspring, and what this (...) would mean for the acceptability of IVG, if it is premised that it is morally problematic to ‘design’ offspring. We argue that IVG might facilitate the creation of preference-matched offspring, but conclude that this should not undermine the moral acceptability of IVG altogether—even if one concedes the premise that creating ‘designer babies’ is morally problematic. In the light of this, we also point at a possible inconsistency for a position that condemns the creation of ‘designer offspring,’ while accepting the various endeavors to have genetically related offspring. (shrink)

Une situation de crise, ici représentée par une demande d’IVG, amène cette femme à exprimer sa plainte et sa difficulté de couple dans un cadre légal auprès d’un professionnel de l’écoute. Il s’ensuit pour elle une demande d’aide qui amène le professionnel à situer son écoute dans le cadre du Conseil conjugal puis, une nouvelle demande s’adressant au même professionnel pour une demande de thérapie avec changement du cadre.

The author examines two open questions for religious ethicists: whether continuing to have children is a bad idea, given the challenges of antinatalism and climate change, and how we should evaluate the future of reproductive technology. Kao responds to these questions without resolving them by drawing upon human rights, the reproductive justice framework, and principles of social justice.