Lunch Hour Lecture: Reproduction without sex — what does technology have to offer?

Professor Joyce Harper’s (UCL Institute for Women’s Health) International Women’s Day Lunch Hour Lecture discussed the often taboo subject of scientific involvement in reproduction, why people choose to reproduce without sex and how science can solve reproductive issues.

Why is there an increased focus on reproduction without sex?

Professor Harper was blunt: “Unfortunately, as women, we aren’t well designed. As you sit here, in this lecture theatre, you are becoming more and more infertile with every minute that slips by, and after 35 years your fertility decreases significantly. By 42, it is very difficult to get pregnant, by 45 it is almost impossible.”

“Evolution has not kept up with feminism.” Across the world, and especially in developed countries such as the UK, women are delaying having children until their 30s. Twenty-first century opportunities mean that women are busy doing other things in their 20s, such as travelling and enjoying their career, rather than settling down and having children at the age that their mothers or grandmothers did.

This means that when women try to get pregnant in their 30s they are often surprised by reproductive issues and they come to IVF clinics at an average age of 38.

What are the current options?

IVF is available on the NHS and in private clinics throughout the UK, however, with the growth of the internet there are also other options.

‘Reproductive Tourism’, as it used to be known, offers women the chance to combine fertility treatment and a foreign holiday, possibly saving money and cutting waiting lists in the process.

As one website selling IVF treatment cringingly states: “The Barbados Fertility Clinic: a vacation that really delivers.”

Potential parents’ growing ability to shop around online can also be found in other areas of reproduction without sex. Just as sperm and egg donations were once confined to clinics, one can now order sperm online for home delivery for under £500, circumventing many clinical regulations in the process.

Other websites such as CoParent.co.uk connect aspiring parents, surrogates and donors with one another, so they can donate sperm or form new kinds of families by parenting together without being in a relationship.

Scientific breakthroughs are also making egg freezing, traditionally limited to cancer patients, available to more women who wish to have children later in life and avert the risk of growing infertility.

In fact, egg freezing is now provided to Time, Citibank, Facebook and Apple employees, among others, as part of their health insurance benefits package.

Moreover, egg freezing techniques have improved: “I used to tell my students, ‘One day, I will recommend you freeze your eggs’, and about two years ago, the technology became so good that I did,” Professor Harper told the audience.

What else does science have to offer?

The majority of these techniques deal with difficulties with getting pregnant; Professor Harper’s specialism, preimplantation genetic diagnosis (PGD), however, seeks to help not with getting pregnant, but with identifying embryos at risk of disease.

Recent advances in PGD mean that you can now buy DNA sequencing kits at your local pharmacy for £125, and Next-Generation Sequencing, which cost around £750,000 and took several months to complete when it was first used in 2008 now costs less than £1,000 and takes only 24 hours.

Traditionally, PGD allows couples going through IVF to ensure that the embryo selected does not have a specific genetic abnormalities such as an inherited disease.

However, with advances in genome editing that make it cheap, easy and precise, we might now be able to cure diseases and disabilities such as blindness by replacing an embryo’s defective gene with a healthy gene.

Such advances and their applications are obviously controversial; many are uncomfortable with genetically modified food, let alone genetically modified humans.

Experiments have already been carried out in China and, earlier this year, the Francis Crick Institute was given the first UK license to use gene editing techniques on human embryos for research.

What will technology have to offer?

The Crick’s licence is very specific: donated embryos will be used for research and not treatment, and experiments are carried out when the embryo is less than 250 cells. But it is not hard to foresee how such experiments will develop.

It seems inevitable that at some point in the future PGD will be used with all embryos and gene editing will be used to treat embryos—perhaps for diseases and disabilities, perhaps for non-medical reasons—in scenes that echo the 1990s sci-fi Gattaca.

Moreover, with developments in stem cell research, Professor Harper predicted that artificial eggs and sperm created from stem cells may allow homosexual couples to have biological children, with artificial wombs being used in place of surrogates.

She warned that if not properly regulated or widely available, these revolutionary technologies have the ability to produce reproductive and genetic classism, as only the richest would have access to genetic editing.

We must be careful with scientific technology surrounding reproduction, and the ethics of new treatments need to be widely debated, however, science offers huge opportunities to help individuals and couples to fulfil one of our basic instincts: the desire to reproduce.