Multiplex parenting: IVG and the generations to come

Abstract

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.

Ovarian Tissue Cryopreservation / Transplantation for Social Reasons: Between (“Good”) Medicalization and Medical Treatment.

“…There are "minimal" forms of biological motherhood, either genetic (as in mitochondrial donation/replacement where the genetic-biological "motherhood" is minimal), or non-genetic (e.g., gestational surrogacy). In addition, under the (still experimental) prospect of "in vitro generated gametes" (IVG) [113], biologic motherhood may quantitatively be varying with regard to each single case.…”

“…Such gametes may enhance the reproductive ability of samesex couples or post-menopausal women [113], two categories for which being a parent is considered unnatural. Besides, in case of oocytes shared donation between the partners of a lesbian couple ("shared biologic motherhood") [114] there is a combination of biologic and gestational motherhood [115].…”

“…The advanced father age is said to be positively correlated with offspring's neuropsychiatric disorders (e.g. schizophrenia) due to damaged DNA in advanceaged father gametes (low quality gametes) [113].…”

“…Therefore, in my view, it might be considered as not (absolutely) unnatural. Our common perception probably might be infl uenced in this direction by the fact that the uterine functionality does not decline over the years as is the case with ovaries and the advent of the forthcoming "in-vitro generation of gametes" [113] through dedifferentiation and reprogramming of somatic cells that is expected to secure women's ability to "produce" gametes for life.…”

Disruptive reproductive technologies

“…Those in the legal and bioethics literature have suggested that IVG may in the future confront us with a still more complex conceptual future, where the number of genetic parents is no longer limited to two. The scientific literature has not yet proven feasibility but, for the purpose of thinking through the implications, consider the speculative possibility of so-called multiplex parenting, where one gamete is derived from two individuals and combined with the gamete of a third individual (24). Would we view each of those three as equal genetic parents, or do we give greater rights and duties to the parent who contributed more genetic material?…”