Remarkable Medical Breakthroughs of IVF and Embryonic Advancements Also Raise Questions

Louise Joy Brown, the first baby ever conceived through in vitro fertilization (IVF), entered the world on July 25, 1978. The medical procedure IVF happens when mature eggs are extracted from a woman’s ovaries, fertilized with sperm in a lab, and subsequently implanted in a receptive uterus to develop into a healthy baby until birth.

At the time, the idea filled some with joy and others with dread regarding what “unnatural” events the future might hold.

Nonetheless, in the past few years, biological researchers have engineered a list of replacement body parts that would turn Victor Frankenstein green with envy.

The depiction of glass eyes, gold or porcelain teeth, titanium bones may have been prevalent in gothic and fictional literature, adding an element of intrigue and macabre fascination. However, today’s updated catalogue includes beating hearts, cochlear implants for the hard of hearing, and collagen (protein) fiber nets that support the growth of new skin.

Scientists appear to be on the cusp of constructing an entirely new human body, signaling remarkable advancements in the field of medical science.

In a significant breakthrough two years ago, separate teams of American and Australian researchers individually collected embryonic stem cells or reprogrammed cells derived from adult tissues, and carefully placed them in a Petri dish. As they observed the remarkable process, these cells gradually transformed into “blastoids,” which resemble blastocysts—the fundamental cellular structures that facilitate the transformation of an embryo into a fetus.

While their objective wasn’t to create a baby, these groundbreaking experiments initiated a promising avenue for enhancing reproductive technologies like IVF. Furthermore, these advancements hold the potential to explore novel approaches in preventing pregnancy loss and birth defects, opening doors to potential breakthroughs in the field.

Or, to create a complete, developing fetus.

This is exactly what Israeli biotech company Renewal Bio did in 2022, albeit at a non-human scale. Without the use of sperm or eggs, they successfully generated a mouse embryo by bringing together rodent stem cells within a Petri dish. These stem cells autonomously connected and developed into an embryo with vital organs such as a beating heart, an intestinal tract, and even a functioning brain.

“The vision of the company is ‘Can we use these organized embryo entities that have early organs to get cells that can be used for transplantation?’ We view it as perhaps a universal starting point,” Jacob Hanna, a biologist at the Weizmann Institute of Science in Rehovot, said in an interview with MIT Technology Review.

Hanna’s goal is to eventually create artificial models of human embryos that correspond to pregnancies at around 40 to 50 days of development. At this stage, crucial organs have already begun to form, along with the emergence of tiny limbs and fingers.

However, the start-up, which is funded with seed capital from the venture firm NFX, had been pretty vague on their overall plan. According to Omri Amirav-Drory, a partner at NFX, Renewal Bio doesn’t “want to overpromise” or “freak people out.”

“The imagery is sensitive here,” Amirav-Drory told MIT Technology Review.

Right now, as Arthur Caplan, Director of Medical Ethics at NYU Langone Health, notes, “embryos/embryo constructs which vaguely resemble actual human embryos but are not the same and cannot be used to create human beings due are useful to study genetic diseases and why miscarriages occur.”

In fact, as you read this, the only stem cell-based products approved for use by the U.S. Food and Drug Administration (FDA) for use in the United States are “blood-forming stem cells (hematopoietic progenitor cells) derived from cord blood. These products are approved for limited use in patients with disorders that affect the body system that is involved in the production of blood (called the ‘hematopoietic’ system).”

But in science “right now” is a temporary time zone. Which means these studies raise several ethical questions.

An additional factor that warrants caution is the current prohibition on federal funding for any research involving embryos in the United States. This restriction, known as the Dickey-Wicker Amendment, applies regardless of the method employed to create the embryos.

Although the current embryoids seem to fall outside the purview of existing legal restrictions, there is a possibility that they could be subject to such limitations if scientists manage to make them more lifelike. The science policy office of the National Institutes of Health (NIH), the notable funding agency with an annual budget of $33 billion, explains it employs an internal evaluation process to assess grant proposals and determine whether the “proposed research would create an organism that meets the statutory definition of a human embryo.”

Scientists are busily working on ways to manipulate fetal genes to alter or eliminate disabilities. If scientists eventually learn to produce viable living beings in their labs, does that mean they will be also be able to produce designer babies, that is, infants with the right color eyes, the right body, and the right brain?

“It’s absolutely not necessary, so why would you do it?” Nicolas Rivron, a stem-cell scientist at the Institute of Molecular Biotechnology in Vienna told MIT Technology Review. Rivron believes scientists should only create “the minimal embryonic structure necessary” to generate cells of interest.

The question of whether to regard this child, along with the countless IVF babies who have come after Louise Brown, including Louise herself as a mother now, as “one of the most remarkable medical breakthroughs of the 20th and 21st centuries” is a complex matter.

Its answer is not solely determined by scientific aspects, but rather by our individual and societal perspectives on how we choose to define the term “human.” In essence, the verdict is yet to be determined at this stage.