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Science Is Getting Us Closer To The End of Infertility (wired.com)
37 points by sethbannon 9 months ago | hide | past | web | favorite | 51 comments

Infertility is terrible, but I worry that technologically-assisted reproduction is a mistake that could cause far worse problems. It will remove selective pressures that keep human reproduction viable without technology. That's true for any step of it: from gametogenesis to birth. If that happens, a whole host of nasty problems erupt:

* What happens to humanity when technological civilization has a hiccup, if it can only reproduce with access to advanced technology?

* What happens to human rights when reproduction can only occur with the assent of the authority that controls the technological means of reproduction?

* etc.

Perhaps the research should be focused on diagnosing and permanently curing the underlying causes of infertility, than on trying to work around them?

Human society has already progressed beyond the usefulness of laissez-faire evolution as evidenced by obvious dysgenic trends. If you think about it, it makes sense: society and technology are now highly influential and dynamic over timespans that are barely a blip when it comes to evolution. There's also the fact that withholding this technology from people would effectively constitute eugenics, and in liberal democracies we tend to value peoples' individual rights in these situations.

Also humans are currently evolving to need technology to give birth due to the use of C-sections anyway [0].

I don't think it matters in the long term as you seem to believe. Within a few hundred years we'll probably have widespread genetic engineering or at least manual selection of traits. So in the short term this technology will help make people happy, and in the medium term the evolutionary effects on the human gene pool will be irrelevant.

[0] http://www.bbc.com/news/science-environment-38210837

Also in the future technology should become more self contained. Factories for producing any other factories should become widespread enough for technological supply chains to be ubiquitous. Let's hope that we can contain the environmental footprint as well. Ecological collapse would be the true interruption/hiccup in all this.

> Also in the future technology should become more self contained. Factories for producing any other factories should become widespread enough for technological supply chains to be ubiquitous

Isn't this a variation on the idea that the internet would render censorship obsolete and ineffective?

Having harmful genetic mutations widely spread in population is indeed a risk, but it's a problem with medicine in general, and we are not close to that point yet.

Also a common cause of infertility that this technology will be helping with, will be old age. And though not marrying when you are young is not the smartest thing from evolutionary point of view, it's not harmful genetic mutation, and there is no good reason for medicine to not help these people.

I agree, i think that the consequences of this tech, combined with advances in genome editing, are insane.

My imagination sort of goes wild with this sort of thing. You could imagine governments or companies creating clonal populations of genetically engineered humans as a captive labor force. Or wealthy individuals creating genetically enhanced "clones" of themselves, many of which would probably be horribly mutated

Most of those scenarios will probably not be possible due to regulation, and the more likely near term outcomes are actually very positive: curing monogenic (or potentially even more complex) genetic diseases for one example. I'd expect a lot of VC investment into this area in the next 5 years, and I'd expect to see a lot more articles like this as people try to prepare the public / regulators for this new technology

I think an argument could be made that we've passed a point at which technology is required for our species to survive.

We can still hunt, farm, eat, and reproduce without it, but not at present population scales. As a result any technological failure would trigger an apocalyptic Malthusian scenario that would probably climax with global thermonuclear war over remaining resources.

I'd say we passed the technological point of no return on July 16th, 1945:


The giant "kaboom" heard in the desert that day was the sound an evolutionary ratchet clicking. It is no longer possible to go backward without catastrophe.

"We can still hunt, farm, eat, and reproduce without it, but not at present population scales."

But isn't that a double edge? As we've scaled so has the depth & breadth of the consequences of that expansion.

I'm no Luddite. But this coin has two sides. It often feel as if we're having to reach further (and the risks increase) as one scientific solution leads to others, and so on.

I think the plain cost of all of these alternative reproduction methods will make sure that the natural method remains the most popular method for a long time.

That will certainly be true initially, but I don't think we could be certain of that over any significant period of time. Assisted reproduction may end up as cheap as a blood test is today.

What scenario do you envision where the whole species (or even large populations) wouldn't be able to have children without technology or approval?

Here's the scenario: assisted reproduction allows infertile people to reproduce. If the causes for the infertility are genetic, the genes for infertility traits will become more common. Eventually, after many, many years, they may become universal (since they stopped being barrier to reproduction). This might happen faster than expected if there's a strong selective pressure for genes related to infertility for other reasons, or the treatments prevent selections for adaptions to newer conditions (e.g. pollutants).

That second point could happen without tech.

The first point could too - modern technology has turned a number of conditions that were extremely serious in the wild into mere annoyances. Myopia, asthma, newborn jaundice, hernias, both high & low birth weight, obesity - all of these could easily be fatal if you (or your mom) needed to outrun a lion, but they're easily taken care of with modern medical technology, and hence have become extremely common in the general population.

And yet, the population isn't exploding in developed countries. This implies that something else must be receiving the selection pressure instead. I wonder what it could be?

Economic ability to pay for these medical treatments (well, in the U.S. at least), as well as all the other things needed to keep the lions away from the kids. There's a big fertility bust among what used to be the middle class, as many people don't see how they could possibly afford the necessities needed to raise a child (health care, housing, education, safe environment, parental attention) as they were raised.

(I suspect that there's also simply less selection pressure, in the sense that more people are having 1 or 2 kids, vs. in historical times where the emperor my have had 1000, a wealthy man dozens, and lots of paupers ended up with no kids at all. That has the effect of letting lots of genetic variation into the genome without immediately weeding it out, at least until some selection event occurs in the future.)

It could, but it would be a much weaker form of control that could be bypassed (by fleeing the city to the hills to reproduce freely, etc.). If you need an IVF lab to reproduce, it'd be much harder, perhaps impossible to escape the controls.

This is really amazing. We can take skin cells, turn them into stem cells, and turn those into viable eggs. The science behind the first step won the 2012 nobel prize in medicine [1]

This advance, combined with our ability to rapidly and precisely genetically engineer zygotes with CRISPR, has some incredibly amazing and some incredibly scary implications. We can already generate viable eggs from cells in mice's tails, fertilize those eggs, and edit the genomes of those zygotes precisely to produce custom genetically engineered mice (genetically engineered mice are a core tech in the biopharma research industry).

These technologies enable an unprecedented advance in the precision and throughput of this process and it seems very likely we will be able to do this in humans in 10-15 years. Factory-scale generation of zygotes and high throughput editing of those zygotes. I'd argue this topic deserves the same level of ethical scrutiny as AGI, if not more, as at least to me it seems that this tech is far closer to becoming a reality. My imagination may be getting away from me, but industrial scale human zygote editing seems like it could be the most significant (for good or evil) technological advance in our lifetime

[1] https://www.nobelprize.org/nobel_prizes/medicine/laureates/2...

This is great news. Before long, we can stop having kids naturally and just create them artificially in factories, like in the prescient 1949 novel "Brave New World", and let governments raise them in institutions run by professionals. Having amateurs raise kids has had mixed results at best, with many people proving to be absolutely terrible parents, and usually the people who are the worst parents having more kids than those who are actually good at it. Finally, we're now finding that when people are financially comfortable and busy with fulfilling lives and careers, they don't want to have kids, or very many of them (not enough to maintain the population). Outsourcing reproduction and child-rearing to the state will fix all of this.

I honestly can't tell if you're saying all of this sarcastically

Go read some Huxley and you'll find out!

Some thoughts:

> We can take skin cells, turn them into stem cells, and turn those into viable eggs.

How accurate of a copy of the parent's genetic material is this likely to be, compared to a naturally-produced gamete? Skin being the exterior organ that forms the body's first line of defense, it is subject to constant attacks and damage from without. As an example, the amount of accumulated genetic damage from sunburns is going to increase as a person grows older. So then, for this to be used on humans, would not the ideal place to take skin from be someplace that gets infrequent sun exposure, like say, the buttocks or thighs?

> These technologies enable an unprecedented advance in the precision and throughput of this process and it seems very likely we will be able to do this in humans in 10-15 years.

If it's available in 10-15 years, it probably won't be available to me and my partner, but it (or perhaps something better) may be available to any future children when they are ready to have children of their own. Something to keep an eye on.

This portion of the article must have a typo:

> "What if there are parents who wanted to select for Tay-Sachs disease?"

I doubt there are any would-be parents out there who want a child with a 5-year death sentence. Judging by the sentence immediately following:

> "There are plenty of people in Silicon Valley who are somewhere on the spectrum, and some of them will want children who are neuro-atypical.”

...I suspect the author intended "Tay-Sachs" to be "Autism".

And that entire paragraph touches on random fears about fertility technology that have almost nothing to do with the subject of this article, which is gametogenesis.

Yes and no because the article is also about the future possibilities of getting kids with desired traits (as you can generate those much better when you have a truly unlimited potential of egg cells). And there was for example recently a court case that (deaf) parents in Germany won so that thier (also deaf) child wont get a hearing implant.

Treating infertility through technological means is not necessarily wrong. For example, taking a safe medication that corrects for some defect of the reproductive system is fine. But this, and IVF, are no such medication.

"Yet a funny thing happened, or didn’t, in the decades that followed: Millions of babies were conceived using IVF."

This doesn't address everything. Certainly, the health of the baby is important, but that's not the only problem. Another problem is the destruction of fertilized human embryos that IVF currently entails. However, even if we assume that we can perfect the technology to such a degree that none of this is an issue. We still have to contend with things like the commodification of human beings and the transformation of human beings into products to be made and sold, and made the subjects of economic transactions. Our acceptance and aggressive defense of such reproductive technologies may be another example of consumerism's hold on our values.

[0] https://pdfs.semanticscholar.org/1d8d/eb87bcc3e610b8ff51b9f1...

Wired is definitely overselling the safety of IVF. Right now the oldest IVF baby, using the first generation technology, is less than 40 years old. So it will be several more decades until we really know even approximately how safe it is.

So far it doesn't seem to be excessively dangerous, but we really just don't know.

IANAD, but I believe that even after implantation, there's a lot of natural selection going on that helps remove unhealthy embryos. "30% to 40% of all fertilized eggs miscarry, often before the pregnancy is known"


That's a good point. But as we say when determining how fast a given piece of software will execute, "tools, not rules."

In other words, the fact that something should logically be safe certainly counts for something, but not as evidence.

Ok, but...is there any particular reason to think IVF is not safe, other than a superstitious ookiness about the methodology of the thing?

40 years without any such indication is fairly strong evudence, IMO.

1) There are a lot of studies showing an increased risk of various conditions, e.g. heart problems for babies conceived with ICSI.

2) It stands to reason that while some infertility is caused by issues that having nothing to do with the genetics of the sperm or egg (e.g. vitamin E deficiency), other cases may be caused by genetic conditions that have coevolved to cause fertility issues to prevent them from being passed along.

3) You'd have to completely rule out the possibility of sexual selection at the gamete level, even though this idea has been gaining traction in the last few years.

Good point. Here's my try at it:

IVF: Seems logically sound, since it is doing the same thing that happens in natural conception, just outside the body.

But in vitro gametogenesis (IVG)—the technique the article talks about—could logically have similar issues to cloning.

For example, telomere shortening & accumulated DNA damage come to mind, but I'm no expert.

As someone who went through multiple IVF cycles I am very happy to hear news of a less invasive process. The idea that you might be able to create gametes from adult cells is the stuff that makes me wish I took more biology in school.

(Our son is now 16 months old and amazing.)

Congratulations, it is a very tiring process

The earth doesn't have an infertility problem. The First World does. This research and solutions are a function of affluence, a market that can afford to pay for them.

The population is already here. It's just unevenly distributed.

Your comment reminds me both of a Chomsky opinion piece [1] and a Swift essay [2]. I couldn't agree with you more. The same can be said about 'food shortages' but in that case it's the other way around.

[1] Recognizing the “Unpeople” - https://chomsky.info/20120107-2/

[2] A Modest Proposal For preventing the Children of Poor People From being a Burthen to Their Parents or Country, and For making them Beneficial to the Publick - https://en.wikipedia.org/wiki/A_Modest_Proposal

I should probably add that empathy, and perhaps the understanding of the true meaning of love is also unevenly distributed.

It would be interesting to see long terms studies of the families of IF or similar technology driven conceptions.

If Mother Nature is speaking, how wise it to ignore her?

Great, now that people don't want to have kids because of over population and a negative impact on the environment, it's easier than ever to have kids.

What I fear is when science gets us to the point that humans are no longer necessary for reproduction


It's a fair sentiment. Infertility, while sad, is good population control. Unfortunately, it tends to affect well-educated, high earning people the most. Meanwhile, teenagers in fly-over county have had 4 children before they hit their 25th birthday.

If you are poor, then having children before 25 birthday is likely better choice. The older you are, the more health problems happen and the more tired you are. In that situation, having children while you are still physically strong and healthy is better idea then waiting till you are over 30, tired and cant afford to pay for higher risks.

These people wont have better paying jobs when they are older. It makes little difference financially.

Perhaps that's the rub? Had those same well-educated, high earning folks pursued procreation instead of education and careers in their formative years, the infertility later in life wouldn't be a concern (and likely more of a blessing).

That sounds like selection bias to me. If you're infertile and uneducated/low earning, then you're not going to be pursuing any IVF options.

The educated and affluent people having few or no kids, while poor teenagers have lots of them, is not a recipe for the long-term success of a nation or society.

Git off me planet! Mars got plenty of spaces.

Either we make life on Earth sustainable before that or we won't have enough time to develop the technology to settle on Mars anyway, so thinking of Mars as a backup Earth does not seem like a particularly good idea.

I think we should be on spaceships out of this solar system personally. Let's infect the rest of the Universe with people!

The universal availability of Taco Bell must invariably be the prime directive.

Just crash Ceres into Mars. Boom, geoengineered to be much nicer for us.

You have to have the power of the Q to do something like that. There's no way for humans to move Ceres that way, at least until we become a Kardashev Class II civilization.

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