The Future of Fertility: In Vitro Gametogenesis, Embryo Regulation and AI in IVF

About this episode

In this bonus edition of More Questions of Science from the Francis Crick Institute in London, experts return to unpack the latest in fertility science and its ethics. The discussion centers on in vitro gametogenesis in humans, embryo modelling, genome sequencing, AI in IVF, and the future of surrogacy and ectogenesis.

Key takeaways include the current status of making eggs and sperm from skin cells, the regulatory constraints around embryo research, the ethical dimensions of genome sequencing for newborns and embryos, and how data driven approaches may influence reproductive choices and policy.

• In vitro gametogenesis in humans remains exploratory and is not yet a standard IVF route.
• Whole genome sequencing raises questions about consent, knowledge, and the social implications for future offspring.
• AI may assist in interpreting complex parental and embryo data but requires careful governance of data and regulation.
• Surrogacy and ectogenesis present long term possibilities but face substantial scientific and ethical hurdles.

Introduction and guests

This episode features Lucy van der Veel, a reproductive technologies expert from King’s College London, and Ganesh Taylor, a developmental biologist at the University of Edinburgh, who return to discuss advances since the original future of fertility panel. They address how scientific progress interacts with ethics, policy, and social impact in fertility care.

In vitro gametogenesis in humans

The conversation opens with an update on in vitro gametogenesis (IVG), the process of generating eggs or sperm from skin cells in the lab. While mouse IVG had been demonstrated, a recent US study extended the approach to human cells using nucleus transfer techniques inspired by cloning milestones. The scientists transplanted a skin cell nucleus into an enucleated human egg, prompting the skin cell to behave as a germ cell precursor and produce fertilizable eggs, though at a low efficiency. The panel emphasizes that this method still relies on donor eggs and does not yet bypass traditional egg retrieval. The ethical and regulatory questions are foregrounded: would IVG become a normal IVF path, what risks and equity concerns arise, and how societal norms about parenthood might shift if technological barriers were lowered?

Regulation, cloning and genetic shuffling

A key scientific nuance discussed is that the IVG-derived eggs carry half identical DNA to the parent cell, reflecting the absence of meiosis driven genetic reshuffling. This leads to concerns about genetic diversity and the potential for increased cloning-like dynamics. Regulators, laws and licensing frameworks around germline modification and embryo manipulation are highlighted as powerful constraints on how quickly such technologies could be adopted, even if automation or new infrastructure make the lab work easier in the future.

Genome sequencing and the reproductive decision making

The NHS initiative to sequence whole genomes of all newborns within the next decade is discussed alongside embryonic sequencing. The experts unpack implications for personal decision making, risk interpretation, and the right not to know information. They note that interpreting complex genetic data will require context from clinicians, AI tools and public health resources, and that embryos present additional ethical questions about selecting against disease risks versus medicalizing reproduction. The potential for AI to assist in weighing embryo options is acknowledged, but with cautions about governance and bias in data handling.

Data regimes, AI and the regulation of fertility tech

The panel explores the difference between regulating cells in the lab and regulating data that flows across borders. Data-driven fertility decision tools could amplify disparities if access is uneven or if commercial platforms prioritize speed over safety. The integration of tech giants and venture-capital backed startups into fertility research is discussed as a trend that could intensify the push for rapid innovation but pose regulatory and ethical challenges.

Surrogacy, ectogenesis and the long horizon

The discussion turns to ectogenesis—the concept of growing a fetus entirely outside a human body, potentially in artificial wombs supported by an artificial placenta. The guests caution that, while there have been advances in placental research and preterm care, achieving a fully functional artificial pregnancy is far from imminent. They stress that pregnancy is a deeply dynamic, interactive process involving maternal physiology and fetal development, making engineering a complete alternative a formidable challenge. They also consider how ectogenesis might influence surrogacy needs in the future, but predict it is unlikely to become a short-term solution.

Fertility decline, diet, environment and actionable advice

Beyond embryo technologies, the episode addresses declining fertility and sperm quality linked to ultra-processed foods and microplastics. Ganesh Taylor notes a measurable sperm count decline in Western populations and underscores correlative, not necessarily causal, links to environmental exposures. He emphasizes that for men, a three-month window – the duration of sperm production – offers an opportunity to improve health by reducing heat exposure, plastics exposure, alcohol and high-fat diets to improve sperm quality.

Future physicians and ethical practice

In response to a question from a medical student Mez Hakim, the guests discuss how future doctors should approach fertility and reproductive health. They advocate for academic freedom, critical thinking, and a patient-centered, justice-oriented approach to ensure equal access to care. They caution that private clinics and private equity influence, while valuable in some respects, can constrain fundamental research and equitable training. The overall message is a call to nurture mindful, ethically grounded clinicians who can navigate rapidly evolving technologies while prioritizing patient welfare and social equity.

Conclusion

The episode closes with reflections on the balance between exciting scientific possibilities and the real-world regulatory, ethical and social dimensions that shape how fertility technologies will be used in the coming years. The presenters thank the audience and invite listeners to join the next episode.