In fall 2014, a speculum light shone bright on Silicon Valley after a number of large companies — i.e. Google, Facebook and Apple — announced they would offer new employee health plans that would include an option to freeze the eggs of female workers. Sounds great, right? After all, each round of egg extraction costs $10,000 plus the $500/year rent you’ll have to pay to store them. Plus, women are waiting longer to have children. According to the U.S. Centers for Disease Control and Prevention (CDC), in 1970, the average age of a first-time mother was 21, as compared to 2008, when the average age rose to 25.1.
So, with fertility treatments being so expensive and women having children later in life, how can these health care incentives possibly carry negative implications? Well, some have lauded it as progress for gender equality in the male-dominated tech sphere. Others claim that leveling the playing field should be about equal compensation and opportunity.
Keeping all these concerns in mind, what kinds of advances are being developed to shape tomorrow’s assisted reproductive technology? Let’s discuss.
1) The artificial womb: This would allow for extracorporeal pregnancy (also known as extrauterine fetal incubation or “EUFI”). In other words, a person could grow an embryo or fetus outside of the body. Not only would this be a huge advancement for men and women who can’t conceive and want to have a genetically related baby, but this would also open up unlimited fertility opportunities to same-sex and transgender couples.
Nearly 10 years ago, Popular Science wrote an article about innovative womb-makers like Hung Ching-Liu, the director of Reproductive Endocrine Laboratory at Cornell University’s Center for Reproductive Medicine and Infertility in New York City, who started growing engineered tissue for this very purpose back in 2001. At the time the magazine was published in 2005, Liu and her colleagues had built an artificial womb made of biodegradable scaffolding that grew a mouse fetus nearly to full term. Scientists say this type of “immaculate gestation” could be perfected in the next 10 to 60 years, but that doesn’t account for bioethicists who are fighting this innovation every step of the way.
“Decisions about reproductive technologies are more often then not made by doctors and individuals in the absence of a social justice framework,” author Soraya Chemaly wrote in a 2012 article for RHRealityCheck.com titled “What Do Artificial Wombs Mean For Women?” She goes on to say, “Progressive people, interested in equality and social justice, need to prepare for how rapidly evolving technology will shift reproductive rights and responsibilities.”
2) Donated wombs: Though we are still years away from developing a viable artificial womb, donated wombs could be a more immediate — and potentially successful — option. In late September, an unidentified woman in Sweden gave birth to a baby after receiving a womb transplant. The 36-year-old female was born without a womb and, believe it or not, her donor was a 61-year-old family friend who had gone through menopause nearly seven years before the 2013 womb transplant surgery.
According to the team of researchers at the Department of Obstetrics and Gynecology at the University of Gothenberg in Sweden, they’ve made 11 attempts at performing this type of human uterus transplantation, but this is the first reported live birth. However, there are two other women with transplanted wombs that are at least 25 weeks along in their pregnancies, which is both encouraging and remarkable.
3) Germinal choice technology: Another ART method geneticists are currently honing and expect to refine in another five to 10 years. This would give parents the power to alter the genes in their embryos, especially useful when a woman is of advanced age and carrying a fetus could mean an increased chance of genetic abnormalities. (For example, a 26-year-old woman as a 1 in 1,176 risk of having a baby with Down Syndrome, compared to a 36-year-old woman who has a 1 in 294 chance of having a baby with Downs.) The key to genetic choice technology is early detection and can be done through screening of embryos and making alterations, or by procedures like cloning. There’s still a long way to go before this method goes mainstream, but current iterations are already proving helpful.
Screening technologies are currently used today to reduce the occurrence of genetic disorders — like cystic fibrosis, hemophilia A, Tay-Sachs disease — which can all be detected before birth, but intervention is limited to termination of the pregnancy and not alteration of the actual genes. Though detractors of human genetic engineering worry reproductive reality is going to morph into the direction of science fiction.
“People’s fears are related to the strangeness of various reproductive possibilities, and certain kinds of knowledge that will become available through genomics just makes them uncomfortable,” said Gregory Stock, biophysicist and author of Redesigning Humans: Our Inevitable Genetic Future, in an interview with World Future Society. “When you are trying to ask what are limits of parental rights as far as making decisions about their children is concerned, we are going to push up against a number things that make us very uneasy.”
4) Reprogenetics: A term coined by Lee M. Silver, a professor of molecular biology at Princeton University, in his 1997 book Remaking Eden: How Genetic Engineering And Cloning Will Transform The American Family, Silver hypothesized that there will be a time when parents can afford to pick out the genetic characteristics of their own children, from their personalities to their individual talents. (You’ve heard of the Build-A-Bear Workshop? Think of this as Build-A-Baby.) The end result of all this genetic customization could even be the creation of an entirely new species of highly intelligent super-human beings.
Obviously, Silver’s theories aren’t without their detractors. “If misapplied, [these technologies] would exacerbate existing inequalities and reinforce existing modes of discrimination,” Richard Hayes, executive director of the Center For Genetics And Society, wrote in a 2008 op-ed for The Washington Post. The essay was in response to an article about “designer babies,” written by Ronald M. Green, a professor of ethics at Dartmouth College and author of Babies By Design: The Ethics Of Genetic Choice. “The development and commercial marketing of human genetic modification would likely spark a techno-eugenic rat-race. Even parents opposed to manipulating their children’s genes would feel compelled to participate in this race, lest their offspring be left behind.”
5) Terminal fusion automixis: One of the most sci-fi sounding new infertility solutions is a process known which would require only one parent to produce offspring. Though this phenomenon mostly occurs in plants, fungi, insects and worms, just this week, the first documented reptile virgin birth happened to a reticulated python at the Louisville Zoo in Kentucky. That’s right. Thelma, who gave birth to six young pythons, conceived without the help of a male python.
According to zoo officials, the fertilization happened like this: “The reproduction occurred through a process known as terminal fusion automixis, where certain cells known as polar bodies behave like sperm. They fuse with an egg and trigger cell division and development, completing what biologists call parthenogenesis. The offspring are half clones, with genetic material only from the mother instead of a normal mix of genes from the mother and a male.”
Experts say the process couldn’t be replicated with humans because embryos require the kind of genetic diversity found in a man and a woman. However, after learning about all the innovative methods of reproductive technology, allow us to refer to the second Jane’s Addiction studio album for our true reaction: Nothing’s Shocking.
Can Women Have It All?
Let’s revisit those initial headlines about the new female-friendly, wellness-oriented health benefits packages being offered by some of Silicon Valley’s biggest and brightest companies. Sure, digital titans like Facebook, Apple and Google can afford to offer such lavish medical amenities, but how realistic is it for workers in Middle America to expect the same options? Plus, just because a woman freezes her eggs, it doesn’t mean she’s guaranteed to conceive. In fact, some critics say the perk is really just a glorified work incentive for female employees. So, if women spend most of their best childbearing years building their careers, what happens when Ms. Go-Getter is ready to start a family — but her body isn’t?
Today, many young women spent their teens and twenties trying not to get pregnant. They enroll in post-graduate degree programs, travel the world and climb corporate ladders. (Translation: They establish their independence.) However, when these successful and accomplished women are a little older and the biological clock is inevitably ticking louder and louder, what affect did their fertility control have on their ability to conceive?
According to the all-knowing medical site WebMD, most women hit their fertile peak between the ages of 23 and 31. Then it drops — and fast. Dr. David Adamson, president of the American Society for Reproductive Medicine, says, “The average 39-year-old woman has half the fertility she had at 31, and between 39 and 42, the chances of conceiving drop by half again.”
Perhaps the whole issue is more about work-life balance than reproductive innovation. As author Nitasha Tiku wrote in a ValleyWag.com article on Silicon Valley’s new health plans, “It's too soon to tell whether female employees will feel pressured to freeze their eggs rather than take time out to have children, just like everyone feels pressured to always be on call to the office, always check email, always have a smartphone in hand. The choice is yours to decide whether or not to take those vacation days, except sometimes that choice feels like an illusion and this decision might be the hardest one working women have to make.”
In other words — generally speaking, of course — the longer you wait to have a child, the harder it becomes to have a child. However, with the constant evolution and invention of Assisted Reproductive Technology, perhaps a fertility breakthrough is creeping up on the horizon and it’s only a matter of time until these innovations are truly able to slow down the clock.
So, can women have it all? Ask us in a couple years and the biological answer could very well be “yes.”
Top photo credit: Shutterstock/Sebastian Kaulitzki