IMAGINE IF ANYONE WHO WANTED TO HAVE A CHILD,
WHETHER THEY’RE STRAIGHT, GAY, YOUNG, OLD,
CANCER SURVIVOR, OR EVEN SINGLE PARENT…
COULD CONCEIVE A HEALTHY BABY EASILY?
WITH MODERN TOOLS, TECHNOLOGIES, AND THERAPIES ON THE HORIZON,
SOME SAY THE END OF INFERTILITY
IS IN SIGHT.
BUT WILL IT BE A WORLD OF 
EMBRYO FARMS AND EUGENICS?
OR ONE WHERE THE FUNDAMENTAL JOYS OF PARENTHOOD ARE AVAILABLE TO EVERYONE?
HOW CLOSE ARE WE TO THE END OF INFERTILITY?
INFERTILITY AFFECTS ABOUT 12% OF COUPLES TRYING TO CONCEIVE A CHILD TODAY.
AND IT'S A PROBLEM THAT DOESN’T HAVE ONE SIMPLE SOLUTION.
- The usual suspects are male factor infertility,
tubal factor infertility, ovulation disorders – when
a woman doesn't release an egg;
unexplained infertility...
One of the, probably, newest infertility factors
that we are seeing more and more is age factor.
People are delaying their fertility and their
childbearing for multiple reasons.
ON THE MEDICAL SIDE OF THINGS, THERE’S A LONG LIST OF OPTIONS AVAILABLE TO HETEROSEXUAL
PATIENTS, DEPENDING ON THEIR DIAGNOSIS, INCLUDING OPTIMIZATION OF INTERCOURSE,
HORMONE THERAPY, AND INTRAUTERINE INSEMINATION…
And then there is IVF, which is, as we call it,
bigger guns.
It's more invasive, but also a more
successful treatment that we have.
IVF STANDS FOR IN-VITRO FERTILIZATION, WHERE
EGGS AND SPERM ARE COMBINED IN A LAB, AND THE
RESULTING FERTILIZED EMBRYO IS IMPLANTED IN
A WOMAN’S UTERUS.
- It was a technology that really I think
blew people’s minds, the idea that we could
have reproduction occur outside the body.
But these days, It’s become part of the
natural landscape of human reproduction.
BUT FOR SOME COUPLES,
IVF WILL ONLY GET THEM SO FAR.
- If you're unable to make an egg or sperm,
then that means you're unable to use In Vitro
Fertilization to have a family.
- Infertility is medical.
It is the idea that you lack something you
need for reproduction.
Dysfertility, on the other hand, refers to
the social aspect of reproduction.
The best examples are gays and lesbians who
need, typically, gametes or a surrogate from
the other sex in order to help them, and single
individuals who might not have a reproductive
partner.
THAT’S WHY ALL OVER THE WORLD, RESEARCHERS
IN LABS LIKE AMANDER CLARK’S BELIEVE THAT
DYSFERTILITY DOESN’T HAVE TO BE THE END
OF THE STORY.
ON THE CUTTING EDGE OF STEM CELL BIOLOGY,
THEY’RE DISCOVERING CLUES ABOUT THE CAUSES
OF INFERTILITY, AND IN THE PROCESS, MIGHT
PAVE THE WAY FOR A NEW METHOD OF REPRODUCTION
THAT DOESN’T REQUIRE EGGS OR SPERM AT ALL…
AT LEAST UP FRONT.
INSTEAD, IT RELIES ON INDUCED PLURIPOTENT
STEM CELLS.
- Basically, you can take skin cells, injected
into with this famous cocktail of transcription
factors, and make them into pluripotent stem
cells.
- Induced pluripotent stem cells are made
by first taking a skin punch biopsy, for example.
And we will grow cells out of the biopsy in
a tissue culture plate, and these cells are
called dermal fibroblasts.
We need to store them under liquid nitrogen
and they can stay here for years and years
and years until we’re ready to reprogram
them.
So it takes about three weeks to fill up a
plate, and it takes about another three weeks
to turn those dermal fibroblasts into induced
pluripotent stem cells.
Oh, that’s a beautiful colony!
- You could take some of my skin right now,
you could take those adult cells and you could
return them to an earlier stage in their development
where they can become multiple
different kinds of cells.
WHAT’S EXCITING IS THAT AMANDER’S TEAM
HAS ALREADY PROVEN THAT WE CAN USE THIS METHOD
TO CREATE GERMLINE CELLS, THE PRECURSORS
TO EGGS AND SPERM.
- Forming germline is a really special cell
type and it's very hard to make.
What my lab was able to show is that it is
possible to make germline cells from
induced pluripotent stem cells.
So how can we take these precursor germ cells
that we make in the lab, and coax them to
move into the next step in development, which
takes us one step closer to making the egg
and the sperm cell?
AND IF THEY’RE SUCCESSFUL, IT WOULD BE HUGE:
POTENTIALLY SETTING THE STAGE FOR THE NEXT
REVOLUTION IN REPRODUCTION: IN-VITRO GAMETOGENESIS, OR IVG.
RESEARCHERS HAVE ALREADY PROVEN THAT IVG CAN
BE SUCCESSFUL IN MICE, SO, IT’S NOT IMPOSSIBLE.
BUT HOLD UP!
DOESN’T CREATING EGGS AND SPERM OUT OF SKIN
CELLS RAISE SOME  SERIOUS QUESTIONS ABOUT
WHAT REPRODUCTION EVEN MEANS?
JUST AS IVF WAS HOTLY DEBATED WHEN IT FIRST
ARRIVED ON THE SCENE,
IVG HAS SPAWNED SOME CONCERNS.
- One is this idea that   we'll end up with
these huge embryo farms.
That instead of producing five or six embryos
and choosing one of them, maybe you would
produce a thousand embryos, and decide amongst
the thousand which to reproduce.
And for some people, that's a very alarming idea.
It raises the possibility of eugenics, perfectionism,
but also this idea that maybe we'll have a
huge market for embryos, buying and selling,
or have thousands of embryos per individual
stored in a freezer or disposed of.
THEN, THERE’S WHAT GLENN CALLS THE ‘CELEBRITY
SCENARIO’ TO CONTEND WITH.
Imagine, you go to a hotel, and you find that
Brad Pitt was staying at that hotel.
You're cleaning the hotel and there's some
skin of Brad Pitt's left on the bathtub.
From that adult cell, you might be able to
use in-vitro gametogenesis to derive a sperm
or an egg.
And the idea would be, you could reproduce
and have a child, that is – genetically
speaking – Brad Pitt's child, without ever
having met Brad Pitt, without ever having
talked to Brad Pitt, without him ever consenting
to the reproduction.
THE BRAD PITT SCENARIO, AS I LIKE TO CALL
IT, DOES GIVE US A LOT TO THINK ABOUT AS WE
CHANGE OUR DEFINITION OF WHAT IT MEANS TO
REPRODUCE.
BUT THAT MEANING IS ALREADY CHANGING.
AND WITH SO MANY TOOLS ALREADY IN OUR BABY-MAKING TOOLBOX,
AND MORE TO COME ONLINE SOON,
HOW CLOSE ARE WE TO THE END OF INFERTILITY?
- In-vitro gametogenesis and making a gamete,
for example, an egg, that we could use for
research purposes I believe is about five
to 10 years away.
The challenge will be translating this work
from a research lab into the clinic so that
it can be used to help couples overcome infertility.
- So, we are nearing the end of many forms
of infertility.
People who have mitochondrial diseases can
use mitochondrial replacement therapies.
People who have other diseases might be able
to use gene editing.
Women who have uterine factor infertility
can already use a uterus transplant if it's
available in their location.
- With the whole IVG thing, that's maybe sounding
like a science fiction now.
But even the whole IVF was a science fiction
50 years ago.
But there is a lot of research going on in
that direction.
And I do believe that probably in maybe, you
know, 30, 40 years, maybe even 10 years, we
will have some clinical applications.
- And the idea that that which can be imagined
in fiction, can become fact within a generation,
suggest to me that there's huge numbers of
other reproductive revolutions still ahead
of us that people still haven't even conceived
of yet.
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