Human genome editing and lab-grown eggs that could theoretically allow same-sex couples to have biological children are among the anticipated scientific advances being discussed by the fertility watchdog to “future-proof” any prospective laws.
As it pushes for the biggest overhaul of fertility laws in 30 years, the Human Fertilisation and Embryology Authority (HFEA) is planning for a range of new reproductive treatments that scientists say could be just a few years away, according to a leading scientist advising the HFEA on its proposals.
The HFEA believes the 1990 act that governs the fertility sector needs updating and has previously said it will seek greater powers to fine clinics and changes to rules on donor anonymity, in recommendations that it will put to the government later this year. Now, a leading scientist who is advising the HFEA on its proposals says the regulator is also discussing whether to recommend changes that could pave the way for the use of lab-grown eggs and sperm, and human genome editing, if these techniques are shown to be sufficiently safe and medically justified.
In theory, lab-grown eggs and sperm could allow same-sex couples to have a biological child together – although scientists are yet to demonstrate the technique using human cells.
“The techniques aren’t there yet. But the rate of progress with either of those is so fast that it will happen,” said Prof Robin Lovell-Badge, the head of stem cell biology and developmental genetics at the Francis Crick Institute in London and a member of the HFEA’s legislative reform committee. “People might be surprised but they shouldn’t be. The science progresses much faster than the law.”
The HFEA will launch a consultation on the issue next month and is expected to make wide-reaching recommendations on how the 1990 Human Fertilisation and Embryology Act should be updated by the end of the year.
There is no guarantee that any proposals will be taken forward by government, but the debate reflects rapid scientific advances that have, to a degree, gone under the radar with public attention focused on the pandemic.
Scientists have already created viable eggs and sperm from reprogrammed skin cells in mice and have used the technique to produce pups with either two genetic fathers or two mothers. Several teams are making advances in research using non-human primates and at least two companies with significant financial backing are aiming to translate the work into humans.
“It’s felt that for humans it’s not far off. It is going to become urgent pretty quickly,” said Lovell-Badge. “If you could take a skin cell and make sperm or eggs, that gives people a chance to have a genetically related child that they couldn’t otherwise have, which a lot of people would say is valid.”
In theory, the technique could also help people who do not have viable eggs and sperm, such as those who have undergone certain cancer treatments.
“If it’s developed somewhere, people in the UK will want it,” he added. “Surely it’s better to have the regulations almost in place to allow it to happen in a controlled way.”
Genome editing of embryos is likely to take longer to be clinic-ready, according to Lovell-Badge, but could also be transformative for dealing with a range of heritable diseases. Currently it is possible to screen embryos for genes linked to conditions such as cystic fibrosis and muscular dystrophy using pre-implantation genetic diagnosis (PGD). But this can require couples to go through many cycles of IVF and in some scenarios, such as when both parents carry two copies of the gene that causes sickle cell disease, PGD cannot help.
Further work is needed to ensure genome editing works efficiently, without causing unintended changes to DNA that would be passed on to future generations. There is particular caution after the 2018 scandal in which a Chinese scientist, He Jiankui, claimed to have edited the genomes of twin baby girls. Jiankui prompted global condemnation and was subsequently jailed.
Lovell-Badge said there was “more nervousness” on the HFEA committee about human genome editing. However, public attitudes appeared fairly positive, with a recent poll commissioned by the charity Progress Educational Trust (PET) finding that 53% of people would back altering the DNA of embryos to prevent severe or life-threatening diseases.
Other proposals under discussion include establishing an embryo bank so that a greater proportion of embryos left over from fertility treatment could, with patient consent, be used for research. Most are currently discarded, which Lovell-Badge described as morally questionable.
The HFEA is also considering whether to recommend extending the 14-day limit for embryo research and whether similar rules should apply to synthetic embryos, which look increasingly like the real thing but are not regulated under existing laws.
Clare Ettinghausen, the director of strategy and corporate affairs at the HFEA, said: “The HFEA is looking at what changes might need to be made to fertility law.
“The act has provided a robust but flexible framework in which innovations in bioscience and clinical expertise in the UK have flourished. However, it is time to look at how it can be future proofed.” She added: “The HFEA is considering a range of options that will benefit patients, clinic staff and researchers, and we will be consulting on changes soon.”
