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Skene, L --- "Deriving Sperm and Eggs from Human Skin Cells: Facilitating Community Discussion" [2008] UMelbLRS 15

Last Updated: 7 December 2009

Deriving sperm and eggs from human skin cells: Facilitating community discussion

Loane Skene,

Professor of Law, Melbourne Law School

University of Melbourne

2008

Introduction

The Hinxton Group, an International Consortium on Stem Cells, Ethics and Law has issued a Consensus Statement, The Science, Ethics and Policy Challenges of Pluripotent Stem-Cell Derived Gametes (2008) to ‘inform public discussion about the state of the science and its potential social implications and to make recommendations about policy and practice’. 1 The language in the Statement is clear but community discussion may be better facilitated by starting from the imagined viewpoint of the listener than from that of scientists explaining what the research involves and where it may lead. The following illustration shows how this might work in discussing this new technology. It suggests a method for scientists with detailed knowledge and specialisation to talk to a wide audience about their research and its implications.

Discussing complex scientific issues: an example

This outline of possible questions and answers is ‘user-based’, delivering what the listener may want to know. It would need to be adapted for individual conversations as each person responds to the other’s questions and comments.

Is it possible for scientists to derive sperm and eggs from a person’s skin cells?

This is not possible at present but scientists have recently been able to derive human embryonic stem cells from human skin cells by using proteins to

1 http://www.hinxtongroup.org/HinxtonConsensus_April2008.doc (accessed16 April 2008).

activate their development artificially (Professor Shinya Yamanaka’s technique). 2 The stem cells derived from this process are pluripotent germ cells. meaning that they had the potential to grow into any tissue in the body

This means that, in theory, they could be induced to develop into other types of cells, like heart cells, nerve cells or muscle cells, though this has not yet been achieved. Pluripotent germ cells can also be derived from human embryos, either donated by couples in fertility treatment programs or created by somatic cell nuclear transfer (the ‘Dolly technique’, where the nucleus from a person’s body cell is inserted into a human egg that has had its nucleus removed and then stimulated to develop). Deriving stem cells from a person’s skin or other body cells if it was possible, rather than from human embryos, would avoid the sensitivity of creating embryos for research. One day, it may be possible to convert the stem cells that come from the skin cells (and also the stem cells that come from embryos) into sperm or eggs. Let’s call these sperm and eggs ‘derived sperm and eggs’ to distinguish them from the sperm and eggs that come directly from people’s reproductive organs.

Have sperm and eggs been derived from skin cells in animal research?

This research is in the early stages. In experiments on mice, sperm-like cells and egg-like cells have been derived from skin cells but they have not developed to mature eggs and sperm. The process of meiosis where cells continue to divide as an organism grows, has stopped. This means that the egg-like cells have not matured to the stage where they can be fertilised.

Could derived sperm and eggs be fertilised in a laboratory so that a fertilised egg could be implanted and develop into a foetus?

This has not happened yet but it is possible in theory. In the research on mice, scientists have not been able to fertilise an egg with the sperm-like cells derived from body cells. However, when those sperm-like cells derived from body cells were placed in the testis of a mouse, the mouse was apparently able to produce viable sperm. Where pluripotent stem cells have been derived from an embryo rather than from skin cells, on the other hand, eggs have been derived that have been fertilised and in one experiment in mice, live pups were born from this procedure but survived for only a short time, succumbing to genetic abnormalities. At the moment, it seems to

2 G Vogel. Researchers turn skin cells into stem cells. ScienceNOW Daily News, 20 Nov 2007. http://sciencenow.sciencemag.org/cgi/content/full/2007/1120/1 (accessed 16 April 2008)

be necessary for the derived sperm-like cells to be in the right physical ‘environment’ in the mouse to become viable sperm.

Why would anyone want to do this type of research, especially on humans?

It is possible that derived sperm and eggs might one day be used to help infertile couples to have a baby who is genetically related to them both. About 10 per cent of couples are infertile (from absent or non-functioning reproductive organs or gametes, chemotherapy, menopause or other reasons). Other couples need to use fertility treatment to avoid having a child with a serious medical condition. They could use donated sperm or eggs but these are in short supply and the baby would then not have the genes of both parents. There are an increasing number of fertility treatments, such as IVF where the parents’ sperm and eggs are fertilised in a laboratory; and ICSI where a single sperm is injected directly into the egg to help men who produce few sperm. However, some couples cannot benefit from any of these treatments and forming an egg or sperm from their skin or other body cell might give them another means of having a child with their genes.

There are other reasons for doing the research. Scientists will learn more about the early development of life which may help them understand more about infertility and the causes of inherited and congenital medical conditions. In time, this may lead to the development of new diagnostic tools and treatments to help infertile couples and people with a range of medical disorders. For example, it could enable a man who has had cancer to have his own child and help scientists study the effect of drugs and toxins on an early embryo. "For example, if you are someone who's been through cancer treatment and as a result no longer has sperm, eggs or gonads at all, this would be a way for you to have genetically related children," Dr Mathews said.

One day, it may be possible to alter genes to correct genetic mutations.

Guardain - Scientists have attempted to create sperm cells in mice, but the animals that were born after fertilisation suffered from deformities and died within months. Another potentially contentious issue is so-called germ-line engineering - making sperm and eggs in the laboratory then changing the DNA.

It might be used to cure genetic diseases such as cystic fibrosis at source by correcting mutations, but it could also potentially allow parents to produce a designer baby. None of these manipulations is possible at present, and genetic manipulation of human embryos is illegal in the UK.

If women could have sperm derived from their skin cells - or men have eggs derive from their skin cells - could same sex couples use the new technology to have a child genetically related to them both? Could people have children who have only their DNA, so a single person is both the mother and father of the child, the ‘ultimate incest’? 3

It may be possible for same sex couples to have a child genetically related to them both but it is expected to be difficult to derive gametes (sperm or eggs) of the opposite sex from a person. If that did happen, people could theoretically have a child with only their DNA but an embryo formed in such a way (even if it was possible) might not develop (at present, developing an embryo for more than 14 days is prohibited by law).

In the UK, legislation currently allows artificial gametes in research, but bans it for creating a human pregnancy.
times online Some campaigners who object to the technology have even argued that it could lead to “ultimate incest”, by which a single person becomes mother and father of a child. Professor Robin Lovell-Badge, of the National Institute for Medical Research in London, a member of the group’s steering committee, said: “It would be very difficult to get eggs from XY cells, and even more difficult to get sperm from XX cells – my own view, indeed, is that the latter is impossible.” 4

Even with male and female partners, wouldn’t the risks be so great in trying to achieve a pregnancy with derived sperm or eggs that it should not be attempted? Remember that we are talking about the birth of a child with a whole life to live.

It is true that the procedure would be new and one cannot know the outcome. However that is the case with any new technology. When Louise Brown, the first IVF baby, was born, no child had ever before been conceived in such a way. Similarly, the first child conceived with ICSI was born from an entirely new procedure. The technique could only be used after thorough testing in the laboratory and in animal research to ensure the procedures are effective

3 Henderson, M. Sperm and eggs from stem cells ‘in 15 years’, Timesonline, 15 April 2008. https://www.timesonline.co.uk/tol/news/uk/science/article3746760.ece (accessed 16 April 2008). 4 Ibid.

and that any embryos produced are normal. Proper ethical scrutiny will be required and fully informing people of potential risks.

How long will it take for this technology to be available?

It is always difficult to predict development in science. However, scientists have said that human eggs and sperm will be grown from stem cells within five to fifteen years.

Is this technology allowed by law?

There are many legal restrictions on this type of research. If animals are involved, there are statutory provisions and codes of conduct to protect the welfare of animals. Research on human embryos and other bodily material is also subject to statutory controls. Even if scientists are permitted to form embryos containing human genetic material in a laboratory, they must obtain a licence to do that research. Also, it is a serious criminal offence to allow the embryo to develop for more than 14 days or to implant it in a woman or an animal. Under the Human Fertilisation and Embryology Bill currently passing through Parliament, laboratory experiments with these cells will be permitted, but it will be illegal to use them in fertility treatment.

I feel very uncomfortable about this kind of research, both in its nature and where it may lead. The community has to protect itself and future generations from scientific meddling. Who knows what effect it could have on children who are not yet born – and their children and grandchildren? Some people are not meant to have children. That is God’s will or Nature’s way. They should accept their infertility - or the birth of children who are not ‘perfect’ - like other people who have medical conditions. We should not resort to unnatural scientific interventions, which undermine human dignity, family relationships and our obligations to future generations. This research contravenes the teaching of the church and its consequences are unknown.

Some people do have intrinsic objections to particular types of research, believing it is wrong in its essence, unnatural or against their religion. Their beliefs must be respected. However, the views of some people in the community should not be permitted to override the views and interest of others, especially where the objections are based on moral or religious grounds rather than on safety aspects, and the lives or health of other people

may be jeopardised. A major message of the Hinxton Statement is that moral

disagreements in society should never be used on their own to stop scientific investigation. If there aer concerns about potential uses of research (such as using the technology to have ‘designer babies’, or make inherited changes in children and so altering the human germ line), then the law should focus on those (as it does), not stop the research.

In a liberal democracy, different views are tolerated. Also, views change over time. IVF, blood transfusions and organ transplants were once novel treatments and people were suspicious. They are now routine procedures and thousands of children have been born from IVF and related procedures around the world.

Conclusion

A question and answer technique of the kind described in this paper may promote more effective communication about sensitive scientific issues. It is especially useful in the parliamentary process when politicians commonly vote according to their conscience rather than on party lines and they must explain to their electorate their reasons for voting in a particular way. Non-scientists can be encouraged to explain their fears about innovative technologies and their implications and scientists can respond to those fears directly. It will not always be possible to reach agreement, of course, but sometimes explanations can dispel concerns, even if the science itself seems strange or frightening.