I’m a Maternal-Fetal Medicine Specialist, a “High Risk” OB/GYN. This is a very interesting post, but firmly set in the realm of bench work. There’s a reason Biotech has historically over-promised and underperformed. Lab results do not correlate well with clinical results in the human model. Human fertility and development are more complicated and vastly less understood than in most any other mammalian model. Human development and pregnancy are some of the least studied areas in medicine. No one in any democratic nation does randomized controlled trials on pregnant women except in rare, highly controlled circumstances. Pregnant women are considered a “protected and vulnerable” group as test subjects. Plus pregnant women would have to consent to any studies. When a future baby is on the line, this is a tall ask. Recruitment is difficult.
The vehicle to accomplish these trials would be In vitro fertilization (IVF). IVF works, but is not near as robust as most may think. In very healthy, low risk patients, the success rate is 40%. Many REI clinics will advertise better rates, but these are highly curated outcomes. If you were a satellite developer would you be excited to put a payload that you had taken years to develop on which you had spent a fortune in a rocket that had a 60% chance of failing? IVF itself is associated with poorer outcomes, mildly increased rate of cardiac malformations and more difficult pregnancies. People are willing to accept these risks when dealing with the pain of infertility or prior pregnancy loss. As a model for iteratively creating a better baby, you will be facing a high wastage rate.
I suspect that arrival of a reliable artificial womb (perhaps not too far off) will accelerate these efforts.
There is also the question of epigenetic phenomenon and the “cellular machinery” in the Ovum. Mitochondrial DNA. Getting a human Ovum to behave in a controlled way in a lab has proven to be very difficult. Cloning efforts in most mammalian models more complex than mice has been difficult.
The lab work using CRISPR has generated realms of new understanding. I am convinced that this is the path forward. However,going from a designed genetic code to a super baby may prove to be a long, complicated path. Biology is messy, unpredictable and rife with unintended consequences (Does anyone read Michael Creighton anymore?). And notice I didn’t say anything about Eugenics or Medical Ethics. Most government officials, physicians and even the general public are going to be highly sensitive to this idea. Most of the protections surrounding pregnant women as test subjects are the direct result of the Nuremberg Trials after WWII. These are deeply rooted ideals.
Hello,
I’m a Maternal-Fetal Medicine Specialist, a “High Risk” OB/GYN. This is a very interesting post, but firmly set in the realm of bench work. There’s a reason Biotech has historically over-promised and underperformed. Lab results do not correlate well with clinical results in the human model. Human fertility and development are more complicated and vastly less understood than in most any other mammalian model. Human development and pregnancy are some of the least studied areas in medicine. No one in any democratic nation does randomized controlled trials on pregnant women except in rare, highly controlled circumstances. Pregnant women are considered a “protected and vulnerable” group as test subjects. Plus pregnant women would have to consent to any studies. When a future baby is on the line, this is a tall ask. Recruitment is difficult.
The vehicle to accomplish these trials would be In vitro fertilization (IVF). IVF works, but is not near as robust as most may think. In very healthy, low risk patients, the success rate is 40%. Many REI clinics will advertise better rates, but these are highly curated outcomes. If you were a satellite developer would you be excited to put a payload that you had taken years to develop on which you had spent a fortune in a rocket that had a 60% chance of failing? IVF itself is associated with poorer outcomes, mildly increased rate of cardiac malformations and more difficult pregnancies. People are willing to accept these risks when dealing with the pain of infertility or prior pregnancy loss. As a model for iteratively creating a better baby, you will be facing a high wastage rate.
I suspect that arrival of a reliable artificial womb (perhaps not too far off) will accelerate these efforts.
There is also the question of epigenetic phenomenon and the “cellular machinery” in the Ovum. Mitochondrial DNA. Getting a human Ovum to behave in a controlled way in a lab has proven to be very difficult. Cloning efforts in most mammalian models more complex than mice has been difficult.
The lab work using CRISPR has generated realms of new understanding. I am convinced that this is the path forward. However,going from a designed genetic code to a super baby may prove to be a long, complicated path. Biology is messy, unpredictable and rife with unintended consequences (Does anyone read Michael Creighton anymore?). And notice I didn’t say anything about Eugenics or Medical Ethics. Most government officials, physicians and even the general public are going to be highly sensitive to this idea. Most of the protections surrounding pregnant women as test subjects are the direct result of the Nuremberg Trials after WWII. These are deeply rooted ideals.