Questions on National Academies in vitro gametogenesis (IVG) meeting sponsorship

Research on in vitro gametogenesis or IVG is jumping ahead and such work could one day lead to new infertility treatments.

In vitro gametogenesis is the process of producing gametes (sperm and eggs) from stem cells. Those powerful stem cells, called iPS cells, can be made from ordinary adult cells like skin or blood cells. I made a diagram of the process below. IVG could then be followed by IVF to make human embryos, which when implanted could lead to the birth of babies.

This concept of an entirely new way for people to have kids has sparked great interest and debate.

National Academies meeting on in vitro gametogenesis

It’s not surprising then that the National Academies (aka NASEM or National Academies of Sciences, Engineering, and Medicine) just hosted a meeting on IVG.

The three-day in vitro gametogenesis event brought together leading scientists, ethicists, legal experts, and more. It looks like it was a great meeting.

Right now the technology isn’t close to being ready for use in humans given many technical factors. There are also important ethical and societal issues to address. Hence the spirit of the NASEM meeting was to bring together diverse experts and stakeholders.

Such Academies meetings are expensive to run. There are travel costs, hotels, food, logistics, and more.

I always thought that the National Academies just paid for the expenses itself, maybe in part from the federal government. However, apparently that’s often not the case. Donors and sponsors may cover costs.

The sources of such money can raise complicated issues.

Thorny sponsorship issues

For example, The New York Times just reported (Sacklers Gave Millions to Institution That Advises on Opioid Policy) that the National Academies took millions from those in the opioid industry. This was even as the prestigious organization was having meetings and influencing policy on opioids.

After The Times piece came out, the National Academies issued a statement in part explaining their checks and balances to avoid undue influence of sponsors. It seems they are still deciding what to do about the Sackler money.

What about IVG meeting sponsors?

The recent IVG meeting had five sponsors (see the screenshot above).

Was it okay to have these sponsors help pay for this particular meeting?

There are some potential issues here.

The sponsor the American Society for Reproductive Medicine (ASRM) and its members may someday benefit in a major way from IVG.

Another factor here is that the CEO of Conception Bio, Inc, Matt Krisiloff, also had a role at the NASEM meeting. The firm’s goal is the commercialization of IVG for human reproduction. IVG technology could end up a big money maker for the assisted reproduction industry if it is ever proven safe and effective.

Open Philanthropy, another sponsor, funds IVG research as well.

Taken together, these factors raise concerns about conflicts overall at this meeting.

Costs & other considerations

The ethical and societal issues around IVG are also very complicated, which in part relate to commercialization. This makes potential conflicts of interest more important to address.

While the current technology of IVF is very expensive, commercially available IVG for reproduction would likely cost at least several times more.

Only certain people would have access to IVG.

There could be eugenics concerns.

Another potential issue is that IVG-based reproduction would make heritable CRISPR gene editing of people far more possible.

On the other hand, IVG could allow many people to have genetically-related offspring who otherwise wouldn’t be able to become parents. Think of all the good that has come from IVF.

Perspectives

Getting back to the NASEM meeting sponsor issue, I’m definitely not equating it with the issue of the opioid industry funding given to NASEM.

Still, ASRM clearly has potential conflicts of interest in the IVG sphere. While I can see how ASRM was an important voice to include in an IVG meeting, their sponsorship raises questions. For example, did ASRM impact the choice of speakers at the IVG meeting? Then there’s Conception Bio’s funding and its role at the meeting.

I asked Stanford Law Professor Hank Greely, who spoke at the IVG meeting, for his thoughts on the sponsorship question:

“Limited support from ASRM for a workshop on a particular reproductive technology, especially one that is probably 15 to 25 years from the clinic, seems a conflict of interest but not a gross one. If the workshop could have been held without their money, would it have been better? Probably, and certainly for appearances. But the federal government wasn’t going to support this workshop – they barely support any reproductive research. Could this have happened without ASRM money? I don’t know, but I think that would be relevant. I’d note that some foundations were sponsors, but they were sponsors that favor reproduction choices. There were a lot of skeptics on the panels, especially on the ELSI panels, but no “embryo experimentation is evil” or “non-natural reproduction is sinful” perspectives. Was that because ASRM was a sponsor? I’m guessing probably not. Is it a gap in the workshop? Maybe…though a gap that made the conference more productive, to me at least.”

It feels like the sponsorship issue and potential conflicts at this meeting are not simple to iron out.

At a more technological level, as a stem cell researcher, I have doubts about the safety and efficacy of IVG to produce people. Risks include unknown epigenetic changes to stem cell-produced gametes or embryos that could lead to developmental problems and disease.

Animal models of IVG will only go so far in teaching us about human reproduction based on IVG. By comparison to IVF, I see IVG-based human reproduction as dramatically riskier. You couldn’t be sure about human safety until you tried it in humans either, which could lead to very bad outcomes.

Still, it may become a commercial reality in the decades to come. There need to be and will be more meetings on IVG.

Who will fund such meetings? If some of these important meetings won’t be possible without sponsors who have some conflicts, what happens then?