From Brave New World to Gattaca, writers and filmmakers have long imagined how reproductive technology might reshape humanity. In the real world, advances in genomics, stem cells, and preimplantation genetic diagnosis (PGD) could make it possible within the next few decades to remove the genetic ambiguity of sexual reproduction, enabling couples to have children who are not only free from deadly diseases, but also possess carefully selected physical and mental characteristics. In The End of Sex and the Future of Human Reproduction, law professor Henry Greely of Stanford University explores the scientific, legal, and ethical consequences of this quasi-inevitable future.
The book is about “the coming obsolescence of sex,” Greely notes in the introduction. Although people will continue to have recreational intercourse, “I expect that, sometime in the next 20 to 40 years, among humans with good health coverage, sex, in one sense, will largely disappear, or at least decrease markedly,” he continues. “Instead of being conceived in a bed, in the backseat of a car, or under a ‘Keep off the Grass’ sign, children will be conceived in clinics.”
Greely envisions a time when fertility experts will create male and female gametes in vitro using induced pluripotent stem cells (iPSCs) derived from a simple skin biopsy, as opposed to the expensive and laborious process of harvesting eggs for in vitro fertilization (IVF). The resulting embryos will then be screened using genomic services that are far cheaper and more informative than today’s, and parents will have the opportunity to select prospective progeny based on traits such as disease risk, sex, hair color, athletic potential, and even mental abilities. Greely calls this strategy “easy PGD.”
The author employs lucid prose to explain the science behind reproduction, genetics, and stem cells, and explores the scientific, legal, and political pathway toward easy PGD. He suggests this technology will make it possible for the majority of people in wealthy countries to bear children that are genetically their own—including gay and lesbian couples via the production of cross-sex gametes (eggs made from men and sperm made from women). But he also envisions more unexpected possibilities such as “uniparents,” individuals who could supply all the genetic material for their offspring.
Greely also explores the barriers that stand in the way of this reproductive future, such as safety, ethical considerations, fairness of access, and coercion (as it relates to the history of eugenics). He anticipates societal resistance to the technology, arguing that religious or moral objections shouldn’t be used to justify an all-out ban. Lastly, he raises concerns over whether parents will be informed enough to make the complex decisions this process will require.
Greely concludes the book with a call to action, challenging readers to decide how they want this brave new future to unfold. “Pay attention to these issues, think about them, talk about them with others,” he writes. “Help us all to shape a world where these new technologies bring as much benefit, with as little harm, as humanly possible.”
The End of Sex and the Future of Human Reproduction
Harvard University Press, May 2016