The Challenge: Develop a proposal for a novel
assisted reproductive technology (ART).
Context: The development and ongoing progression of ART has been pivotal to
overcoming limitations of reduced or impaired fertility status, but significant and
insurmountable barriers persist. Many individuals who wish to reproduce but do not have
the capabilities to conceive are not afforded the luxury of family planning and/or ART. In
non-heteronormative relationships, the desire of a couple to reproduce and bear a child
may be eclipsed by the inability to achieve fusion of gametes. Individuals who are childless
or infecund often face severe social stigma and mental health issues, especially for
marginalised people and in developing nations. Other individuals may have medical
conditions or undergo procedures which render them infecund.
A number of circumstances exist where individuals and/or couples are unable to conceive:
• Homosexual, intersex and other LGBTIQ2+A relationships
• Male-to-female/female-to-male individuals
• Surgical procedures (eg. Hysterectomy, bilateral orchiectomy)
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• Primary Amenorrhea and maturation arrest of spermatogenesis
• Chronic conditions (eg. Endometriosis, PCOS, Metabolic syndrome-associated
prostatitis)
• STI-induced infecundity (eg. Bilateral tubal occlusion, HPV-related cervical cancer,
acute chlamydial epididymitis)
• Chromosomal disorders (Eg. Turner syndrome, Klinefelter syndrome)
• Congenital disorders (Eg. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome,
Androgen insensitivity syndrome, Pure gonadal dysgenesis)
• Childhood cancer survivors
Currently, the prevailing options for these individuals are limited to: donor conception,
surrogacy, fostering/adoption or childlessness. In many of these circumstances, there are
no treatments, therapies or technologies which overcome reproductive barriers. There can
also be profound cultural and religious beliefs or “justifications” which allege why some
individuals shouldn’t be able to reproduce. Without appropriate acknowledgement, further
ART development, and medical advances; the under-representation, marginalisation, and
social isolation of these individuals in society is exacerbated.
There is no doubt that established ARTs can already overcome significant reproductive
barriers (eg. ICSI for individuals with Klinefelter disease). However, as all individuals are
diverse, so too are the reproductive barriers they face. The MRKH syndrome, for example,
permits oogenesis in affected individuals, but they are often born with only a partial uterus
or without a uterus entirely. Similarly, a hysterectomy may be required for cervical cancer
patients whilst still within optimal reproductive age, and for many young adults with cancer
most chemotherapy treatments render them infertile. There are options for storing sperm
(expensive) and for taking sections of ovarian tissue for storage and later implantation, but
the latter is still somewhat experimental, and available only in 1st world countries. The
ethical implications of collecting gametes from minors undergoing cancer therapy is also
an important consideration.
In other instances, individuals who have undergone complete surgery for male-to-female
transition ordinarily have a vagina and vulva, but have no uterus and all gonadal tissue is
removed. Additionally, individuals afflicted by androgen insensitivity syndrome and primary
amenorrhea may produce immature germ line cells, but cannot ejaculate or ovulate.
Despite these unique and formidable limitations, scientific advances such as gene therapy,
transdifferentiation and artificial womb technologies may provide solutions.
- Demonstrate understanding of why there is still a need for the development of new
ARTs to support individuals unable to conceive or reproduce. - Clearly explain the specific demographic for your novel ART and the reasoning for
their need. - Describe how your ART is tailored to work for your target.
- Possible societal implications of your ART device.
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