A pop and pop operation

“Sexual orientation is absolutely no stumbling block to anybody who wishes to have a baby,” declares Dr Albert Yuzpe, co-director of the Genesis Fertility Clinic in Vancouver.

“There really isn’t anything that’s preventing [same-sex couples from having children],” he continues. “Very, very rarely we’ll see a male couple, but female same-sex couples, we see every day.”

Gay and lesbian people who choose to have children already have a range of options. Adoption, co-parenting, artificial insemination, sperm donation and surrogacy have been realities for decades, but what other possibilities might emerge for reproduction among queer people in the future?

Dr Timothy Rowe is division head of reproductive endocrinology and infertility and a professor of obstetrics and gynaecology at the University of British Columbia. He believes that cloning technology could one day be adapted to help queer people have children on their own terms.

Cloning is a type of asexual reproduction where all of a child’s genes come from the cell of one parent. The best-known cloning technique is somatic cell nuclear transfer in which the nucleus from one cell is transplanted into an egg that has had its original nucleus removed. Using chemicals or electricity, the modified egg may then develop into a viable embryo. If the developing cells were placed into a uterus and brought to term, the resulting child would be a genetic duplicate, or clone, of the parent who provided the transplanted nucleus.

But cloning is morally controversial.

“Cloning carries multiple concerns from society at large,” Rowe explains. “I see a lot of end-stage fertility for which cloning would be a godsend, bit it’s simply not something that’s tolerated by the public. The idea just sounds too farfetched.”

He believes that for cloning to be accepted, “it would require, not only scientific advances, but also changes in how society responds to these things.”

Yuzpe disagrees. “Nobody wants to clone humans,” he asserts. “As a matter of fact, I spoke to [Dr] Robert Edwards who was the pioneer, along with Patrick Steptoe, in the first in vitro fertilization successfully into humans. When we were talking about cloning he said, ‘Frankly, I’ve never met anybody that’s worth cloning.'”

What about the more distant future? Could stem cell technology one day allow two people of the same sex to each contribute genetic material to the conception of a child?

Human stem cells have the amazing ability to become any type of differentiated cells in the body. Stem cells could be manipulated to become nerve cells, skin cells, muscle cells, sperm cells or even egg cells.

In 2003, a small flurry of scientific papers were published describing how scientists might create what are called artificial gametes. Artificial gametes could have several different uses to biomedical science but, in a nutshell, it may be possible to create a human egg cell from any other cell type regardless of the donor’s gender.

It’s still science fiction, but imagine if two gay men could go to a fertility clinic. One man could donate some cells from his body, perhaps by a swab of the inside of his cheek or a drop of blood. A scientist could then use the cells to create an egg with the man’s genetic material. The egg could be fertilized with the other man’s semen. The resultant embryo could be implanted into a surrogate mother, and the child would be genetically related to both men.

_ Yuzpe is adamant that such an experiment would be dangerous and doesn’t think men will ever bear children. Rowe is less certain.

“The accident of nature called abdominal pregnancy shows that babies can develop without a uterus,” says Rowe. “The argument that this [is] a dangerous condition came from the era when imaging didn’t allow detection of any potential risk… The imaging techniques we have today mean that you could indeed plan having an abdominal pregnancy; implanting embryos into a bed of tissue and monitoring the growth to know if there was any potential risk to the gestational carrier, be that male or female.

“Now, of course, there are many, many unknowns,” he admits. “The influence of male hormones, for example, in female babies and even male babies; nobody knows what the significance of that will be. There’s not just a risk to the man or woman carrying this pregnancy, but also, do you get a normal outcome? The old data says that a lot of these babies were abnormal.

“Society is likely not ready to accept that idea but unless you advance the possibility and look at the good and bad of it, we’d never know,” he concludes.

Science fiction aside, both Yuzpe and Rowe see continued progress in reproductive science as they look into the future.

“We will develop refinements in in vitro fertilization where we don’t have to necessarily use the drugs that we use now,” Yuzpe explains. “There will be developments that will simplify treatment and perhaps make it a bit safer.”

“We look at potential changes in our ability to preserve sperm, eggs, [and] ovarian tissue as possibly one way of reversing the effects of age on female fertility,” offers Rowe.

Regardless of how the future unfolds, reproductive technology will continue to evoke moral debate.

“Canadians will do what Canadians want,” Rowe insists. “If there is a change in the tolerance of society to allow research in cloning and stem cell development and so on, it probably will take a lot more education before most people will become comfortable with this. It depends [on] what kind of country we’ve got 10, 20 years from now.”