From the first test tube baby to genetic modification: 40 years of advances and controversy in reproductive medicine

Forty years ago Louis Brown was born, the first "test tube girl" in the history of mankind. This woman came to the world in 1978 marking the first of the many milestones of reproductive medicine. Since then, the investigation has opened doors that cannot be closed.

Behind them there is hope, but also restlessness. Today, having offspring is easier than ever In our history: artificial fertilization, genetic selection, modifications ... Some of the discoveries are still the result of bitter controversies. What have we experienced during these four decades?

From the birth of the first "test tube baby"

The first baby born from fertilization in vitro, or IVF, and reimplantation, is called Louise Brown. This woman had a few years ago her own offspring, which finished closing what is the first major milestone of reproductive medicine. Being the first, Louise's role in the story is essential. The controversy has been linked at all times to his life.

From the beginning, he has had to pass numerous analyzes to show that his health is good and that the procedure had no negative consequences. Today we do not see where the problem is, but there are still doubts (less and less justified) about the dangers of fertilization in vitro. What dangers? That is the question, we do not know.

But fear "is free", everyone takes what they want, and there is nothing that produces more fear than the unknown. So the birth of Louise's son, in 2007, finally convinced most experts: Louise is a normal, healthy and reproductive woman. The terrible unknown consequences have not appeared.

From Louise, IVF techniques were rapidly improving. In 1984 the GIFT technique was introduced, or intrafallopian transfer gamete; in 1986 the ZIGT appeared, zygote intrafallopian transfer and in that same year there is the first birth after freezing and thawing of the oocytes. In 1988 the SUZI appears, subzonal sperm insertion, and in 1989 the partial zonal dissection, which helps the sperm to enter the egg more easily.

In Babies and over 40 years since the first 'test tube baby': more than eight million children born by IVF in the world

In the 90s appear the two most significant techniques of reproductive medicine: ICSI, and the DGP

Already in the 90's there are those that are, possibly, the two most significant techniques of reproductive medicine: intracytoplasmic sperm microinjection, or ICSI, and preimplantation genetic diagnosis, DGP. All these, quickly reviewed, indicate one thing: fear was overcome by the desire to celebrate life.

That, of course, together with a technical capacity and greater security, silenced the doubts, little by little. Today, nobody seriously considers whether having a child through IVF or any assisted reproduction technique will pose a serious health problem beyond any conventional medical treatment.

The controversy of surrogacy

Almost at the same time that the birth of Luois appears another controversy of a social nature, and not so much medical: the moms for rent. In 1976, lawyer Noel Keane signed the first agreement between a married couple and a surrogate mother. Surrogacy is a technological advance, but also a source of legal discussions.

This is that a woman breeds the baby of a couple who does not have that possibility (for physiological reasons). Although pregnancy is carried out with the help of the body of a "rental belly", the filial relationship is exclusive to the parents. There are many countries where this practice is not legal. In Spain, specifically, this situation falls within a curious legal vacuum: according to article 10 of Law 14/2006, of May 26, on Assisted Human Reproduction Techniques is not allowed.

However, the paternal-filial relationship is allowed provided that the child has developed outside the Spanish borders. Therefore, if the couple has money, they can undergo this assisted reproduction technique outside of Spain. The controversy remains enormous as many people see in this practice the lucrative interest over health or the right to life.

This occurs in numerous countries, especially in those with more social differences where this treatment can become an element that accentuates these differences. For the moment, Surrogacy is still one of the most debated issues across the planet. But we cannot deny that it also marked a before and after in the history of artificial reproduction.

A baby and three parents

As we have advanced technically, so have the reproductive possibilities. And with them, ethical and moral doubts. An example of this can be found in 1996: Dr. Neill and Wallace demonstrated the possibility of carrying out a complete cytoplasmic transfer. This consists of removing the content of an egg to introduce that of another.

This technique serves to solve a problem of a genetic nature from the mother. The technique, although effective, should wait until 2016 to finish settling. In the United Kingdom, Dr. John Zhang, director of the New Hope Fertility Center in New York, successfully used a mitochondrial replacement therapy that had not been used before in humans.

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This therapy is the culmination of cytoplasmic transfer and is used in very specific cases of mitochondrial disease. This disease occurs when the original maternal mitochondria present a problem, causing a syndrome known as Leigh disease. This causes the gradual brain death of children.

With mitochondrial substitution, this problem can be saved. This only requires the mitochondria of another woman. Therefore, what we have in the end is, a "three-parent" baby, two moms and a dad, who have given part of their genetic material. The material of the third mother is only in healthy mitochondria, but does not have any manifestation in the baby, beyond which she will no longer suffer from dysfunction.

Even so, the technical confusion provoked intense debate in the United Kingdom. The courts of this country, however, decided to legislate the use of this technique in a consistent manner. Currently, it is practically settled, although there are still slight doubts about it in the long term.

The first genetically modified girls

This same week we lived the last of the great milestones of assisted reproduction: the birth of a genetically modified baby. This is the barrier that we had not yet passed in the world of reproductive medicine. And we had not done it, mainly, for ethical and moral issues.

In Babies and more Genetically modified babies: what has happened in China and why it worries everyone so much

As Dr. He Jiankui has shown, it is possible to modify the genome of a human being completely. Lulu and Nana were born healthy, he announced, with a modification to the CCR5 gene that makes one of the sisters immune to HIV. The achievement is very important as it opens the door, de facto, to genetic alteration.

Lulu and Nana were born healthy, he announced, with a modification to the CCR5 gene that makes one of the sisters immune to HIV

However, the ethical and legal dilemma has only just begun. At the moment the law does not allow you to do what this doctor has done in most countries. That has not prevented him from carrying out his experiments in China, where they are not illegal or legal, but are in a sort of allegal limbo.

With this demonstration the last chapter of the advances in reproduction opens to date, a chapter that is far from over. Experts still see very far the day when we modify babies "routinely" as another medical procedure to eliminate certain diseases. However, there was also a time when fertilization in vitro It was cause for alarm.

Will the same happen with CRISPR and genetic modification? Only time will tell. For the moment, this result has put the investigator himself against the sword and the wall, which has been openly denounced by the scientific community. No one ever said that marking a before and after would be easy, but we cannot forget that in the face of any scientific advance, the welfare and progress of the whole society must reign.

Video: Genetic Engineering Will Change Everything Forever CRISPR (March 2024).