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Advances in reproductive medicine are expanding what is possible. From IVF and embryo screening to emerging gene-editing technologies, prospective parents now face choices that were unimaginable just a generation ago. These innovations promise to prevent inherited diseases and offer hope to millions struggling with infertility. But as technologies evolve beyond treatment toward potential enhancement, new ethical and societal questions emerge. Where should the line be drawn between medical care and genetic selection? Who decides which conditions should be prevented and which traits should remain beyond intervention? And as reproductive technologies become more powerful, how can societies balance parental choice, medical responsibility, and collective values about what it means to shape the next generation?
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TechTranscript
00:24All right.
00:26Hello, everyone.
00:27Hi to the panelists.
00:30This is Human 2.0, the Fertility Revolution and the Future of Reproduction.
00:36My name is Phineas Ruckert, and it's going to feel very weird to say this in front of
00:40all of you people, but I am a journalist based in Paris, and I am a test tube baby.
00:46The reason that I have worked on this topic extensively is that about a year and a half
00:54ago, I found out through my mom, who came up to me and basically announced this to me
00:59on a random Saturday, that I had been born through IVF, so in vitro fertilization.
01:05This experience made me want to look into how IVF had changed over the basically 32 years
01:15of my life, and to look at how technology is intersecting with the field of human reproduction,
01:23generation, which is how I came to be here today with this very excellent group of panelists.
01:28panelists.
01:30I will just do a very shameless self plug rapidly.
01:34The story that I ended up publishing about this topic about my own finding out that I
01:39had been born through IVF and the technological advancements that have happened since.
01:44It's called My Unlikely Existence, and you can find it on Longreads, which is a long-form
01:49online magazine.
01:51So enough shameless self promotion.
01:54I'm going to first of all introduce the group of panelists here, and the range of panelists
02:00that we have is actually a testament to how interdisciplinary this field is.
02:06We have a professor, a startup founder, a demographer, we have researcher, and over the next 40 minutes,
02:15they're going to guide us through what is going to be certainly a fascinating discussion
02:20on the fertility revolution and the future of reproduction.
02:23So I'll quickly introduce the panelists, and then we're going to get started.
02:28So actually, this works great.
02:30To my left, we have Anu Bashambu.
02:33So Anu is senior group leader in human developmental genetics at the Institut Pasteur here in Paris,
02:40where she spent the last two decades uncovering the genetic causes of infertility,
02:44and differences of sex development.
02:47She's a world leader in human gonad organoid development, and you're going to have to explain
02:52to us what that is, and has received the Royan International Award for Reproductive Genetics,
02:58the Prix Géle from the French Academy of Sciences, and the Henning-Anderson Prize,
03:03and sits on France's parliamentary office of the Evaluation of Scientific and Technological Choices.
03:09Next, we have Micheline Mishahi-Abadou.
03:12Micheline is a professor of biochemistry and molecular biology at Paris-Saclay University,
03:18and a member of the Academia Europea and European Academy of Sciences.
03:23She is a pioneer in reproductive genomics, and was the first to clone the progesterone
03:32receptor gene, and has spent her career identifying the genetic roots of infertility and premature
03:37ovarian insufficiency.
03:40Next, we have Jennifer Shuba.
03:42Jennifer is President and CEO of the Population Reference Bureau, a private nonprofit organization
03:48specializing in collecting and supplying statistics for research and academia, focused on environment,
03:55health, and the structure of populations.
03:56She is a political demographer, and the author of several books, including 8 Billion and Counting,
04:03How Sex, Death, and Migration Shape Our World, and most recently, Toxic Demography, Ideology,
04:09and the Politics of Population.
04:12And finally, last but not least, we have Kaisiwa.
04:16Kaisiwa is the co-founder and CEO of Tanit AI, a medical software startup using AI to support clinical decision
04:22-making in IVF.
04:24He also serves as the chief strategy officer at Fertilia, which delivers fertility treatments
04:29to some 30,000 couples from 40 countries.
04:32A three-time co-founder in the fertility sector, he has worked across entrepreneurship research
04:37and has published work on fertility treatments access since 2016.
04:42So, for this panel, we're going to take the first 15 minutes to try to slow down a little bit
04:46and talk about the science behind essentially reproduction and the technology that's going into it.
04:53Then we'll look at some of the more ethical questions that can come up in this field.
04:57And finally, we'll try in the best that we can to look at the future of the field of reproduction.
05:04Where are we headed?
05:06So, I will start with the first question for Micheline.
05:09So, maybe you can start us at the stage of the diagnosis.
05:13Recent advances in genetics and AI are transforming our understanding of female fertility,
05:19including ovarian insufficiency and diminished ovarian reserve.
05:23So, can we move from diagnosing infertility after it occurs to actually anticipating reproductive
05:33lifespan before fertility is lost?
05:36Yes, thank you for the invitation.
05:39I'm very glad to be here.
05:40Yes, I would like to explain how AI and genetics are completely changing the paradigm of infertility,
05:51because now we can understand the basis of infertility.
05:54If infertility is not a disease, it is a syndrome, and a syndrome may be due to hundreds of causes.
06:01And this is the case for infertility.
06:03Furthermore, genetics teaches that there is a direct link between genes involved in infertility
06:12and genes involved in physiological aging, in the age of menopause.
06:18This has been shown by the larger genetic studies, especially from the group of John Perry.
06:25And fertility is highly controlled by genetics.
06:31We know that because there is a high correlation between the age of menopause of a mother and the daughter,
06:37high correlation between monosecate twins, and also you have familial forms of infertility.
06:44So, the recent leap in genetics has been the development of what we call next-generation sequencing.
06:55You know that 20 years ago, it was the whole genome project, and it takes about 10 years
07:05and costs $3 billion to sequence a single genome.
07:08And now you can do it in one week for some less than 1,000 euros or dollars.
07:17So, it's really a leap.
07:20And now we have a lot of information, and this information, AI, help us to, of course,
07:29to classify all the variants.
07:30You get millions of variants, and what you want to isolate finally is one or two of them
07:37which are responsible for the disease.
07:41So, primary ovarian insufficiency and diminished ovarian reserve correspond to the complete loss
07:46of ovarian function in 4% of women under 40 years, or correspond to a high proportion of women
07:56that are treated in IVF, for example, and correspond to the loss of alteration of quality of the ovarian reserve.
08:04And so, it's a high proportion of patients, but we know very few of the causes.
08:11But thanks to next-generation sequencing, in the recent years, in the last decade, several groups,
08:19including ours, have identified about 100 genes involved in what I call POI and diminished ovarian reserve,
08:29different genes. So, it's a very large number of genes, and we have studied the largest international
08:38cohort of primary ovarian insufficiency, and we showed that using genetics, 70% of causes were unknown,
08:46but in this 70%, we could identify causes in 30% of patients, or a very large number of patients.
08:55And what was important is that we could describe the genetic architecture of this disease.
09:03And what we show is that even if you have 100 of genes, you can classify genes in three main
09:11pathways.
09:12And these pathways are very different, and the consequence of alteration of each one is completely different.
09:20And the big surprise was that the main pathway involving this kind of infertility was DNA repair genes.
09:28Because DNA repair genes, of course, are involved in meiosis, so it must be expected, but nobody did it.
09:35And so, if you have alteration of DNA repair, of course, you have loss of oocyte quality and very poor
09:43prognosis of fertility.
09:45But DNA repair genes are also cancer-predisposing genes. So, it could be a direct link was made between infertility,
09:58cancer, and longevity. And this was the discovery of last year.
10:04The other two families are of better prognosis. It corresponds to genes involved in follicular growth,
10:11or genes involved in production of energy in the ovary, metabolism, or mitochondrial genes.
10:18And we have shown for the first time that genes of a funcony anemia pathway, like BRCA1, BRCA2, FUNC-M,
10:27correspond to genes that cause isolated primary ovary insufficiency.
10:34So, when you identify such genes, it's the opportunity to prevent cancer in such patients.
10:42And also, if you have alteration of other class of genes, you know that the prognosis
10:48must be better. If you have a block of follicular growth, you suppose that they are follicles,
10:54of course, but they are blocking the growth and you have infertility.
10:58So, we move from now.
11:01Just, I want to make sure that we have enough time for all of the panelists. So, if you could
11:05just
11:05finish that thought and then we'll, we have many other questions to get through.
11:08Yes, of course. So, to conclude, I will say that now we move to predictive medicine. If you understand
11:16the biological pathway involved in this form of infertility, you move to predictive medicine.
11:24You can predict fertility or not in this patient. You can predict evolution to loss of the ovarian
11:33reserve if you have an alteration of DNA repair. You can predict the existence of comorbidities,
11:40like cancer, for example. So, you move to predictive medicine and you can prevent such
11:48situation to occur. You can, for example, propose fertility preservation, urgent fertility preservation.
11:56You can also propose a kind of protection of a patient to avoid the occurrence of cancer. So,
12:06it's a completely change of paradigm. Great. Thank you so much. We've gone very far already,
12:12but I did want to maybe step back a second. And Kais, could you tell us a little bit about,
12:19first of all, you know, what the IVF process actually looks like? You know, what are the different
12:24steps and stages of that to address these infertility challenges? And also, how is AI starting to be used
12:31and integrated into this process? All right. So, thank you for the invitation first. And yeah,
12:39I'm going to talk about it as an insider working and managing a fertility center, like for the past
12:4510 years. And this is like the focus. So, AI is involved today in different steps for when,
12:52while treating patients. And I will take one typical treatment that is ICSI,
12:59intra-cytoplasmic sperm injection. So basically here, we're going to select one sperm, one oocyte,
13:05and then inject it and hope it's going to grow as a good embryo and then transfer it to the
13:10uterus.
13:10And so, this work involves a lot of steps, a lot of doctors. So, we need to prepare very good,
13:17like the sperm, but also the oocytes in order to deliver the best ones to the embryologist.
13:25And that's going to do the work inside the lab to grow it and then deliver it back
13:32to the gynecologist. So, for the past 10 years, a little bit more, most of the work of AI was
13:40focused
13:41in what is happening inside the lab. So, because we had a lot of images and videos, basically, and
13:47computer vision was used for this massive amount because we had to look for the, for sperm in order
13:55to select which one is moving better, has the best morphology, etc. And so, AI started like detecting
14:02these and also the same thing for the oocytes and then having a lot of pictures and videos on the
14:12evolution of embryos and trying to select which one is the best to implant back. So, that's the first one
14:21and a lot of good results was done. And then, moving to the second thing is like more recent and
14:29that is
14:31robotics. And so, today there is like a lot of companies and startups giving like
14:38fully automated labs where when you deliver oocyte and sperm everything is going to be done
14:46automatically. That's like future. And then, getting back to the work of gynecologists. Some work was done
14:55but mainly basic machine learning, machine learning models in order to predict one specific thing,
15:03what are like the medication we're going to use, what is like the percentage of success rate, etc. But then,
15:08with the event of generative AI, NLP was moving way much faster and this is actually the focus of our
15:16startup. So, we are helping gynecologists in order to better diagnose and treat infertility using all
15:25this massive data of the different fertility cycles and treatment that was done. And so, now we are doing
15:33a large multi-centric and national study on that. So, our work is actually to improve what is happening
15:41inside the lab, not to discover new techniques. And so, yeah, because, and also this last thing is that
15:50we arrived to a point where there is a good amount of retrospective cycles and data for us to deliver
15:59completely new types of models that doctors can be using like more confidently and as a day-to-day
16:07basis in order to improve their results. Great, thank you for that. Anu, I'd love if you could
16:13maybe take us, take us in the, into the research lab a little bit. You know, when in 1978, the
16:21first
16:21quote-unquote test tube baby, Louise Joy Brown was born, already the idea of fertilizing egg and sperm
16:29outside of the body was quite controversial, but now we're actually at a level where there's essentially
16:35eggs and sperms being grown in the lab. Could you tell us a little bit about your research and also,
16:40again,
16:40how sort of AI technology is, is playing into what you're, what you're looking into? Yeah. So,
16:47thank you very much. So, what you're talking about is in vitro gametogenesis. So, just briefly before
16:54that, for the testes and the ovaries to function, you need both somatic and the germ cells. The germ
17:00cells are ova or the somatogonia, and there are somatic cells of the tissue. So, when you're trying to
17:06develop one outside, you have to develop both. So, our lab has been developing what's organoids.
17:12Organoids are essentially mini organs in a dish. So, we have done the testicular organoids, but more
17:17interesting are the ovarian organoids, where we have developed the, the somatic cells and then both
17:22the germ cells of the gonad. Now, there are other labs working in the same field, and the idea is
17:28now
17:29reproduction could move from more from biology to technology. Essentially, the term infertility would not
17:35be there anymore because you can take a cell from a person's body, re-transform it into a basal cell,
17:44that you can take it down to what lineage you want. It's been successful in the mouse, where in vitro
17:49both spermatozoa and urgonia have been developed, and healthy pups have been born. But for human,
17:55there is still an issue to go. More importantly, okay, we can take the cells down to a certain point,
18:01but then they cannot, we do not have enough clinic lab data to take it into clinic to say that
18:07this
18:07would be what it would be used for. However, the consensus amongst the people who are working in
18:12the field is that this would be available within the next 10 years. Wow. A perfect pivot to what I
18:20was hoping to speak to with Jennifer. So, Jennifer, you have a big task, which is to sort of take
18:26us out
18:26of the lab and put this all into context. You're obviously a demographer. You've written several
18:31books about fertility trends. How do you see these technologies that we've been speaking about,
18:40which are improving, you know, fertility overall, and even leading to, yeah, exactly, sort of almost
18:48humans being born outside of the body. What does this look like on a global scale? And, you know,
18:55of course, this is probably a very limited number of cases where this is happening. But
19:01how do you see this playing out as the technology races so far, so quickly forward?
19:07Well, I do think it's important to underscore the piece that was in your question, which is,
19:11this is still a really small proportion of births worldwide. And the reason that's important is you
19:16may all be noticing that headlines of, and no matter what your language is, the headlines of the
19:21newspapers are often about global demographic trends and how radically they've been shifting
19:26in the last few years. Of course, we had a century last century that was all about exponential population
19:31growth. It's been more about differential this first couple of decades, but we're now firmly in a
19:36place where two out of three people in the world live somewhere with what's called below replacement
19:41fertility, which just think of a shorthand of replacing both parents. So that means that
19:48those countries are on course to, of course, they're aging rapidly and then depopulate.
19:53So that brings this issue, of course, then firmly into the political sphere, which is why the leaders
19:59of all of your countries are thinking about this, because they're thinking about it in terms of
20:03economic growth, working age populations. Sometimes they're thinking about it in terms of gender,
20:08that's nice, and rights and helping people have the number of children that they want to have.
20:14And sometimes they're thinking about it in terms of existential questions. And so it's in that maybe
20:20array from being concerned about gender issues and equality all the way to existential issues
20:26that this scientific and technological conversation enters. And that's why we have to be really
20:31careful and thoughtful when we discuss these issues, because
20:37you know, we were talking in the green room beforehand, it's not that technology does anything.
20:41It's a you made a thing, but it's that the technology enters into a larger social,
20:46political and economic conversations. And right now, those are spicy, they're hot,
20:51and they're only going to get more so as we see a real acceleration in this trend around low fertility.
20:57The other piece to mention is, of course, that when we were, we asked me to paint with a really
21:02broad brush
21:03stroke. So I give the big, the big brush stroke. But if you just zoom in a little bit, you
21:08see,
21:08of course, that there is much differentiation within trends. So we might be two out of three
21:14people with below replacement fertility worldwide. But that means one out of three live somewhere that
21:17there is high fertility. And of course, it's not the case that everyone that lives in a country where
21:23there's high birth rates is, has an easy time having kids, right, there's infertility even in those
21:28contexts. And so there's there's inequality of access, there's differential trends, even within
21:33countries and communities. Yeah, thank you for that. And it's very helpful to step back. So let's
21:39talk a little bit about those spicy questions. I think they're quite important and interesting.
21:43You know, within the field of reproduction and IVF and technology, there are different levels of what
21:52we're seeing, right? There's, you know, for example, some some labs are using AI to to do some sort of
21:59embryo scoring to try to find, essentially, the best fit embryo, whereas others are going a little bit
22:05further, and actually trying to do testing on, you know, embryos for intelligence, for height, for eye
22:14color, all these sorts of things, you have to kind of think of designer babies. So, you know, for you,
22:19as researchers and academics, looking at these topics, where, where do you draw that line? Maybe
22:25if you wanted to actually pick it back up, and then, and then on new ones. Sure. You know, I'm
22:31not
22:31going to draw a firm line myself. But of course, I'm just going to say that we need to ask
22:34these
22:34questions, because we just see this throughout history. So there's really nothing special about
22:38this moment, except that the technology itself has changed. So the questions that we're asking are all
22:43similar to questions we would have asked 100 years ago, when, of course, was a really hot time for the
22:49eugenics movement, where they really believed that science would make a better race. And so those
22:54ideas are still present. And we have to think about what the policy environment does to allow
23:01different ideas to come to the surface. But I do want to say that it's not just limited to policy.
23:08One example I think about is in South Korea, which did not have the one child policy, like think about
23:13China having the one child policy, South Korea did not. But in 1990, we can look at birth sex ratios.
23:21So normally, it's about 105 boys born for 100 girl, girl babies born. For third births in South Korea,
23:30in 1990, it was 193 born per 100. And so it was that the it wasn't because the government was
23:39pushing
23:39this. It was these cultural norms plus technology that led it there. So when we have this conversation,
23:44we don't just want to think about what is the role of government, but we also think about
23:48you know, different cultural norms and the technology. In 1994, they said no more fetal sex
23:54determination and the ratio starts to normalize. So policy does have a role.
23:59I'm just going to take a step back from there and talk about the pre-implantation genetic testing of
24:04the embryos for the eugenics you talked about at the question you asked. So the the legal parameters
24:10are different in different countries. Pre-implantation genetic diagnosis for debilitating disease like
24:15Huntington's, Tay-Sachs, it's allowed. You can do it and but however for selection,
24:22either sex selection or selection of traits. Now there because for those genetic causes are not
24:27definitive, there you have got a polygenic risk score. You've got multiple genes involved. So
24:33where do you go right and where do you go wrong at that point of time? And most the consensus
24:37in
24:38most of the countries in terms of legal definitions is that is not allowed. Or in some countries,
24:43there is some leave over the for the attending physician. But and that's where I personally would
24:48draw a line that if you have a debilitating condition, yes. However, just one more sentence there.
24:55In these conditions, let's say hearing impairment is not a part of these conditions. But if you ask a
25:00hearing impaired person, for them, that's reducing their quality of life. So should the embryo screening
25:05be extended to that, then where do we stop? Exactly. Very, very challenging. And this,
25:13I think both of you touched on something quite important, which is the idea of how do we regulate
25:17all of this? And one thing that has happened, has been seen in other medical fields is sort of
25:25medical tourism, where because the rules are one way in one country, if you want to get a certain
25:30type of treatment, you will go to Turkey or the Philippines or Tunisia. So, you know, how do we
25:37start to look into regulating this? Have there been attempts already made? And is there a risk here that,
25:47you know, reproductive tourism could start to become the norm, especially for those who can afford it?
25:54I think maybe to put something here, the intent is really important for medical tourism and why you're
26:03in there. Some, some people do travel because there is no infrastructure, period, that's it. But some
26:10other people travel because there is a better legal system or fertility reproductive medicine act or law
26:21that will let them access to a treatment that don't have access to it in in their country. And so,
26:28if the intent is to better have a chance to do it, and I think it's it's fine, it's more
26:34fine, I think,
26:35than doing it for less ethical, I believe less ethical thing of optimizing the superpowers of an embryo.
26:46So if you're going to do it to have access to gene sequencing in order to see if there is
26:53like a disease
26:53disease or something. So to better select the embryo, I think that's fine. And to the fertility center
27:01that we have, it's almost like 20% of our patients are international patients. And mostly they come
27:07because they don't have the infrastructure in their countries to do it and not for embryo superpower.
27:14And actually, the the law in Tunisia doesn't doesn't allow it simply.
27:21I don't know if Jennifer you wanted to add to this or?
27:24I mean, I think we already have it. I think that that's what I would take away.
27:27And we know this, we already have it. And and so when we're thinking about the future and we think
27:33about this tourism, we know that it's the people with the most education access and means that are going
27:38to be the ones to have the freedom to travel and the people without it that won't. So when we
27:42want
27:43to project forward and, you know, will this be, you know, give people greater access to having
27:48children? Some people certainly, but not everyone. But then the counter argument to that is that if
27:57the science has still not told you that you are at that point, I give you the I gave you
28:00the example
28:01earlier of these babies born from in vitro gametogenesis, but partially in vitro gametogenesis is
28:06a long story. Anyway, the group had to go out of U.S. and get it done in Peru
28:11because the legal conditions were different. They didn't get the FDA approval.
28:15However, what we do not know, the children were born normal in theory, but it's been a year and a
28:21half and nobody knows what's happening with those kids because science still has not told us.
28:25So once the science is not clear or anything, taking advantages of these loopholes by doing
28:29reproductive tourism is not an easy thing, not a happy thing. Let's put it that way.
28:37I think that's actually a great pivot to the next section of this of this chat. We've got about 10
28:42more minutes. And I did want to take a stab at looking at the future. And one thing, so we
28:50talked
28:50about regulation, but we also have, you know, there's also big questions about sort of responsibility.
28:56So let's say for example, we have an AI, not an AI, a fully AI, but a technology that's using
29:05AI to
29:05a certain extent that's recommending embryo A over embryo B. Who is ultimately, you know,
29:13responsible, for example, if embryo B has, you know, for example, some sort of disease that was
29:20not caught by the AI or if embryo B, you know, was actually very clearly to the human eye, the
29:26less
29:26successful choice. Where do we start to lay the responsibility? And does this again kind of fit
29:32into some sort of broader question of having to regulate and having to have some sort of
29:37governance over these types of technology? I think that thankfully there is a minimum of regulation
29:47because today to put inside a lab or a hospital like a solution that's going to support a clinical
29:55decision making support, it has to be certified a minimum. So you have like FDA approval,
30:02for a solution or here in Europe, there is a CE European marking for this type of AIs. And by
30:11the
30:11way, I mean, now they're getting tougher and tougher, especially with the introduction of a large
30:16language model, generative AI or scribe and ambient AI. And they used to be classified like simple,
30:24basic, but now they are going to higher, higher classes and there is more scrutiny on it.
30:32There is like more barriers in order to validate your solutions, at least from a performance
30:42perspective before giving it to the hands of the doctors or the gynecologist. And for instance,
30:49this is the path we are going through because doing like a national research in different centers,
30:55multi-centering like working with the tens of thousands of just even, even more of cycles in
31:03order to, to validate this respectively and then prospectively. And I think this is kind of the
31:09barriers, but getting back finally to the intent. This is, this is still, I mean, an ethical point that there
31:20is like different,
31:20uh, um, um, um, like, um, perspective of how do you write intent? Right. Yeah. I mean,
31:28and even like for the, uh, for certifying like a product that it is the, the, the intent use,
31:34this is the first thing that you need to define when filing for an FDA. What is the intent use
31:40of,
31:40uh, of your product? But then it can be, um, yeah. And, um, again, this is all, you know,
31:48kind of, it's all happening at once. And there's always the, the sort of the tension between,
31:52you know, the, the idea, you know, in the sort of startup world and technology of, of move quickly
31:58and break things and of also regulating. Um, and, and these are going to become questions that are,
32:02that are more and more important. And, and you all are really on the, on the front line of this.
32:06Um, I did want to take a step back at, you know, and, and look at sort of take, take
32:11stock of where
32:11we are now and where, where all of this is headed. You know, in 1978, when the first child was
32:17born
32:17through IVF, um, one of the three scientists who are credited with discovering DNA called it a
32:23descent into hell. Um, and you know, uh, even when I was born in 1993, this was not still very
32:30widespread.
32:31Um, and, and, and now we've seen IVF explode. Um, and now we're starting to see these technologies
32:36explode. So I know none of you have a crystal ball, but, um, where do you get a sense of,
32:41of,
32:41of where this field is moving? Um, do you have any, um, qualms or, or, or, or, or fears? Um,
32:48like,
32:48you know, the, the, the, the co-founder of, uh, co-founder, the co-discoverer of, of DNA did,
32:53or, or, or, or, you know, are we, um, you know, heading in a direction that, that feels good to
32:57you?
32:59Um, in terms of scientific discoveries, what's most interesting right now is this in vitro gametogenesis
33:04that will give, in theory, it will democratize, uh, democratize the reproductive potential for
33:09people. However, there are other technologies developing, and that are going to help these
33:15ideas. So the watershed moment came when in, uh, 2018, you know, when the guy,
33:21he used CRISPR technology to, uh, edit a gene and had CRISPR babies without having enough evidence in
33:28the lab that this is going to work and there are not going to be any off target effects or
33:32epigenetic
33:33changes. So as we were saying before, that the technology is developing very fast, but the
33:37problem is not the technology there. The problem is how people are using it, how much society is
33:42regulating it, how much legislation is around it, and how much ethical considerations are around
33:48these technologies. That comes from a scientific point of view. I also would like, uh, you to think
33:54about one thing. I just told you that there are a hundred cause of infertility. How many treatments do
34:02we have? One, we stimulate women with hormone and we hope to have growth of follicle and good quality
34:13oocyte. IV, the art is only a single treatment. So it's urgent to have more treatments because all genes
34:23are identified are in fact targets, specific targets, you know, and we have to develop new treatment based
34:33on these targets. This is targeted therapies. This is done, for example, in oncology and it was a real leap,
34:44you know, for patients because first you characterize molecular alteration of patients and then you give a
34:52specific treatment, not the same treatment for everybody. So it's urgent. For example, I want, uh,
34:59there was an article in February in science for patients with alteration of follicular growth.
35:07They just screen drugs, FDA approved drugs, and they find a drug which is able to stimulate follicular
35:17growth. They study 14 patients and 14 had stimulation of follicular growth. And it's a drug that is FDA
35:26approved. If you have alteration of DNA repair, resveratrol, for example, antioxidant is able to promote
35:35DNA repair in the ovary. So we have to think about new treatment to identify the cause of infertility,
35:45and then to develop targeted therapies. This is urgent and has to be done because all IVF
35:53inefficient, it's a loss of cost, economic cost, mental health cost, cost at work, and we have to
36:00avoid all these. I think that Anu wanted to jump in. One statement for this is that all these things
36:06have been
36:06done very fast using organoid systems. They are being used for toxicological studies, they're being used for
36:11hormonal studies, and they're used for folliculogenesis in our lab and other groups as well.
36:17Yes.
36:18And I think maybe very shortly, um, just getting back to the perspective of women health,
36:23and, um, there is not that much money being poured in, uh, injected in women health, either from, uh,
36:31from research or even, uh, after that. And I think, um, a lot of advocacy for this needs to be
36:38done,
36:38even for research in, uh, in different, uh, drugs and molecules that have been developed,
36:43it's more focused on men, even for the studies. And now there is an urgent way to put more money
36:49in order to find, uh, more solutions for, uh, for this. And I mean, France, for instance,
36:54they do in like, uh, a national, uh, like, um, plan for, uh, fighting infertility. Some money is being
37:02injected for that, but it's still very low.
37:05Just maybe one last question, because I think it's a really important point that you bring up,
37:08and this wasn't one of the questions in the, in the, in the, uh, the list, but, you know,
37:14how can we make men care more about these issues? Because I think, uh, you know, looking at it,
37:18the audience, it's pretty female. Um, and so, so, you know, from, for me, the, the, the entryway
37:25into this was a personal one. He's learning about my own, um, history, you know, story of being,
37:30of being born, but you know, how do we, uh, democratize this and, and, and, and get the
37:34sort of funding that's necessary to, to ensure that, you know, this is not being, you know,
37:39you know, unidirectional.
37:40So France has started this, just once, but France has started this program, PPR,
37:44which is specifically for, uh, uh, for the health of the women and, uh, health of the couples.
37:50So France is, uh, putting in money for these issues and how men will react to that.
37:55Only guys can answer that.
37:57Just maybe just one final, not a man, but I can answer that. Here's what we wouldn't
38:01want to happen. We don't want people to be interested in this because they want births
38:07at all costs, right? Which is, I think where, and some of the private conversations that you
38:12hear around this are, we want to, we want to invest in these technologies, not because
38:15we care about helping couples have the number of children that they want, not because we care
38:20about making, you know, dreams come true, but because we want to do this, um, for maybe
38:26reasons that don't put rights at the center of that. And so, you know,
38:30the worry that I have, the more awareness we raise about this is that you don't get to
38:34choose what people do with that. Do they, you know, how do they instrumentalize that? And so
38:39I think it's just good that we can surface those kinds of cautions here.
38:42Great. Well, we've got, uh, pretty much, uh, no time left. So thank you to all of the panelists
38:47and thank you to you all for following along so attentively. And please stick around for the next panel,
38:52if you're interested in learning more about wearables, uh, and implants.
38:58Oh, thank you very much. Thank you.
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