Updated November 9, 2026, 8:23 a.m. ET
The first successful human pregnancy using in vitro fertilization, or IVF, took place almost 50 years ago.
Today, more than 100,000 babies are born each year through IVF in the United States, according to the Society for Assisted Reproductive Technology.
And in 20 years, Ivan Glenn Cohen, a professor at Harvard University, believes it will be possible to create human life from stem cells – starting with skin cells, without resorting to invasive egg retrieval. Stem cell fertility treatments could arrive in clinics even sooner, within a decade, according to Henry Greely, a Stanford professor who specializes in the ethical, legal and social implications of new biomedical technologies and whose book with the provocative title “The End of Sex” was published in 2016.
It’s called in vitro gametogenesis, or IVG, and it’s one of several developing fertility technologies being tested around the world. Cohen, a leading expert on the intersection of bioethics and law, told USA TODAY that the technology could eventually allow same-sex couples to reproduce without a donor, more than two people to have a genetic connection to a child or a single person to procreate alone. Proponents say these advances will change medicine and provide the long-awaited next frontier in fertility. Critics argue that some implications might be unethical.
“It’s one of the things people have dreamed of for many years,” says Dr. Thomas Molinaro, board-certified reproductive endocrinologist, obstetrician and gynecologist and chief medical officer of Everleap Fertility. He adds that several groups are currently working on this research, “but I think we’re still a long way from being routine and something being offered as a treatment.”
Other inventions that might sound like science fiction to some are being developed around the world to aid human conception and gestation, including genome editing and artificial wombs. The future of fertility is full of possibilities, including a world in which humans might have the ability to create an embryo in a petri dish from skin cells, modify the genetic makeup of the embryo, and grow that child to term in a machine without compromising the physical health of the baby’s parents. This hypothesis raises many fears among some about eugenics and the possibility of creating personnel or defense forces with characteristics adapted to effectiveness. It seems far-fetched, but the science is moving relatively quickly, Greely says. A lot could happen in the next 50 years.
But precisely because science has this potential, should humans pursue a world in which babies could be made using machines? What would this world look like? Would this solve declining birth rates and fertility problems, or would it create new problems? As scientists advance and commercial investors buy in, legal and ethics scholars attempt to keep pace.
“I don’t think it’s possible to think too soon about the future of reproduction, because these kinds of things will fundamentally change the way we (make babies),” says Elizabeth Chloe Romanis, professor of biolaw at Durham Law School. “Everyone has a very significant interest in it.”
“The business of creating families”
Romanis’ research focuses on ectogenesis, or the possibility of machines that could “simply grow babies from scratch for us.” Full ectogenesis probably dates back 50 years in humans, she says, but scientists at Children’s Hospital of Philadelphia were able to successfully extract a premature lamb fetus from its mother’s womb, place it in a uterus-like machine, and carry the fetus there to term. The goal, researchers say, is to provide better outcomes for premature human babies. But full ectogenesis could benefit women with diabetes or other pregnancy-related illnesses, or people diagnosed with cancer during pregnancy. This could eventually become an alternative to surrogacy.
“Some people claim that ectogestation is a solution to women’s inequality,” Romanis says, but she’s not so sure. Society treats pregnant women poorly, she says, calling them economically unproductive and potentially dangerous to their fetuses. It could get worse with ectogenesis, she says, if ectogestation is considered safer than women’s bodies.
“There’s a deep and I think passionate divide within the feminist movement over ectogenesis, where one wing says, ‘This is the patriarchy’s latest attempt to get rid of us completely. If they don’t need our wombs, then they don’t need us,'” Greely says. “And the other wing says, ‘It’s so liberating, we can have children without having to be pregnant.'”
If we’ve learned anything from IVF, it’s that it’s a business, says Nava Dimer, director of reproductive bioethics for Rader Law Group and IVF Law Group — “the business of creating families.”
Yet the pace of progress in fertility technology doesn’t always give stakeholders the chance to stop and think about the broader impact it might have on people, says Sonia Suter, a law professor and founding director of the Health Law and Policy Program at George Washington University.
“What worries me the most,” she says, “is that most of the biggest efforts are being made in the commercial sector.” She adds: “The ability and wisdom to develop these technologies are two very different things. »
The target audience for any fertility technology is those who want to become parents. This desire, Dimer says, can put people in a vulnerable position.
“If standing on your head led to more successful pregnancies, many of my patients would be standing for eight hours a day,” Molinaro says.
Scientists still have work to do on abortion
IVG has been successful in animal birth trials, Cohen and Greely say, and human embryos have been created this way. “No one has done it all the way for human reproduction,” Cohen says, adding that the United States bans human abortion and all research on embryos older than 14 days. In the United States, biomedical companies are campaigning to ease restrictions on embryo research, while other countries in Europe and Asia continue their efforts in hopes of bringing abortion to patients as quickly as possible.
While it’s exciting that scientists have successfully used IVG to give birth to mice, Greely says “mice are not human beings. And even if you can do it, the safety concerns are enormous.”
Dr. Paula Amato, director of the Division of Reproductive Endocrinology and Infertility at Oregon Health & Science University, is one of the researchers working on abortion. She said the human embryos her team created were missing certain chromosomes after fertilization.
Still, she believes the technology could be ready for human clinical trials within 10 to 15 years, giving a chance to same-sex couples, postmenopausal women, cancer survivors and anyone who currently can’t reproduce.
Although giving same-sex couples the opportunity to have genetically related children might be an argument for equality, Cohen and others worry about society’s obsession with genetic connectedness. The LGBTQ+ community has spent a lot of time emphasizing that the genetic connection doesn’t matter that much, Suter says. Would abortion undermine the value of the chosen family?
“The ethical questions here, I think, are wrapped up in some of the culture wars that we’re experiencing in this country,” Suter says. Some people’s resistance to same-sex parents, “let alone genetic parents,” she says, could lead to backlash.
IVG could also give people the opportunity to reproduce with multiple partners by “collapsing generations,” says Suter. Cells from two people could create one embryo, and cells from two other people could create another embryo, and then scientists could create eggs and sperm from those embryos to create another embryo, in several iterations. In theory, Greely said, 16 people could have a child together through abortion. “They would be like great-great-grandchildren,” Suter says.
And then there’s the wilder possibility, Greely says, of a single genetic parent to what he calls a “unibaby.” It’s different from cloning, Suter says, because the person’s offspring through abortion “would not be exactly the same mix of genes.” Who would want to do that? Single parents, Suter explains, who want to avoid the personal or legal difficulties that may arise from using donor gametes.
“But it raises some ethical concerns about safety,” Suter says, “because it’s a bit like having incest on steroids.”
Anna Louie Sussman, a journalist and cultural critic who wrote “Inconceivable” about her own fertility journey, says abortion “sounds good,” but she’s not sure what it will look like in practice. Undergoing a small skin biopsy that doesn’t even require stitches is “obviously preferable to getting injected with hormones,” she says. But what will the monetary price be and what about the success rates?
“I imagine most people prefer the old-fashioned way,” says Sussman. “It’s free.”
Genome editing, “designer babies,” and the slippery slope toward eugenics
According to Greely, one of the arguments for expanding IVF and eventually GIV is the ability to screen embryos for genetic diseases through a technology called preimplantation genetic testing, or PGD.
Several companies are working to make the IVF process better and more efficient using robotics, automation, and artificial intelligence. The hope is that it will be cheaper and more accessible, giving more potential parents the opportunity to prevent diseases like spina bifida, sickle cell anemia and other disorders in their babies.
But it’s a slippery slope, and some of these technologies “border on eugenics,” Dimer says.
The tension between embryonic genetic testing and the disability community is palpable.
“I think part of it is just deciding, as a country, what do we think are appropriate uses of reproductive technologies?” Suter says,…
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