E33 The Future of Reproduction
In this interview, Don MacPherson is joined by Hank Greely, a specialist in the ethical, legal, and social implications of new biomedical technologies. They discuss the roles CRISPR, preimplantation genetic diagnosis (PGD), and in vitro fertilization will have on the future of reproduction. They also discuss the ethical questions that will accompany selecting specific characteristics for implanted embryos and the possibility of creating babies with superhuman capabilities.
Season Three of the podcast is dedicated to exploring the future and how life is sure to change over the next decade. This episode provides insight into how developments in reproduction will disrupt the way we live and work.
Hank Greely specializes in the ethical, legal, and social implications of new biomedical technologies, particularly those related to neuroscience, genetics, or stem cell research. Hank is a genetics professor at the Stanford School of Medicine, the Director of the Center for Law and the Biosciences, and the Chair of the Steering Committee of the Center for Biomedical Ethics.
Don MacPherson:
Hello, this is Don MacPherson, your host of 12 Geniuses. For 25 years, I've been helping organizations and the leaders who run them improve performance. Now I travel the world to interview geniuses about the trends shaping the way we live and work. Today's topic is the Future of Reproduction. Our guest is Hank Greely from Stanford University. Hank is an attorney who specializes in ethical, legal, and social issues arising from advances in the biosciences, particularly from genetics, neuroscience, and human stem cell research. In this fascinating discussion, we talk about designer babies, the ability for same-sex couples to have their own biological children, and we even get into the ethics of species de-extinction.
This episode of 12 Geniuses is brought to you by the Think2Perform Research Institute, an organization committed to advancing moral, purposeful, and emotionally intelligent leadership. You can learn more and access the institute's latest research at T, the number 2, pri.org.
Hank welcome to 12 Geniuses. Let's get started with your background. Could you tell us about your personal history?
Hank Greely:
Sure. I trained as a lawyer. I practiced law for about four and a half years, but I've been a recovered attorney for about the last 35 years, during which I've been a law professor at Stanford. For the last 30 years or so, I've focused on ethical, legal, and social issues in the biosciences; genetics, stem-cells neuroscience, assisted reproduction, and many of those different strains came together in my 2016 book, The End of Sex, about human assisted reproduction and genomics.
Don:
And what is the history of reproduction? Because we're going to talk about the future of reproduction, but what is the history? And you can go back as far as you want.
Hank:
Until the last hundred years or so, there was only one way for humans to reproduce, but going back at least to the late 19th century — and there's a little bit of anecdotal evidence that maybe it happened a little bit earlier — people occasionally would have babies without having sexual intercourse through artificial insemination. There’s reasonably documented cases about the late 1880s, 1890s; didn't get particularly popular until the 1950s. We started using it for a lot of livestock earlier than that. But it was in the 1940s and ‘50s that people started doing artificial insemination in humans, which really meant, for the first time in any significant members, babies were being born who hadn't been conceived through sexual intercourse.
That led to lots of interesting law, ethics, religion. There were questions about whether it was an adultery if he used another man's sperm. There were all sorts of religious questions about whether this was a legitimate birth or not. Within a few years, though, states pass laws, everybody began to accept that, at least when used to overcome infertility, artificial insemination was fine. That, however, didn't deal with a lot of infertile people's problems. And for that, we really began to get some efforts, began to get a little bit of help in the ‘60s and early ‘70s with drugs that would increase ovulation, so make women ovulate more, increasing the chances of conception.
But things really took off in 1978 when Louise Brown was born, the first so-called test tube baby, the first child born after in vitro fertilization, where eggs were removed from the mother's ovaries, and then combined with sperm, donated the old-fashioned way by the father, combined to make embryos. The embryos were kept alive for several days and then moved into Mrs. Brown's uterus where an embryo became Louise.
Don:
That's only 42 years ago. That's not a very long time, and we've come a long way since then, right?
Hank:
We've come a long way. We've come 8 million, roughly 8 million people have been born as a result of in vitro fertilization since then. The first 10 years, probably a thousand people were born. These days, it's probably close to half a million to three quarters of a million people around the world. In the United States, about 180,000 people born every year as a result of in vitro fertilization. That's about half of 1% of the births in the U.S. But there are some countries, Denmark, Israel, a few others, where one or 2% of the babies born every year are born as a result of IVF. Then another certain percentage will be born as a result of artificial insemination. So, now there are probably 2% or 3% of the world's births are not as a result of sexual intercourse, something that was completely impossible until about 20 years ago.
Don:
And the current capabilities obviously include IVF, but what are some of the other capabilities related to reproduction?
Hank:
IVF is the mainstay, but there are other ways to try to improve reproductive success. We're still using fertility drugs. There are a few other procedures beyond IVF that might be used. Usually they're used for people who have some religious concerns about IVF, but not necessarily about these alternatives. But the thing that's become really interesting is add-ons to IVF. And the particular add-on that is most interesting is something called pre-implantation genetic diagnosis. As it was with Louise Brown 42 years ago, your basic IVF is you get eggs from a woman, you get sperm from a man, you combine them. You let them grow for several days in a Petri dish, and then you move them into a uterus and hope that that embryo will successfully implant and become a fetus and eventually a baby. That hasn't changed much, but the big add-on is pre-implantation genetic diagnosis — PGD for short. With PGD, on about day five, the embryo is a tiny little soccer ball.
Some people with really sharp eyes can see them with the naked eye if there's good lighting, but they're right at the edge of being visible. It's a little soccer ball. The outside of the ball is made up of a couple hundred cells, and they'll eventually become the placenta, the amniotic sack, and the other support materials for the pregnancy. Inside the soccer ball, there are a few cells that are called the inner cell mass, and that's what eventually becomes the fetus, the baby, the podcaster, the law professor, the human. this embryo at day five or six is called a blastocyst. It's still sitting in the Petri dish where you put it. You can take some cells off of the outside of the soccer ball without hurting the soccer ball. And then you do genetic tests on those cells. And those genetic tests can tell you — did this embryo inherit its father's tendency to get colon cancer?
Did this embryo inherit the mother's high risk for breast cancer? Which way will it develop? And a little bit about even some more strange things like, is it more or less likely to be an introvert or an extrovert? Is it more or less likely to have dark eyes or light eyes? So, we take cells from the outside of this blastocyst, we do genetic analysis of it, and we use them to make decisions about which embryos to implant. It is the case today. This has been changing very rapidly just within the last three or four years. Four years ago, only about 8% of the IVF cycles, of the IVF uses in the U.S. used PGD. These days, it looks like it's probably closer to 50%, 60%, 70%. Most of the time, though, they're not looking for diseases. They're looking to see, is this embryo likely to be able to develop at all?
Almost all of us have, in each of our cells, 46 chromosomes. A pair each of chromosomes one through 22. And then for women, a pair of the X chromosome; for men, one X and one Y. It turns out a lot of embryos don't have 46 chromosomes. And if you've got 45 chromosomes and you're missing chromosome one, or chromosome 12, or chromosome 19, you're never going to be a baby. If you've got 47 chromosomes and you've got three copies of chromosome four, you're never going to be a baby. You can't survive. PGD is now being widely used to count the chromosomes in those embryos. You've got an embryo that has three copies of chromosome eight, and there's no way it's going to be a baby, no point transferring it into a woman's uterus. However, once you're looking for anything from those cells, you can look for everything. You could do what's called a whole genome sequence on each of those embryos.
Don:
Does that identify diseases and physical and behavioral traits for these embryos?
Hank:
Yes, no, and maybe — all of the above. Once we know your genome, once we know your whole genome, we know everything that genetics can tell us about you. And that's true if you're a five-day-old embryo or a 55-year-old person. Once we know the whole genome, we know everything genetics can tell you. Some things they can tell you really, really certainly. So, there's a very nasty genetic disease called Tay-Sachs disease. Babies are born normal, and within two or three years, their brains, almost literally, turn to mush and they die. You can tell, at day five, after conception, after fertilization, whether or not that embryo is going to get Tay-Sachs disease. That's, as far as we know, 100% certain. Then there are things like, say, predisposition to Alzheimer's disease. There's a gene called APOE. If you've got two copies of APOE in a version called APOE4, your risk of getting Alzheimer's disease in your 60s and early 70s is about 80% — 80% to 90%.
But it's not 100%. If you've got a bad copy of a gene in the immune system; part of the genome, what's called the HLA section, your risk of getting Type 1 diabetes is about 10 to 20 times higher than the normal person's. It's still about 1%, but it's a lot bigger than it would be otherwise. Sometimes the genes can tell us with certainty — this embryo would get Tay-Sachs disease; this embryo wouldn't get Tay-Sachs disease. Sometimes it can tell us this embryo will have a higher risk of Alzheimer's; this embryo will have a normal risk of type 1 diabetes. And then, on a bunch of things, it can't tell us anything at all. It can't tell us — will this embryo grow up to be somebody who finds it easier to learn English than Chinese? The genes won't tell us.
Don:
So far, you've been talking about pre-implantation genetic diagnosis, PGD, and you've written about something called Easy PGD. Could you explain what that is and how the two are different?
Hank:
In 20 to 40 years, which is my timeframe for Easy PGD, it's going to be cheap. It's not going to be zero, but you'll be able to read a whole embryo's whole genome for $10, $20, something like that. It's going to be cheap. It's getting cheaper every year. That's one advance. And so, when we read the whole genome, we'll be able to tell you anything about anything genetics can say. It can tell you about those nasty early diseases like Tay Sachs. It can tell you about your risks of later diseases like colon cancer, breast cancer, ovarian cancer, Alzheimer's disease, diabetes, and so on. It can tell us a little bit about what you'll look like about cosmetics — dark hair, light hair; dark eyes, light eyes.
We're pretty good at telling light eyes from dark eyes. We're not very good at telling what particular shade of dark eye or light eye. Is it going to be gray, green, or blue? But we'll get there. It's clearly genetically determined. We will find that out. Are you going to be tall? Are you going to be short? Are you going to have a straight nose? Are you going to have a roman nose or a pug nose? Will your hair be straight, or curly, or kinky? All those things are in the genes. We'll know that. Fourth, we'll be able to say a little bit about your behaviors. Now, probably not very much because brains are even more complicated than genomes. But we will probably be able to say, “This embryo has a 60% chance of being in the top half on the SAT test. This embryo has a 70% chance of being above average in musical ability. But this embryo has a 30% chance of being above average in math ability.”
They're not likely to be very powerful predictions, but we'll be able to say something about it. And then the fifth and last thing, so early diseases, later diseases, cosmetics, behavioral traits, the fifth and easiest is boy or a girl. Part of Easy PGD is being able to do whole genome sequencing cheaply, accurately, easily, and give parents a bunch of information. The other part, though, is what really makes it easy, and that comes from stem cell research. Right now, nobody does IVF unless they have to. It is expensive, unpleasant, and risky. Getting eggs is a difficult thing. Getting sperm from the man is normally pretty easy. I don't know of any men who've ended up hospitalized as a result of donating sperm, but about half of 1% of women who have their eggs harvested end up in the hospital, and several of them, a year, will lose their reproductive capacity.
And every few years, somebody dies as a result of it. It's an arduous process. You have to shoot yourself full of drugs for about a month or more beforehand. Bare bones IVF is about $15,000. About half of that. It's just the drugs needed to get women to produce lots of eggs. And it's unpleasant, it's uncomfortable, and it's a little bit risky. Nobody goes through egg harvest unless they have to or unless they're getting paid a lot of money. Those eggs and sperm, those all started out as embryos. Remember the inner cell mass I talked about, the cells in the middle of the soccer ball? Some of those eventually became eggs; some of those eventually became sperm. We have another name for that inner cell mass. They're also what we call human embryonic stem cells. And so, you can take these cells and turn them into every cell type humans have.
We know that happened because it happened with us. We are the product of these human embryonic stem cells, also known as inner cell mass. But about 12 years ago now, a really cool thing happened — A Japanese scientist named Shinya Yamanaka figured out a way to take cells from living people's skin and turn them into things that look all the world like embryonic stem cells. So, he hits them up with a cocktail of genes and proteins, and they become cells that look like they can become brain cells, skin cells, kidney cells, liver cells, eggs, and sperm. These are called induced pluripotent stem cells. And people are spending an awful lot of money trying to figure out how to successfully and effectively make them become certain cell types. Because, for example, if you've had a heart attack, some of the heart muscle cells will have been damaged.
Those don't grow back. But if we could take some cells from your skin and we could turn those into these induced pluripotent stem cells, and we could turn those into heart muscle cells and put them back into you, they'll go to your heart muscle and they'll restore it. And if we're using your own skin cells — here's the beautiful thing about these iPSCs —they have your own genome, which means your immune system views them as a long, lost twin. It doesn't attack them. That's why they're so magic. That's why people are spending billions of dollars trying to figure out how to make replacement cells and tissues from iPSCs.
Don:
What's so amazing to me is that we could potentially take these skin cells, turn them into stem cells, and then create an egg or sperm, and then create a baby.
Hank:
Nobody's done that yet with humans, but it has been done with mice.
Don:
How far away are we from doing this in humans?
Hank:
There are about five labs around the world I know of that are working hard at this. It's not being pursued as rapidly as you might think, in part because governments aren't very eager to fund this kind of research; it raises concerns, but there are four or five labs doing it. The one that's gotten closest so far is a Japanese lab, which has made cells, taken these iPSCs and made them sort of two steps short of mature human eggs. You go through about 10 or 12 different steps to get there. So, they've gone through all but two of them, and they're working on the last two. This firm cells are a little farther behind, but not much. So, I think we're going to get there within a decade. Could be wrong, but there seems to be no inherent reason why it shouldn't work.
Don:
There's some pretty incredible potential implications to this. Or maybe not implications, but benefits too, right? So, a same-sex couple could then biologically have their own children.
Hank:
Now, it's a little tricky to go from, say, a man cells to make eggs, but there are a variety of ways people are thinking about being able to do that. And the same thing in the other direction, to go from a woman's cells to make sperm. No one has tried that yet with mice, but I suspect somebody will. And if you do, then gay couples, lesbian couples can have a child that is genetically theirs. So, I think there are lots of gay and lesbian couples who will want that, but they're not the only ones. There are a lot of couples in this world who can't have babies because one of them doesn't make eggs or sperm either as a result of congenital problem, the result of an accident, the result of a disease. And I think the biggest group that would be interested in this is people who used to make gametes but don't anymore. So, women who are old enough that they no longer have fertile eggs.
Don:
You have said that in 20 to 40 years, most Americans won't have sex to reproduce. What does that truly look like in 20 years?
Hank:
I say 20 to 40, in part because I think it'll take a while for the science to get there, in part because I think it should take quite a while for the safety testing to be done. And if it turns out that making eggs from skin cells disables 10% of the babies that are born that way, that's a terrible result. We need to be really careful to make sure this is safe before we go forward with it. And then part of it there'll be some period of time when people get used to the idea. Initially, the early adopters will flock to it. But when people see their friends and families having kids, healthy kids who don't have genetic diseases, I think it will catch on. Because most parents, more than anything else, want healthy kids. It's true that not that many kids are born with serious genetic diseases.
There are about 6,000 known serious genetic diseases that we could predict through PGD, but each one of them is rare. However, when you multiply rare times 6,000, you get about 1% or 2% of births. So, about one or 2% of births in the U.S. and everywhere else leads to a child who has a serious genetic condition that could have been selected against at the embryo stage. I think that's going to be the argument that will persuade many parents to do that. And I further think that they'll be encouraged to do it because it will be free. I mean, obviously, it will cost something. My best estimate, and you got to be crazy to estimate medical costs even today, and let alone in 40 years, for a procedure that doesn't yet exist, but I did it anyway. I think it's around 10,000 a baby.
So, if you're making a hundred babies and it's $10,000 a baby, that's a million dollars. That's not a trivial amount of money. On the other hand, if, by making a hundred babies this way, you prevent the birth of one baby with a serious genetic disease, how much money do you save? 3 million, 4 million, 5 million, 6 million? I would like to think that it will be subsidized and free because we'll want everybody to have equal access to it. But I'm a cynical enough guy to think it'll be subsidized and free because we want to save the money on our healthcare costs by encouraging parents to select against really expensive babies.
Don:
So, talk about CRISPR and how that factors into reproduction.
Hank:
It is the most exciting biomedical tool invented in this century, in the last 20 years. It's a gene editor; it's a DNA editor. If you've ever used a word processor, say Microsoft Word, you know how to do a find and replace. My name is spelled G-R-E-E-L-Y. Most people spell Greeley, G-R-E-E-L-E-Y. So, if I were to get a manuscript and it had my name misspelled in it, 40 different places, I can ask the word processor, find G-R-E-E-L-E-Y at every place it appears in this book, in this document, and change it to G-R-E-E-L-Y — And I push a button and Microsoft Word does it. CRISPR is kind of the same thing. The most exciting human use for CRISPR isn't to make babies — it's to fix genes in people who are sick. People are working on this for a variety of diseases; Cystic fibrosis, sickle cell anemia, beta thalassemia, basically every powerful genetic disease people are now trying to figure out how to use CRISPR to fix it. Nobody has yet exactly, but there are trials ongoing. There are some gene therapies using techniques that predate CRISPR, earlier techniques, but CRISPR is 10 times faster, cheaper, more effective, more accurate than its predecessors. It’s 10 times to a hundred times.
Don:
What did the Chinese doctor who was involved in the birth of the twins — I think he was trying to treat HIV — what did he use? He used CRISPR, right?
Hank:
Yeah. So, CRISPR's most exciting human use is to treat people who've already been born, but you could also use CRISPR on an embryo. People had talked about it, from the time CRISPR was discovered, people began to worry about this and talk about this. If you use CRISPR in an early embryo, you're not just changing the lung cells, or the liver cells, or the kidney cells — you're changing all of it cells, which also means you're changing its eventual sperm and its eventual eggs, which also means you're changing the genes of any descendants, children, grandchildren, great-grandchildren that, that person may have, or at least you're potentially changing them.
This is called germline genome editing. Germline means it's getting into the eggs and the sperm. And so, it goes from one generation to the next. Lots of different groups had worried about it, talked about it, and everybody had said, “Maybe this should be done in the future, but boy, nobody should try it now for a whole bunch of good reasons.” Little did any of us know that He Jiankui, a scientist Shenzhen in China was doing exactly that. In November of 2018, he announced at an international CRISPR meeting that two twins had been born earlier that fall whose genes he had changed. Subsequently, it's turned out that there was a third one-born about six months later, seven months later whose genes he had changed. The two who had been born in the fall of 2018, he had changed a gene called CC5.
It's involved in the immune system; may be involved in other things. One of the complicated things about genetics is many genes do many different things. But what we know best about CCR5 is that it sits on the outside of immune system white cells called T cells. And it's a molecule that sits on the outside and lets some things into the T cells. Unfortunately, one of the things it lets into T cells is HIV. So, what He Jiankui thought was — I'm going to take these kids and I'm going to change their CCR5 genes so that those genes don't work. I think if those genes don't work, then HIV could not get into their T cells and they can't get AIDS. Now, He Jiankui, the Chinese scientist, had actually gone to a support group for HIV patients in China. He went to the association, found a bunch of people who were eager to be able to have kids who couldn't get HIV, and then preyed on them to get his subjects.
And when I say preyed on them, I mean it. He told them that this was a HIV vaccine study. He didn't explain to them that this was something involving a technique that had never, ever been used in human embryos that were tried to turn into babies. And no babies had ever been born after this. The risks of this are immeasurable. And we still actually don't know anything about the babies that were born because the Chinese government, which ultimately arrested He and then found him guilty of various crimes and sentenced him to three years in prison. They're not making any information available about these babies other than that they exist.
Don:
What if the benefit was much larger? Isn't the genie out of the bottle, knowing that he proved it? And if the implications were larger, like COVID-19, if somehow they were able to use CRISPR to create some sort of immunity for children.
Hank:
One group says, “No, you should never do it. Humans should not be tinkering with our descendants’ genes. It will only lead to bad things.” Another group says, “Well, it kind of depends. How important is it? Are there other ways to do this?” to use your COVID example, if there's a good vaccine for COVID, then probably it doesn't make sense to take very many risks, tinkering with the genes. If there's a real good treatment for COVID, then it probably doesn't make that sense to tinker with the genes. If there is no good vaccine or treatment, then yeah, it could make a lot of sense if we think the overall process is safe. One set of the voices are saying, “We should ban it. It should be a red line. Nothing that passes down from one generation to another should be allowed. And another set of voices says, “Well, it depends. Depends on the circumstances.”
Don:
Who are the ones who are redlining this?
Hank:
It's an interesting mix, actually, of people from what's often the conservative side of the political spectrum and the liberal side of the political spectrum. It's both religious objections and then sort of in favor of nature against science, worried about technology, worried about naturalness; people who are typically found on the left. So, it's an odd combination.
Don:
I wanted to get back to, it might be the IPSE or the Easy PGD, where the potential is to create sperm or create an egg just using cells, skin cells, and what the implications are, the ethical implications around consent or lack of consent. So, if somebody was in a coma, you could potentially use their cells to create an egg or create sperm?
Hank:
In general, there's actually a lot of ethics discussion about this in old-fashioned IVF — things like, should you be allowed to retrieve sperm from dead men? And there's a lot of back and forth about it. Most people are okay with it as long as the dead person agreed to it in advance. Some people are okay with it if the dead person's spouse says, “Yes, I want this, and he would've agreed to it.” Some people aren't. And so, I think those kinds of consent issues are likely to play out. If people consent to it, then I don't think… Some people will still oppose it for a variety of reasons, but I think the consent issues will be limited. But if people don't consent to it, it's going to depend, I think, a lot on the circumstances. One of the things this leaves open. You leave your cells around all the time.
You throw out a Diet Coke can, and some of your skin cells and cells that were in your saliva are on that can. What if somebody falls around a celebrity and makes Steph Curry’s sperm, for people who really want a great basketball player? I think there, very few people would disagree, without Curry's consent, that shouldn't be allowed. But it gets a little trickier if it's somebody who died without being able to make a decision and the widow or the widower says, “No, he or she would've wanted this.” So, there are going to be some hard cases somewhere in the middle.
Don:
So, at one point, abortion was illegal in this country, but there were obviously abortions that were happening. Can you see a future where you're going to have these back-alley chemists or cooks who are doing this sort of thing, work for people illegally, or am I just getting a little paranoid with the technology here?
Hank:
I think there will almost certainly be people offering the service of Easy PGD or of CRISPR babies, either one, before it's legal in the parents' home country. I don't think it's as likely to be a back-alley kind of thing because you need an IVF lab, you need an IVF clinic, and IVF clinics are run by doctors who've got something to lose — their licenses and usually some assets and other things. But if it's illegal in the US, which it currently is, doesn't make it illegal in Tijuana, Mexico, or in Rio de Janeiro, or in Macau, or in the Cayman Islands, or other places. So, I expect we will see clinics offering services illegal in the United States. That where the clinic is not in the United States, Americans will go there and get those services.
I only hope there aren't too many of them because it'll mean they're doing it, for the most part, they're doing it before it's been proven safe. And that could lead to some really bad consequences for babies — we talked about consent earlier that babies never consented. They didn't get a choice in it. So, that's another reason why we should be really, really careful about safety before we move forward with this at all.
Don:
Could it lead to some really bad consequences to humanity?
Hank:
And some of the people opposed to it are very focused on the downstream issues. I think the answer, at least in the next 40 years or so, is probably not. Beyond that, it's hard to know. People are worried about designer babies. What they're mainly worried about, I think, is super babies, is X-Men. And who can make the super babies, who gets to have super babies, and who doesn't? Rich people, poor people, people in some countries, not people in other countries? The good news is we don’t know how to make super babies. We don't know the genes for making a super baby. We know genes that can protect you somewhat from heart disease or from various forms of cancer or from Alzheimer's, some kinds of heart disease — not most. There are not going to be genes that are going to be able to make you fly like Superman.
And we don't even know the genes that are going to make you really, really tall or really, really smart, or really, really fast, or really, really anything. On intelligence, we know hundreds of genes that are really important to intelligence, in that if the genes are broken, somebody has very, very low intelligence. But we know almost nothing about genes and genetic variations that give you higher than average intelligence. We know that good nutrition during your childhood gives you higher than average intelligence. We know that having parents who read to you gives you higher than average intelligence. We don't know anything really about the genetics of higher than average intelligence. And that's true up and down the line with respect to the kinds of traits that people think people want to make super babies with. Let me add one thing on that.
Selected embryos, Easy PGD is about embryos selection. So, if two people want to have babies together and they use Easy PGD, the baby can't have anything that the parents can't provide, right? If the two parents are both really short, highly unlikely that they've got genes that will lead to them having a seven footer. Super babies are almost impossible in an embryo selection world, in an easy PGD world because you need the parents to have all the genetic variations that we don't know yet, it could lead to super babies. In an embryo editing world using CRISPR, super babies become more of a possibility because you don't have to wait to find parents who've got the right genetic variations. You can just change the genes to turn them into the right genetic variation. But there, again, we have no idea what those right genetic variations are, how safe they are, whether they work or not, etc. And we won't for a while.
Don:
Let's hope so. Who is deciding these things? Are we moving toward a global council?
Hank:
If all you need is an IVF lab and a gene sequencer, then it's relatively easy to make gene edited babies or to do Easy PGD. I think enforcing that would be hard. And I think a lot of countries just wouldn't care enough. So, there are a lot of groups talking right now about global regulation of these various genetic technologies with respect to reproduction. The most notable is the WHO. The World Health Organization has a commission that's looking into issues around germline gene editing using CRISPR on embryos. I am sure I've got friends on that commission. I'm sure they're going to come out with worthy recommendations. And I bet a lot of money that it doesn't become a treaty that gets signed by most of the world's 200 countries.
Don:
Where are we with de-extinction? It's off topic, but I wanted to ask you about it. Are we ever going to see the wooly mammoth again?
Hank:
What we may see won't be a wooly mammoth, though, it'll be an Asian elephant with enough changes to its DNA that it looks an awful lot like a wooly mammoth. I think we're probably 30, 40, 50 years away from getting something that has an entire mammoth genome. But we could get effect similarly, a reasonable effect similarly, probably within 15 to 30 years if somebody cared enough to try. It's going to be tricky. I mean, Asian elephants are an endangered species themselves. Trying to do in vitro fertilization on a mama Asian elephant may not be all that easy. Their gestation periods are 22 months long. So, there are people exploring de-extinction. The thing that makes everybody go, “ah,” is the wooly mammoth, but I think we may see it sooner than that, both things like the passenger pigeon or the heath hen, which was another little bird in New England, or huh, here’s an interesting one — the northern white rhinos.
It's a subspecies; it's not extinct yet, but it's a zombie species. It's a living dead species. There are only two of them left. They're both female and they're also both old and sick and couldn't bear a baby anyway. We've got some frozen sperm from dead males and we've got plenty of cell samples. So, San Diego Zoo is working on a project where they're trying to figure out how to make, turn cell lines from dead white northern rhinoceroses into eggs and sperm.
Don:
Wow. It's a crazy, crazy world we're living in, Hank. I really appreciate your time. Thank you for sharing your knowledge and your wisdom with us, and thank you for being a genius.
Hank:
Well, the first part, you're welcome. The second part, I'm glad somebody thinks so. [laughing]
Don:
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