In a study published in 2016, Dr Hans Hanevik, Dag O. Hessen, Arne Sunde, and Jarle Breivik had claimed that IVF (in vitro fertilisation) can influence human evolution.
The study gave the following reason for it: natural selection, which includes several barriers, stops faulty (read infertile) genes from being passed on to ones progeny; IVF, on the other hand, works differently and allows the inheritance of these infertility genes. This, thus, increases the chances of the next generation also needing technological intervention to have children.
Thus, the study added, as more couples resort to IVF, future generations may become more reliant on technological aid to conceive.
And now, lead study author Dr Hanevik, who heads the fertility department at Norways Telemark Hospital, is gearing up to present arguments in favour of the claims made. The topic will be up for discussion at the annual European Society of Human Reproduction and Embryology (Eschre) conference on June 26 at a session titled Can IVF influence human evolution?
…[IVF is] a technological intervention at the point in human life cycle where natural selection operates at its strongest, his abstract reads.
Professor of clinical embryology Soren Ziebe, who will also be presenting at the conference, however, is of the view that IVF cannot influence human evolution, but it may change the fate of many families.
Eschre was founded in 1985 to promote and recognise study and research on reproductive biology and embryology, to share findings with all stakeholders, to reflect on the ethical concerns related to it, and to influence policy.
How the study makes a case for IVF-evolution link
The study contends that various pre- and post-zygotic barriers exist to screen the biological entitieseggs, sperm, embryo, etcconsidered fit for reproduction. Assisted reproduction adopts a different set of criteria from natural selection and works by bypassing these barriers.
In natural reproduction, for example, only one ovarian follicle of about 20-mm in diameter, responding appropriately to FSH and LH, is selected in the course of a single cycle. This is not followed in IVF. The natural process also favours sperm capable of swimming long distances, whereas, short-distance swimmers are preferred in IVF.
In addition, in IVF, the spermatozoa are subjected to chemicals and environment other than the reproductive tract. They will probably not be able to fertilise an egg under natural conditions.
Also, these eggs and sperms have to overcome a different set of barriers in the laboratory, such as light and temperature conditions and cryopreservation.
In the context of infertility or subfertility being inherited, the study elaborates, Overall, it seems clear that IVF facilitates the propagation of genetically heritable traits of subfertile couples, and we suspect that ongoing studies of IVF offspring will show an increased risk of subfertility for this group.
What causes infertility?
A number of conditions not linked to ones genetic make-up can cause infertility. The odds of pregnancy also decrease as a woman ages. Several factors related to ones lifestyle, like smoking, drinking, obesity, and stress, too, can affect both sexes’ ability to conceive.
In addition, the Primary Ovarian Insufficiency and Polycystic Ovary Syndrome (PCOS) can lead to problems in ovulation.
A combination of genetic and environmental factors leads to PCOS, which is characterised by excessive secretion of androgen. It is one of the least talked about conditions, even though it affects one in every five Indian women and one in every 10 women worldwide. PCOS is also considered a lifestyle disorder, and urbanisation is probably one of the reasons that has contributed to its prevalence.
Some of the other causes of infertility in women are endometriosis, fibroids and polyps in the uterus, and STIs (Sexually Transmitted Infections).
Endometriosis also affects one in every 10 women worldwide and can impact ones personal and social life severely. Yet, research on the condition is still inadequate.
Infertility was seen through the lens of gender bias for a long time. It was widely held that only women are responsible for it. According to a recent report by WHO, male factor infertility accounts for approximately 50% of the cases. Not acknowledging male infertility can also stigmatise men who suffer from it.
For men, infertility may be due to poor sperm concentration or motility, or abnormal morphology. Downs syndrome, Klinefelter syndrome, deletions on the Y chromosome, etc. are some of the genetic causes of male infertility.
What is IVF?
IVF is one of the several assisted reproduction technologies wherein an egg is fertilised by a sperm outside the human body. It is a treatment for infertility and is also used by couples opting for surrogacy.
In his study, Dr Hanevik has used the term IVF broadly to include a host of related technological methods, such as ICSI (Intracytoplasmic Sperm Injection).
IVF is a boon for couples struggling with infertility, many of whom go through intense psychological trauma because of their failure to conceive. In her recently published autobiography, Becoming, Michelle Obama wrote about her anguish on suffering a miscarriage before she opted for fertility treatment. This anguish can be compounded for many because of their ignorance about how common infertility issues are.
In spite of this, the technology was mired in controversy in its early years, and many were suspicious if the babies born out of the procedure would be healthy. Some feared that IVF might become linked with the abortion debate. The Catholic Church remains opposed to the practice as it considers it to meddle with the sanctity of life.
In 1978, Louise Brown became the first IVF baby. Interestingly, the second successful birth occurred in India, only 67 days after Brown was born.
Since then, the technology has consistently been fine-tuned in keeping with advances in research; however, a number of complications can arise to thwart an IVF pregnancy, such as multiple births and implantation in the fallopian tube.
IVF is usually considered as the last resort for a couple, because its an expensive procedure and the probability of success isnt high. Even for women under the age of 35, the chance of a live birth is only around 40%. Add to this, the menace of unlicensed clinics that operate without government regulations and often make dubious claims about their success rate.
IVF has also given birth to an assisted reproduction industry, where questions of ethics and responsibility often go for a toss.
In 2018, it was estimated that 8 million people have been born worldwide using IVF and other assisted reproduction techniques.
But the assisted reproduction market is booming
A report by Transparency Market Research projects the global assisted reproductive technology market to register a CAGR of 6.3% from 2017 to 2025. IVF accounts for a leading market share. The report mentions that government subsidies for infertility treatment in the Asia-Pacific region will play a key role in this.
In an interview to Economic Times, Dr Rajalaxmi Walavalkar, medical director of Cocoon Fertility, said, Incidence of infertility has increased over the decades, mainly due to delayed marriages, increased use of contraceptives, urbanisation, and lifestyle patternsalcohol and smoking, PCOS, endometriosis, STIs, stress, obesity, etc. As a result, one in six couples face infertility.
According to research conducted by Inito, a Bengaluru-based medical technology company, 10-15% married couples in India face infertility problems. It amounts to a total of 27.5 million Indians.
The 2017 Revision report estimates that the fertility rate of Indians (measured as the number of children born to a woman), has fallen by more than 50%from 4.97 during the 1975-80 period to 2.3 for the current period of 2015-20.
However, the Surrogacy (Regulation) Bill considerably limits Indians IVF options. It bans commercial surrogacy and allows only married couples to seek altruistic surrogacy. And though Section 377 was struck down last year, same-sex couples cannot avail IVF.
Instead of banning commercial surrogacy, the Bill should have focused on regulating it to curb possible exploitation of women from economically weak backgrounds.
Significance of the study
The study is only a theoretical analysis, and there is no conclusive evidence to prove the relation between IVF and evolution. However, it focuses on an aspect of assisted reproduction that has not received much attention till now.
The possibility of embryo screening, the question of whether to store or destroy embryos not used in implantation, etc. have been the contentious topics surrounding IVF.
As Dr Haneviks study abstract states: The purpose of this talk is not to judge or impose a set of norms on IVF… Rather, the aim is to promote a better understanding of it.
Nidhi Kumari Jha is a Writing Analyst at Qrius