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What is missing from the article is the reason the startup picked eggs.

The main reason is that eggs are very expensive due to the invasive procedure needed to extract healthy one (and the after effect of the procedure whole not dangerous to my knowledge can require you to stay in the hospital to recover).

But fertility medtech is something that brings I think the reoccurring question of the biggest reason we don't have kids after financial, and that is that the 1950s model isn't sustainable/compatible with modern day lifestyle and no amount of conservative lifestyleshaming will change that.

And the solutions to that can only be done via social ingenuity, something I think in general there's very little research and interest in.

So the question then becomes of course just what solution will be used?

Will we see government run child homes?

Maybe a new definition of family based more of old tradional agrarian communal family structure?

Something entirely new?

Who knows but I think it's equally important to figure out a new more sustainable way of raising kids than the 1950s model as it is to fertility medtech.

> Will we see government run child homes?

It seems like quite a jump to skip right over daycare into gov run child homes.

In a way daycare is a temporary child home.
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From the societal point of view, the difference between TFR 1,5 and 1,8 might be quite crucial. Both translate towards an aging and shrinking population, but one of the slopes is much less steep and more manageable.

Putting political labels aside, the main current problem with fertility is the length of education and career start. For someone who wants to have a good job, it means spending your twenties without actually making money and obtaining property. In the 30s, when this platform is finally built, plenty of people suddenly find that their fertility is no longer sufficient to produce the desired number of offspring.

Given that we are not likely to see shorter career starts anytime soon, IVF improvements seem to be the only way to partially escape this trap.

Also, gametes produced by this method could be cheaper in the long run. Classical stimulation involves a lot of doctors and procedures. Maybe this process could be automated and streamlined; it matters way less if you produce "only" 400 ova out of 500 possible than if you get 4 instead of 5 ova from a living person.

> Putting political labels aside, the main current problem with fertility is the length of education and career start. For someone who wants to have a good job, it means spending your twenties without actually making money and obtaining property. In the 30s, when this platform is finally built, plenty of people suddenly find that their fertility is no longer sufficient to produce the desired number of offspring.

A big part of that is rising life expectancy. I'm 31, and my parents (probably and hopefully) won't die until I'm 60+ myself - which means unlike the generation prior to mine that had a reasonable hope of inheriting some wealth as a kickstarter (i.e. a downpayment or a place to live without having to pay shitloads in rent), I and many others of my generation will not have that.

Related to this is that so fucking many Boomers can't leave the workforce - some (more so in the US) because they literally can't afford to live otherwise, but here in the EU more because they are completely unable to imagine a life without work. The result is that all upper layers of management are filled with old people, and young ones can't rise (and earn more money). Just look at the German Mittelstand - the amount of 80+ year olds still running their companies is utterly insane.

You are right, healthcare improvements have translated into enormous slowdown of generation exchange on the top.

The average age of CEOs of the largest 500 companies in the world at hire has grown 14 years between 2005-2019 [0], i.e. no generation exchange at all.

Looking at the American politics, the combined age of Trump and Biden exceeded 150 in the last election, first such event in American history. Given that they both may be running again ... oh, well.

And in the Czech presidential election, the winner (61 y.o., with a grandfatherly gray mane) defeated a 68-y.o. challenger.

Putin is over 70, Xi is over 70, the Pope is over 80, the freshly crowned British king only stopped being "prince" at 74.

Now add some more longevity progress onto the table and the once-famously geriatric Brezhnev politburo may start looking like a kindergarten. I can definitely see some members of the American Senate or SCOTUS exceeding 100 by 2050.

[0] https://marginalrevolution.com/marginalrevolution/2020/01/ce...

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We already had a 100 year-old Senator 20 years ago, Strom Thurmond. He was a good illustration of the stultifying effect of gerontocracy on change, too. A man who had supported Jim Crow and ran for president on a segregationist platform still serving as Senate Pro Tem in 2003.
>A big part of that is rising life expectancy. I'm 31, and my parents (probably and hopefully) won't die until I'm 60+ myself - which means unlike the generation prior to mine that had a reasonable hope of inheriting some wealth as a kickstarter (i.e. a downpayment or a place to live without having to pay shitloads in rent), I and many others of my generation will not have that.

I'm of a similar age as you but I don't see how that is any different than the previous generation?

Because by the time previous generations were 30, at least the grandparents distributed their wealth downwards. These days, even if people get children late(r) in life, you can easily have four to five generations of a family alive at a single time.
It probably differs much per country and individual, but in my experience (Western Europe) it's the other way around.

My parents generation grew up with 5 children at home, there wasn't much wealth to distribute downwards and anything that did had to be divided by 5.

Now it's usually two children and there's quite a bit more wealth, most people I know that buy a house do get financial help from their parents.

> Given that we are not likely to see shorter career starts anytime soon

I think you are right but it’s a big indictment of the scoliotic nature of our current culture that it’s inconceivable that we could make even medium sized changes to how things work because they are producing suboptimal results.

We are at the civilizational stage where we have massive fights over tiny tweaks at the edges and no longer even dream utopic dreams. I don’t think that’s a healthy sign.

I think it is mostly a matter of coordination.

It is much easier to develop a new fertilization technology than to get 150+ countries of the world to agree (and actually implement that agreement) that they will limit schooling of their youth and give them career opportunities sooner, so that their fertility rises.

Why do all 150 countries have to do the same thing? Why can’t the Swedish people decide they are sick and tired of the Washington consensus with its effects on fertility, among other things, and try something different?

It was less than 100 years ago that a small but not trivial number of people conceived and founded kibbutzim. Not the somewhat pathetic version that exists today, but the original radical version.

I’m not saying it was a great idea but they believed that something different was possible and tried to build it. Who does that today?

It is a bit of a Red Queen problem.

Surely you can individually opt out of a certain secular trend, but there may be serious adverse consequences. Same as if you decide not to employ, say, gunpowder or the printing press; how many such societies survived the pressure of their neighbours?

> 1950s model isn't sustainable/compatible with modern day lifestyle

I genuinely don't understand what you mean by that (as a parent of three who knows plenty of modern parents).

The whole "your life is over once you have kids" is a falsehood from my experience. I'm working less, making more and picked up all the hobbies I wanted to pick.

The first 2-3 years can be more demanding but nothing like the scaremongering I've heard all my life. Sure, I spend weekends with the family and not partying in Ibiza.

> Will we see government run child homes? Where do you think the clones for the Galactic Empire in Star Wars are coming from?

That's wonderful for you that you're working less and making more; do you think that's the experience for everyone? Aren't around half of all births paid for via Medicaid these days?
A lot probably depends on how much personal time you expect to get, how you spend your free time, and how serious you are about what you do in your free time.
I'd have picked eggs too. Curren process costs around $10k, only works for women under 40 (ish), takes 2 weeks of being pumped full of hormones, followed by up to a week of bed rest after the retrieval operation.

To be able to offer this to men and women of any age with nothing more than a cheek swab sounds like a real breakthrough.

What is missing from the article is the reason the startup picked eggs. The main reason is that eggs are very expensive due to the invasive procedure needed to extract healthy one (and the after effect of the procedure whole not dangerous to my knowledge can require you to stay in the hospital to recover).

The other thing is that even after you go through all that you get 0-30 usable eggs. There’s steep further attrition at every step of the process. A couple is lucky to end with 5 implantable blastocysts at the end of multiple rounds of egg extraction, fertilization, and cultivation.

This makes embryo selection for multiple traits very weak and not really worth it. However, if hundred or thousands of eggs could easily be produced that would open up a lot more possibilities. There’d still need to be other advances—current cultivation, cell biopsy, and genetic testing techniques would not scale—but it would very much open the door.

Scientists are understandably reluctant to make this point, given the Luddism on display even at a place like HN.

> But fertility medtech is something that brings I think the reoccurring question of the biggest reason we don't have kids after financial, and that is that the 1950s model isn't sustainable/compatible with modern day lifestyle and no amount of conservative lifestyleshaming will change that.

In the west, eastern cultures aren't suffering the same problems for a reason, they still value families.

The west doesn't seem to do so, and i think it's one of the reasons for the "mental health pandemic".

Not a single Eastern European country has a replacement birth rate[0].

In fact certain Eastern European countries have a worse birth rate than western European countries[1].

It's also makes no sense to proclaim "eastern Europe" as a unified cultural group, as eastern Europe technically includes Austria, despite Austria having a modern history more aligned with western Europe due to not being part of the Warsaw bloc.

And no, even if we take your argument at face value eastern European culture does not value "family" more in practice, outwards it does, but younger people in eastern Europe are just like westerners in that they are seeking out career, social and cultural fulfillment before wanting to settle down.

The only real difference between west and eastern Europe is that Western Europe is aware of the issue and don't know what to do (yet), while certain eastern European countries thinks that you can duct tape conservatism with modern ideals (and cut away anything that doesn't fit their view).

[0]https://ec.europa.eu/eurostat/web/products-eurostat-news/w/D... [1]https://ec.europa.eu/eurostat/statistics-explained/index.php...

I wasn't talking about eastern Europe.
It is actually a dangerous operation, probably most if not all invasive operations are.
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Celebrities better walk around dressed like in a semiconductor fab lest millions of people steal their DNA.

Paternity lawsuits will be fun as well.

Why do modern startups always make the world a worse place to live in?

Because technology advances quickly, but human nature does not.
Stealing DNA isn't sufficient, you'd need to steal live cells.
Which still isn't particularly difficult. We shed live cells all the time.
Imagine the situation when a well-meaning celebrity donates blood, someone unscrupulous steals a vial of it, and, a year later ... that poor guy has several hundred kids and is actually their mother.

Could be done, if you have a reliable method of turning human white blood cells back to stem cells and then to ova.

News stories about the children of celebrities should be enough to dissuade this.

But all joking aside, I suspect the main interest will be in people getting eggs from their own cells. Now sperm might be another matter, especially given the premium on being tall.

> Why do modern startups always make the world a worse place to live in?

Well, this one has an actual product in mind, that is aimed at making its customers happy. So it beats 90% of modern startups already.

Now, if they find a way to lock the children behind a subscription paywall, I'll be the first to agree with you.

And there will still be ads behind that paywall.
I'm a scientist working in this field and I agree with Amander Clark: Conception needs to publish more data if they want people to believe their claims. The FOXL2/DDX4 immunofluorescence image in the NPR article is literally the only thing they've released.

(Conflict of interest: I'm partially funded by Gameto, a competitor to Conception)

Seeing an expert here, this process already works in mice, right? Healthy mice were born this way.

I know that "in mice" doesn't translate to "in humans" easily, but it is a proof of concept of sorts.

I don't think anybody denies that this is possible, but "possible" is a different status from "accomplished".
What's their plan on tackling the legal barriers to this? This is most definitely human experimentation. Additionally, in many countries including the US using genetically modified embryos to create a pregnancy is completely illegal. I can see this hitting the Supreme Court.
Creating an egg presumably isn't
In all likelihood, the ban of genetic modification of embryos will go away, too. Not tomorrow, but it will.

Once we know with high probability that some genetic interventions improve lives of people a lot (say, by reducing probability of cancer or heart attack significantly), there will be an enormous pressure to introduce them.

I'm generally very positive about science and engineering, but I'm completely sick and tired of its use in dehumanising technologies. We need to be a lot more savvy about what we consider acceptable, and politics will have to change to facilitate that.
Having been through multiple rounds of IVF and knowing many couples and their stories during such long, expensive, physically and emotionally exhausting process, I believe this technology would be extremely positive for humanity.
From a point of view of someone who knows more than a few desperate couples, inhuman and unacceptable would be to deny them efficient treatment based on vague moralistic instincts.

Would you be happy if some person denied you insulin or glasses based on the fact that they feel sick and tired about such ungodly inventions that pervert the course of nature?

Both diabetes and myopathy are direct results of our society. They represent cases where our technology and our living standards have caused diseases in abundance.

Adding yet another easily avoidable disease to the pile seems reckless.

Diabetes is as old as humanity, up until a century ago it was death sentence. Our living standards have caused people to live where earlier they would have died. Here we are allowing people to reproduce where otherwise they would not be able to. All of this is a good thing.
Do you mean "myopia"? Yeah, it is a civilizational disease, but from a sufferer: it is very much bearable and tolerable.

I surely wouldn't like to play some sort of eugenic match against people who would rather either stop civilization in its track or prevent myopic people like me from existence for their own good, or ban them from doing anything that could possibly cause myopia in them.

People suffered all sorts of aftereffects from civilizational progress, but I am optimistic in the sense that we can eventually conquer them and next generations may enjoy all the benefits without suffering harms.

Yeah, but your scientists were so preoccupied with whether or not they could, they didn't stop to think if they should.

- Dr. Ian Malcolm (Jurassic Park)

Infertility is a pathology. Perhaps we should treat it as such and nothing more.

No one morally sane would deny a person in a wheelchair a chance to walk, or a blind person a chance to see, just because they were born "naturally" lame or blind.

Same with having kids, no?

We’re meddling with far larger forces here. Some fertility issues are a sort of quality control system for our species. If this technology becomes widespread it could ultimately change human evolution dramatically.

If this were to supplant normal biological reproduction and reproductive organs atrophy we could eventually become wholly dependent upon technology to reproduce as a species.

"Some fertility issues are a sort of quality control system for our species."

I am not discounting your argument, but quality isn't a stable value. A short-sighted or asthmatic person in a hunter-gatherer society might have been useless; nowadays, they may be an excellent engineer or doctor.

With technology like the one being described in the article, you actually have a much higher chance of producing viable embryos free of known genetic problems.

Dependence on technology, well, it is sorta dangerous, but also unavoidable. For example, the # of people who produce their own food is very small in the West. And that small number would become almost zero if we added further constraints (as in "don't use any industrially produced chemicals in the process").

Our ancestors from 200 years ago would probably consider us unviable.

(And the actual hunters and gatherers would consider them unviable. What, you depend on good weather and rain not to starve?)

If we put all-natural you, with no products of technology, at a random point on Earth, you'll be dead before the search party finds you.
Kind of a non sequitur here. This is about messing with the fundamentals of nature and our species in a way we do not understand its consequences.
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>hey maybe messing with things we don't really understand that could affect our genepool is potentially a bad idea

<wow so you hate glasses!

By the same argument you could also argue that certain genetic traits are part of the "quality control system". E.g. Before the modern era having a gene that makes you disabled would lower your chance of reproduction.

This is an extremely dangerous path to set out on.

We have already completely changed human evolution, and I would argue with great success. Do we really want to start undoing this?

Biologically a healthy woman can have kids well into her 50s and even 60s yet her eggs reserve starts to deplete the moment they are born, accelerating exponentially as they approach 40.

From an evolutionary point of view this could have made sense 200 years ago when the lifespan of a human was 45 years.

Our bodies are not perfect and we have been able to understand and to certain degree fix many issues with it such as infectious and cardiovascular diseases and some types of cancers.

For example we never saw polio as a quality control system for our species.

Our understanding of infertility and methods to treat it have remained unchanged for decades.

We basically pump an awful amount of drugs into a woman's body hoping to harvest a few good eggs via surgery.

It is a brutal and painful process, physically, emotionally and financially that most times has very poor odds of succeeding.

If we can do the same with a few drops of blood, removing the drugs, the cost and the randomness of the current procedures while increasing the odds 10x, this would be an amazing feat of science in a positive way.

> From an evolutionary point of view this could have made sense 200 years ago when the lifespan of a human was 45 years.

The lifespan of a human was not 45 years in the 18/19th century. The average lifespan may have been, but that number is extremely misleading due to infant/child mortality being much higher prior to modern medicine.

If you made it to adulthood prior to modern medicine, you stood a good chance of making it to 70.

Depends on what you mean by "good chance".

This is the mortality curve in England in the half of the 17th century, which was already a fairly modern society; for example, not suffering from as frequent famines as in the Early Middle Ages. [0]

Out of 1000 people born then, approximately 680 reached 20 years of age and approximately 170 reached 70 years of age. So, 25 per cent of all the adults lived to be 70. Not a "good chance" in my understanding of the word. "Somewhat of a chance", perhaps.

[0] https://www.cam.ac.uk/sites/www.cam.ac.uk/files/shorthand/21...

Thanks for sharing some concrete info, it looks like 60 is a better age to use than 70 for a ‘good chance’, and even then it’s a 50/50 chance of making it from 20 to 60.
There is an growing body of evidence that points to change in environmental conditions (ubiquity of microplastics, forever chemicals, etc.) as a significant driver of infertility. I guess you could make the argument that humans just need to adapt or die. It seems a little Victorian. "Then they should do it and reduce the surplus population" kind of thing. Say no to your inner Scrooge. Life is sad and hard and complicated and exciting and wonderful and absolutely worth living. Babies are wonderful, children are hard, teenagers are a nightmare, and I absolutely don't want to die alone.
Millions of years of biology have brought us nearly to the point where we can take the evolution of our species into our own hands. We're new at this and like any other human endeavor in its earliest days are bound to make some horrible mistakes. So the arguments toward caution are well-justified.

We've yet to prove our civilization is responsible enough to handle such consequential abilities - e.g. nuclear arms, climate change, genetic engineering.

But I anticipate several generations from now, today's cultural taboo will be ancient history and our "meddling", "treatments", whatever you label it will be just another aspect of humanity that has been normalized. I bet my progeny will be able to go and get a tail just as easily as someone today would acquire a tattoo.

Obviously not the same. You are not just curing a "disease" (I actually would not even call infertility a disease), you produce a new human in the process. With an experimental technology.

Perhaps new humans have a right not to be produced by whatever means current Brave New World technology allows?

"Perhaps new humans have a right not to be produced"

The problem is asserting such right on behalf of someone not yet born. Personally, I couldn't just demand that someone not be born because of my own opinions regarding technology. I just don't feel justified to deny other people procreation.

And remember, in the 1980s, there were similar attitudes towards "regular" IVF. Frankenstein, ungodly, lab kids etc. Fortunately these prejudices mostly died out.

Though obviously it could be no other way, it's always struck me as odd that new humans can never consent to their creation, no matter the method. One of many reasons I will never create one.
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Not sure if you're serious, but if anyone's wondering, no, it wouldn't. Donor eggs are extremely expensive (thousands of dollars each). Donor sperm is practically free.
> unnecessary reproductive vestige

Men are still really strong and have a lot of testosterone, and women will literally never be able to kill us off or enslave us due to this.

It's weird anyone still thinks strength of arm is the determining force-multiplier in the era of drones, nukes, or even firearms.
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There is a Netflix documentary now called “King of Clones” and it describes a a very similar technology currently used to clone animals. They take skin cells, take and empty a real egg of the same or similar species of its own DNA and insert the cell DNA to copy an individual. There seems to be some small variety in the output and obviously a plethora of ethical issues (one scandal involved the main researcher asking many of his female staffers donating their eggs for human cloning). Currently the tech is used to clone prized Camels and pets for wealthy individuals.

The value and risks are obviously beyond numerous. For risks specifically:

1. The surrogate developing cancers (happened to prized tigers they were trying to clone).

2. The source of the eggs (possibly what this company may be trying to do differently)

3. Sociopaths cloning themselves or being brought back to run violently suppressed societies (Including someone trying to bring back dead ones).

4. Egomaniac individuals flooding the world with copies of themselves.

5. The Technology being easy enough to replicate in less regulated locations becomes essentially unregulated.

For value, assuming the startup that is trying to generate both egg and sperm succeeds, you can cure infertility and enable same-sex couples to have biological children. They have to show data that that is indeed what they have been able to achieve vs just cloning.