What to expect from assisted reproductive technologies? Experts' forecasts for the next two decades

Abstract

In recent years, In-Vitro Fertilization (IVF), Pre-implantation Genetic Diagnosis (PGD) and genetic engineering (GE) have developed substantially, raising hopes but also concerns. Relying on a panel of experts, this article explores expected scenarios related to the evolution of Assisted Reproductive Technologies (ART), thus helping to ascertain which expectations might materialize over the next twenty years. We use the Delphi method, whereby forecasts are extracted from a survey, and combine it with in-depth interviews with experienced doctors and geneticists in Israel and Spain. Our results reveal prospects for an increase in birth rates per InVitro Fertilization (IVF) cycle, an improvement in treatment quality, and advances in reproductive genetics. Experts predict that within 20 years, 14-19% of births in their countries will result from IVF, among which 34-47% will involve PGD. However, they remain skeptic regarding the increase in the number of oocytes required for an expanded PGD, thus skeptic regarding inflated hopes or dystopian scenarios and indicating that GE by CRISPR/Cas could set the tone. We conclude that ART’s market development in the next two decades will continue to be mainly linked to growing infertility rates and improvement in outcomes, while reproductive genetics will advance but remain secondary.