Regulating the future of procreation: a proposed comprehensive framework for in vitro gametogenesis (IVG) in Israel

In vitro gametogenesis (IVG) is a novel reproductive technology that promises to derive functional human gametes from both embryonic and reprogrammed somatic cells. Currently, this technology is still in the experimental stages, but is approaching clinical viability, which necessitates the development of robust regulatory frameworks for its application in human reproduction. As assisted reproductive technologies (ART) are widely utilized in Israel and heavily subsidized by the state, it would be timely to propose a comprehensive framework for incorporating IVG within the nation's fertility treatment landscape. This requires careful integration of Israeli civil law with the administrative regulations established by the nation's Ministry of Health, while carefully navigating the profound cultural and religious sensitivities of the country's major populations, specifically the Jewish and Sunni Muslim communities. Here, we evaluate the application of IVG across a spectrum of reproductive scenarios: overcoming primary and age-related female infertility, facilitating transgender and intersex parenthood, enabling posthumous reproduction, the mass production of donor gametes, same-sex, solo-, and multiplex-parenthood, as well as the prevention of genetic diseases and the controversial prospect of genetic enhancement. Rooted in Israel's strong pro-natalist ethos, the proposed framework suggests that therapeutic applications of IVG aligning with traditional family structures and the imperative to heal will be integrated into the existing public health infrastructure. A nuanced, centralized oversight mechanism that balances the right to parenthood with ethical boundaries is thus proposed, ensuring that the clinical translation of IVG respects both the diverse moral and religious landscapes of Israeli society and the fundamental rights of the child.