Medicine

Ukraine leads in reproductive medicine due to contributing factors, not technology

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Albert Tochilovsky, the owner of Biotexcom center for human reproduction, told Delo.ua about designer babies, body rejuvenation, bearing children in an “artificial uterus”, moral and ethical issues of reproductive medicine, and harassment by authorities.

Part 1

– Before we discuss the real world, let’s talk about the future. Could you tell us about the most interesting trends in the field of reproductive medicine? What do you think will happen in the nearest future, and what is the role of Ukraine in this area?

– Reproductive medicine is the future of mankind. Genome editing is the first trend for which such English-speaking countries as the United Kingdom and the USA are striving. It is virtually a designer baby. You get to choose a child’s hair and eye color, skills and talents. China is already editing the genome, and a baby immune to HIV was born there.

The second major trend is a shift towards more mature pregnancy, between the age of 50-60 years. Biotexcom clinic is already performing a mitochondrial replacement, while other clinics transplant cell nucleus. In that way, the effect of youth is prolonged.

The third and perhaps the most important trend is ectogenesis. It is an ability to bear a child outside the human body and is simply defined as an artificial uterus, sort of factories we’ve seen in the Matrix movie. I think that we will acquire ectogenesis within 5-7 years, and our clinic keeps working in this direction. I doubt, though, that Ukraine will let us do something like that because Ukraine is afraid of everything. Most likely, ectogenesis will be allowed in the mentioned above America and Great Britain. The problem of urbanization is pressing there, while only 2% of the population is involved in agriculture. This is a highly developed society, where women build their careers before they reach the age of 40-45, after that they want to have children. Nowadays, immigrants help to solve this issue. I believe, in future this problem will be solved through the use of ectogenesis and mitochondrial replacement.

As for the role of Ukraine… There is an instructive story concerning preimplantation genetic diagnosis. This is an embryo research before its implantation in uterus during in vitro fertilization, IVF. The method was invented in Kharkiv by Yuri Verlinsky. For this, a criminal case was brought against him. He had to leave for the United States, where he immediately assumed the position of a researcher in Chicago. Decades later, his method created in Ukraine returned to his country. It happened, though, only when Verlinsky became famous in the United States.

At this stage, Ukraine is a leader in reproductive medicine, which is not due to technology, but due to the contributing factors, like the donation of eggs because the choice is great, and surrogacy since it is cheaper here than in other countries. If it develops into technology in future, it will be nice. If it doesn’t, everything will end sooner or later and incubators children will be raised by other countries.

– Ectogenesis can cause serious moral and ethical resistance …

– You know, once Beate Uhse started the sex industry, she opened the world’s first sex shop. Needless to say that society opposed immediately, and she became an enemy number one. She fought against this attitude. Then the sex industry began producing more money than agriculture. Now Beate Uhse is an esteemed entrepreneur and a public person.

The banking system was also considered harmful. Remember how usurers were reproached and everything was semi-legal in the old literature. Nowadays, this is the basis of the global economy.

Although people have been charged for the possession of marijuana since the 60s, today it is a promising market. We are talking about who will be the first person to legalize it and earn money on it.

After the first cars were developed, all the media demanded to ban the iron monsters after the first road accidents.

Now, referring to biology. As soon as IVF and the first in vitro children appeared, religious countries were proclaiming it to be a tragedy. IVF had been legalized in 10-15 years.

The main thing society has to realize is that we will face a serious demographic crisis and will have to deal with that. At a world’s artificial intelligence conference, Elon Musk, an innovator who subtly feels what is happening, predicted a demographic collapse over the next 20 years. Jack Ma fully supported him, declaring reductions in population growth in China.

Although this seems to be impossible against the background of constant population growth, let’s take a look at the situation of major cities in India and China. If Beijingers have just one baby for a family, there will be 150 million people left in their city, which will lead to a sharp depopulation after one generation. Since migration cannot solve this problem, we need to advance reproductive medicine.

– If Musk highlighted this point himself, news of immortality will soon appear.

– A revolution will take place in biology in the nearest future. We will live longer, for 300 and 500 years. And better, as well. At first, this technology will be madly expensive, but then the cost will decrease tenfold. The question is who’s going to be the first in these technologies.

The whole future is here, in biotechnology. The car industry will stop turning profit, and it’s quite clear why. This industry will be destroyed by car sharing. A self-driving electric car will be everywhere, and it can be recharged itself. There will be no need for taxi or private cars, just get outside, put your child in a car, and send him or her to school, then take another car and go to work. The third car will be for your spouse, the fourth is for the second child going to a kindergarten. These cars will be then taken by other people. Consequently, 10-15 people can use one vehicle. It’s similar to a taxi, but without paying for a driver’s service and refueling.

Ukrainian people talk much about the software. But it will not remain a klondike for a long time. It is a code creation, outsourcing. The programs that can perform the work of a programmer exist.

Therefore, the leading countries are eager for biotechnology which will make up half of the GDP in many states shortly. Does Ukraine understand this, do our officials understand this? I don’t think so, because we bet on agriculture. We need more people who understand the industry, not talkers. I dare to say that there is a need of the Committee on Biotechnology in Verkhovna Rada. Everything is getting cheaper, everything can be produced. Biology is an exception to the rule.

– Then how does Ukraine show itself so well in human reproduction, if there is no in there? What is the difference between us and other countries of Europe?

– The advantage of Ukraine is that this area is not well regulated in our country yet. Therefore, it was possible to collect all the technologies that generally exist. Foreigners see our performance, if in Germany it is 15-20%, therefore we have 60% success rate from the very first attempt.

Why is it so? Because you can transfer an embryo already on the second day in Germany. And this is wrong in terms of fetal survival. On the second day, you don’t know exactly which embryo you need to transfer. The male factor, for example, appears only on the third day. One more thing is apoptosis and embryo mortality which can be found in many spermatozoa. On the fifth day, when the weak ones die, it is clear which embryo needs to be transferred. In Germany, they considered the one embryo transfer to be a sort of selection, the rest embryos were frozen. As a result, their percentage of positive results had fallen pretty much.

In France, there is a serious problem with egg donation. Ethical authorities allowed only non-commercial egg donation there. This means that a woman who wants to give birth must bring a friend of hers, who will give out her egg, after which the expectant mother is put in a line. What is the chance that a 40-year-old woman will have a 20-year-old friend with young cells? It’s rather small. She brings her friend of her age, as a result, someone gets the same mature eggs. Efficiency sharply moves to zero.

As a result, due to ethical issues, everyone goes to Spain. But there is a lack of donors, one donor per six people. Embryos can be half dead.

After 10-12 attempts, Europeans come to us – and they succeed in any of our programs from the very first cycle. We say yes, you can save a lot of money. But no one wants to save on this particular issue.

– It turns out to be a twofold situation: on the one hand, we’ve got good results, but on the other hand, they don’t like the country itself.

– The war in Ukraine led to a negative attitude. The French suggest us to create a clinic in a civilized country like Algeria or Morocco. I ask them: “These countries are in Africa, so what’s the difference?” They respond that it is wrong to compare these countries, because Ukraine’s level is lower. You see, Europeans think that the level of Ukraine is lower than of many African countries! And this is a tragedy. It’s hard to prove your brand. We – Biotexcom – have proven it. The clients come to us, not immediately, but still they are coming. After having 5-15 failed attempts there, they come to us and get a successful attempt from the very first try.

– Maybe the matter is in the lack of advertisement?

Everybody does advertisement – we, the Spanish, the Czechs. But people do not believe advertisement. They gather in groups, on the forums, follow the effectiveness. They see that our success rate is much higher, and come here. But the image of our country is not so good as we wanted it to be. Even when they talk about bringing an investor here… Let’s be honest, how many cases have already happened that a businessman comes here, but not stay here for long. Each time a new government comes and promises that this will never happen again. That they will not deceive anymore. But in 28 years, Ukraine has earned the image of never telling the truth. Moreover, these are not some kind of thugs, they are authorities, bodies, and prosecutors.

– You do not like Ukrainian officials too much, don’t you?

“Why should I like them?” I do not like them, especially prosecutors, as they have already brought 10 acts against me regarding occupied territories. The last case was even funny. I lent money to a person, he didn’t return it, and in a judicial construction they wrote that I allegedly had taken the advantage of his trust to lend his funds … It’s clear that it is ridiculous, but such cases force us to be engaged in complete nonsense for several years instead of solving serious cases.

In general, it is very interesting to observe Ukraine in the process of globalization, with open borders. Kiev still lives well, but the rest of the country… You see, the state convinces us of patriotism, but the young people still continue leaving our country, and they become patriots of Canada, Portugal, Spain, the USA. The Ukrainian flag hangs in their houses, but they live there, and pay taxes also there. If we don’t take strategic measures and do not choose the areas for developing, serious problems wait for us.

– What measures are you talking about?

– The most important thing is to prohibit the intervention of law enforcement agencies into our work. Now – and everybody has noted this – it has become much easier. But we are just afraid that this is a short-term advertising promotion. There is a feeling that I am being fooled. A new government came, things turned out for good, but not for so long, sooner or later they will realize that it is possible to take the business away. I simply lost my faith. I know thousands of cases that occurred with my friends, with business, and all of them are negative. So, everyone is praying that the current calm situation will last at least a year or two, that will give a chance to Ukrainian entrepreneurship.

– Maybe you need new laws that will help your industry?

Our politicians are used to load on populism. You see, there was a case, when a good law on transplantology was going to be adopted, to save people. The deputy came out and said that kidneys will be cutting out for an expired communal apartment. There are really a lot of populists but lack of smart and thinking people who move the country forward. In 20 years, everyone will agree with this, but today…

– There is one unpleasant scandal connected with Biotexcom: ex-Prosecutor General Yuriy Lutsenko declared that a Ukrainian child was taken out of the country. Will you comment?

– This happened in 2011, 5 years before I bought the clinic, and, frankly speaking, we have not still figured out the situation. The man’s sperm – and it was an Italian couple – came in a container. Nowadays, it is impossible as for any of our surrogacy programs, the clients must come here additionally to give a fresh semen sample. And from this point, doubts arise. Either the sperm wasn’t originally his, or embryology was wrong, or the samples could be mixed up while transferring the catheter. According to our laws, for parents to be recognized, there must be a genetic relationship with one of them. In that situation, it turned out that both parents weren’t genetically related to a child.

There is one BUT. The Prosecutors said that this was human trafficking, although it is obvious, that, in this case, it is only a possible violation of medical standards, but not a crime.

We decided not to touch that matter of arguing over right-wrong, but compensate all the costs for Italian couple instead. Now, fortunately, the possibility of such mistakes is excluded. Tablet incubators has appeared, each client has its own separate door. By the way, the Americans still do not use them, thus they still have cases where embryos are mixed up.

Interviewed by Dmitry Bunetskiy, specially for Delo.ua

Source :
https://delo.ua/business/ukraina-lidiruet-v-reproduktivnoj-medicine-ne-za-358495

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