Below is an edited version of remarks that Jennifer Lahl originally delivered in Rochester on September 18th as part of a panel on “The Particular Threat of Technological Acceleration to Women and Children” at the 2026 Women’s Convention. We will be publishing the remarks from Kristin Collier later this week. Mary Harrington’s remarks are available here. A full, unedited video of the panel discussion can be viewed here.
I want to start with something I witnessed a long time ago now, because I think about it every time we speak about the unintended consequences of new technologies.
In 2000, I was at a private meeting of the American Association for the Advancement of Science, held in San Francisco. The focus of the meeting was the provocative long essay Bill Joy, at the time chief scientist at Sun Microsystems, published in Wired called “Why the Future Doesn’t Need Us.” Joy, one of the people who had helped build the technology he was writing about, laid out in careful detail why he had come to believe that genetic engineering, robotics, and nanotechnology posed a real risk of making human beings unnecessary, or worse. Joy was not an outsider, and not a technophobe. This was one of the architects, standing up and telling the rest of the field to be afraid of what he had helped build.
That evening, a public discussion took place at Grace Cathedral in San Francisco, right in Silicon Valley’s backyard, where we like to say we have a front seat on the future as it relates to emerging technologies. A robotics researcher from Carnegie Mellon named Manuela Veloso was on the panel with Joy. She went after him—hard. Her argument, as I remember it, was that Joy had spent his career helping launch exactly the technologies he was now warning about, and that if he actually believed what he had just told us, he should give all his money back.
I have never forgotten that exchange, because I think it is the exact shape of every conversation we are about to have about reproductive technology. The people closest to a technology are often the first to see where it actually leads. And the establishment’s answer is rarely to slow down and look. It is to go after the person who raised the alarm, for having been close enough to see it in the first place.
Bill Joy did not stop robotics, genetic engineering, or nanotechnology research by writing that essay. All three fields are larger and faster today than they were the day it was published. I don’t tell you this to be fatalistic. I tell you this because I think we are about to watch the same pattern play out with lab-grown synthetic eggs and artificial wombs, and I would rather we saw it coming than be surprised by it.
I want to pick up on one thread Mary left on the table and pull on it for the rest of my remarks. Mary described a technological mindset that doesn’t just want to help women who long for children. It wants to make children, and increasingly, to design them. I want to start further back than that, at the assumption underneath it. It is one we rarely say out loud. Once you see it, you can’t unsee it in every “solution” this century has offered women.
Here is the assumption: infertility is a problem, and problems have engineering solutions.
I want to push back on the first half of that sentence before I even get to the second. Infertility has always been with us. It is in Genesis, in the ache of Sarah and of Hannah, long before anyone had a laboratory. It is a part of the human condition, woven into the same biology that also gives us menopause, miscarriage, disease, and death. Infertility is a sorrow, and sorrows deserve to be accompanied. The moment we recategorize it as a defect awaiting an engineering fix, we’ve already decided something enormous about what a woman’s body is for, and what happens to her when it doesn’t perform on schedule.
I don’t say this to minimize how much that sorrow can hurt. It is one of the deepest griefs a person can carry, often quietly, often for years. But the depth of the grief is exactly why it matters what we hand her in response. A culture that cannot tolerate an unresolved sorrow will always reach for a mechanism instead of a companion, because the mechanism promises to make the sorrow stop, and the companion only promises to stay.
Here, I want to draw a distinction this whole debate actually hinges on, one we have let go blurry: medicine and technology are not the same thing.
Medicine, properly understood, is oriented toward health and healing, whenever possible. It looks at a body that isn’t working the way it’s supposed to, asks why, and tries to restore its own proper function. A physician who sets a broken bone isn’t replacing your leg with a different leg. She is helping the leg you already have become, again, what a leg is for.
Technology, in the sense I mean here, is not oriented toward healing. It is oriented toward producing an outcome, regardless of what the body is doing, by building a workaround. A workaround does not ask why the body isn’t producing the result on its own. It routes around the question and manufactures the result by some other means. That can be a genuine mercy in an emergency. Such is the case with mechanical ventilation, which is temporarily used to save a life, until the lungs regain proper function.
Assisted Reproductive Technology (ART) is not medicine, and we should stop talking as though it is.
If a technological workaround is an acceptable substitute for medicine when the problem is a blocked fallopian tube, there is no principled reason why it is not also an acceptable stand-in for not having a partner’s egg, or not having a uterus, or not having a body involved at any stage at all. The original diagnosis quietly stops being what the technology answers to. A workaround has no internal stopping point, because unlike medicine it was never oriented toward restoring anything. It only has to keep producing the requested outcome, by whatever means keeps working.
That is the actual mechanism: not a slippery-slope argument but a simple description of incentive, by which a technology invented to work around one blocked tube became egg donation, then surrogacy, and is now funding research into growing eggs from skin cells and gestating a child with no woman’s body involved at all. Medicine restores what a body is for. Technology, once allowed to substitute for medicine, only ever asks what else it can be made to produce next. That mechanism has run through the last fifty years, with each step dressing itself up as the solution to the last.
IVF was sold as the fix for infertility, but it doesn’t ask what is wrong with a woman’s body. It bypasses the question and goes straight to the embryo. A woman can complete cycle after cycle without ever learning why she couldn’t conceive.
Egg freezing was sold as insurance against the clock, but freezing eggs does not freeze fertility, only eggs, and most women who buy it never return to use what they bought. What they purchased was the feeling of having done something about a fear.
Donor eggs and surrogacy were sold as the way to create the family a woman’s own body could not. But this requires relocating the risk onto a second woman’s body through a contract specifying exactly what she is and is not obligated to deliver. Mary told you about the couple suing the surrogate who refused to abort a baby with a cleft palate because they considered the child a defective product. That is what happens when a body is treated as an engineering problem, all the way down to the child himself.
And now genetic testing and embryo screening are sold the same way, as protection from a hard diagnosis. Companies like Orchid now offer “predictive” screening that helps couples predict what medical conditions their embryos might someday develop, like heart disease or diabetes. Screen enough embryos for enough traits, and you have quietly redefined which children are worth keeping. The child is no longer simply welcomed. He is selected, and every selection implies a rejection sitting right beside it.
Two frontiers are being pursued right now seriously, and with real money, and they are exactly what that Grace Cathedral evening warned us to watch for. The first is growing human eggs in a lab from ordinary cells, potentially skin cells, rather than from a woman’s own ovaries. Researchers have made real progress and hit real walls: recent published results show fewer than one in ten resulting embryos reaching even an early viable stage, and every one of those had the wrong number of chromosomes. Getting there took real donated eggs and real embryos, created and destroyed purely to run the experiment. Credible estimates put reliable success a decade or more away, if it arrives at all.
The second is the artificial womb. Today, that research is aimed at extremely premature infants, not at gestation from conception. Full ectogenesis remains speculative, not around the corner. I want to be honest about that distinction. Still, many couples will soon be asked if they will consent to their embryos—their children—being guinea pigs in experimental research.
Look at the shape of the whole fifty-year story again, and you can see exactly where these two frontiers sit. First, the bypass replaced the diagnosis. Then a second woman’s body was rented to replace the first. The frontier now being funded, quite openly, is one that would remove the woman’s body from the process altogether: first her womb, and eventually, if the research succeeds, her ovaries too. This is my read on the direction of travel and the money behind it. It is time to ask what technology is actually for, once you strip away the marketing.
I don’t think we are going to master the human body this way. I think every attempt will keep producing the same ratio we are already seeing: a great deal of investment, a great deal of promise, and a great many women and embryos absorbing the cost of finding that out. But the attempt will not stop just because it keeps failing, because a workaround has no internal stopping point. Women speak about being put on a “superhighway with no exit ramps” once they enter the office of a reproductive endocrinologist. ART will simply keep looking for the next material with which to route around the woman’s engineering problem, until the problem it is routing around becomes the woman herself.
So here is what I actually want to ask of you, plainly, without hedging: Do not sell your eggs. Do not rent your womb. Do not test embryos for the “best” one. Do not freeze “surplus” embryos. Medicine’s bright line is to never remove egg and sperm from the body, doing whatever it can to promote fertilization within the body.
I ask that with care, and with no judgment toward any woman who already has children who have been made in this way. Many did so because they thought what they did was ethical, acceptable, and even proper good medicine. Nonetheless, every one of these transactions accepts the premise that a woman’s body is raw material for somebody else’s outcome, and that premise does not stay contained to a single transaction once it is granted. It is the same premise now funding the frontier that would remove her altogether.
Now, I want to address the part I think matters most. A call to refuse something is not yet an answer. So the question is this: if not ART, what do we offer to a woman who wants a child and cannot easily have one? There is a real alternative, but hardly anyone tells her about it. It is called Restorative Reproductive Medicine (RRM).
RRM is not technology wearing medicine’s coat. IVF asks: “How do we achieve a pregnancy despite the body?” Restorative medicine asks: “What is actually wrong, and can it be treated?” In practice, that means cycle-charted hormonal panels, targeted diagnostics, laparoscopy where it’s actually indicated rather than skipped, and treatment aimed at conditions like endometriosis, ovulatory dysfunction, and structural problems that IVF simply routes around without ever naming. It is slower, it is less glamorous, and it does not cost tens of thousands of dollars.
But it works. One study of a Canadian program using this cause-based approach, called NaProTechnology, found a sixty-six percent live birth rate over the life of the study, compared with roughly twenty percent in a similar population that received no treatment at all. This number is in the same range as commonly cited IVF outcomes. That is not a fringe result. That is evidence-based medicine most women are never told exists, because there is far more money in selling her the same bypass twelve times than in curing her once, and because a field that finds the cause of infertility eventually finds itself with fewer paying customers, not more.
Now widen it past medicine. What if we provided honest counseling that tells a woman her real odds before trust is purchased through marketing, not after? What if we built real communities of presence around women facing infertility, crisis pregnancy, or lasting childlessness? What if we treated each as a sorrow to accompany, not a defect to route around? What if we spoke of adoption and foster parenting as a genuine calling, not a consolation prize?
This is the alternative Mary put in front of you at the start of this session: not a mechanism, but a meeting. It is one woman showing up for, encountering, and supporting another.
Infertility has always been with us. So has the temptation to treat a woman’s body as broken machinery, waiting on whatever tool this century happens to have invented. Every generation gets a new version of the same offer: give us the body, and we will hand you the outcome you want, no sorrow required. It has never once been a fair trade.
The choice in front of this movement was never technology against no technology. It is a mindset that manufactures against a mindset that meets with and accompanies those in sorrow. I am asking you to choose the second one, in what you will and will not do, what you will and will not buy, and what you will and will not sell.
