The study, published in Reproductive Biomedicine Online, is authored by nine specialists in reproductive health, aerospace medicine and bioethics. They describe how two once-separate revolutions, human spaceflight and assisted reproductive technologies, are now intersecting as space becomes both a workplace and destination while fertility treatments become more advanced, automated and accessible.

Lead author and clinical embryologist Giles Palmer from the International IVF Initiative notes that more than five decades after the first Moon landing and the first proof of human fertilisation in vitro, these trajectories are colliding in underexplored ways. The report does not promote conception in space but instead highlights foreseeable reproductive risks for space travelers and calls for clear standards before irreversible harm occurs.

The authors emphasise that there are still no widely accepted, industry-wide standards for managing reproductive health risks in space. Key gaps include the management of inadvertent early pregnancy during missions, assessing fertility impacts from radiation and microgravity, and defining ethical boundaries around reproduction-related research in extraterrestrial environments.

Drawing on limited laboratory and human data from past missions, the report characterises space as a hostile setting for healthy reproductive processes. Known adverse factors include altered gravity, exposure to cosmic radiation and disruption of circadian rhythms, all of which can interfere with normal physiology relevant to fertility and pregnancy.

Animal studies have shown that short-term radiation exposure can disrupt female menstrual cycles and increase cancer risk, but the review identifies a lack of reliable data for male and female astronauts on longer missions. The cumulative impact of radiation on male fertility is described as a critical knowledge gap that must be addressed before commercial and long-duration missions become commonplace.

Existing data from female astronauts on Shuttle missions provide some reassurance, indicating that later pregnancy rates and complications are comparable to those of age-matched women on Earth. However, the authors stress that these findings do not extend to longer-duration missions, and that both male and female reproductive outcomes in such settings remain poorly documented.

The report argues that as the number of people and the total time spent in space increase, new evidence will be required to guide diagnostic, preventive and therapeutic strategies in extraterrestrial environments. Without such data, medical teams and mission planners will be forced to make decisions in the dark about reproductive health and potential pregnancy risks.

While pregnancy is currently a contraindication for spaceflight and menstruation is typically suppressed using hormonal methods, the authors note that developments in reproductive medicine may still play a role. They point out that automated laboratory techniques for fertilisation and cryopreservation could align with the operational demands of space-based reproductive research or future clinical practice beyond Earth.

Palmer notes that assisted reproductive technologies often emerge from extreme or marginal situations and then expand to wider use. He argues that these technologies are highly transferable because they address cases where reproduction is biologically possible but constrained by environmental, health, timing or social factors, conditions which are already common on Earth and are likely to be present in space.

The report raises ethical questions that extend beyond the mechanics of conception. It calls for careful consideration of issues such as the disclosure of pregnancy by space travelers, the use of genetic screening, and the governance of experimental reproductive research in orbit or on other celestial bodies. The authors observe that while some policies are emerging, there is still no global consensus on acceptable boundaries.

They further highlight that the risks of pregnancy during long-duration missions remain insufficiently characterised. The report asks what protections would be in place for a pregnant astronaut, who would bear responsibility for adverse outcomes, and whether male fertility might be compromised by the space environment.

According to Palmer, in vitro fertilisation technologies in space are no longer purely speculative but a foreseeable extension of existing capabilities. Gamete preservation, embryo culture and genetic screening are now mature, portable and increasingly automated, making them technically compatible with off-world settings if ethical and safety frameworks are established.

The authors argue that action is required now not because assisted reproduction in space is imminent, but because the opportunity to set clear boundaries is closing. They warn that treating these issues as distant or speculative overlooks the way reproductive technologies often enter practice gradually, with justification coming after their use has already begun.

The report frames urgency as a call for proactive governance, noting that regulation delayed can amount to regulation denied. Without early agreement on standards, commercial and governmental actors may proceed with reproduction-related activities in space in ways that are difficult to reverse or control.

Senior author Dr Fathi Karouia, a research scientist at NASA, stresses that reproductive health can no longer remain a blind spot in space policy as human presence beyond Earth expands. He calls for international collaboration to close critical knowledge gaps and to establish ethical guidelines that protect both professional and private astronauts while safeguarding humanity as it moves toward sustained life beyond Earth.

Research Report:Reproductive biomedicine in space: implications for gametogenesis, fertility and ethical considerations in the era of commercial spaceflight

Related Links
International IVF Initiative
Space Medicine Technology and Systems