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Fabius claims the title of 'Primogenitor'. Is this a wild boast? Could he actually create a primarch of his own design?

And if he can do what he boasts, why has hasn't he done so? Does anyone think renegade marines might commission such a project?

It would be interesting if he actually made one and set it loose.

I don't think the title "Primogenitor" means, literally, that he is the creator of Primarchs. I look at it more like "Geneticist Prime" or "Primary Genetic Scientist" or similar meanings. It's more a reflection of his mastery of various sciences and medical fields, not a reference to a specific action or time.

You need to add MAD to these titles.
Bile created abominations, mutants and "golems" but nothing from scratch like it was done with Primarchs and Space Marines.
He uses his knowledge like a modeller would do a conversion from a boxed kit and a few spare bitz.