Ectogenesis is the growth of an organism in an artificial environment (Synthethic wombs).

You’re looking at a lamb in an artificial womb. This is a major breakthrough, it could eventually be used to bring premature babies to term. Premature birth is the leading cause of death for newborns. The lamb was put in the biobag 105 days after fertilization. That’s equivalent to just 22 weeks in human fetal development. It was kept healthy thanks to a pumpless circulatory system. And artificial amniotic fluid. The work was done by the children’s hospital of Philidelphia. But what about for humans?

In the next 30 years, you could grow a baby in an artificial womb. This man made womb could carry partially-developed fetuses and embryos. An outer shell made of human cells holds a developing embryo or fetus. While amniotic fluid promotes muscular and skeletal development, a regulatory system provides oxygen, nutrients, and hormones. Scientists have been developing artificial womb technology since 2001.

 

It could be as soon as 5 years or as long as 40, but you can essentually take frozen eggs or frozen sperm and make your own person out of that, design your own baby without ever needing to get married. It’s not that far from cloning, to creating vast swathes of people with the exact same DNA,. It keeps bringing up the topic of eugenics, but that’s another topic on your own. But what are the ethical implications of creating a child without parents? Aside from tthical, there are moral concerns. Some have a very real worry about children that would be grown in an artificial womb, that they wouyldn’t have that experience of bonding with their mother when they’re developing insider her. Childhood trauma can have a lot of effects down the road. What about a baby raised outside of the womb without a mother, a baby raised in a machine, that didn’t have a mother singing got it, loving it, no attention. However, artificial wommbs can help with the fertility crisis in western nations. The current fertility rate on average is about 1.4 per couple, replacement rate is 2.1, meaning the populations are shrinking and not replacing themselves. Dince we don;’t have that, it results in the importation of incompatible cultures that breaks out into racial violence. The question is, wioll these artificial wombs help people reproduce faster? Will it increase our birth rate to a sustainable level. However, this might actually cause the birth rate to go down. First of all, we already have a lot of this tech, IVF, C-esections, Donor eggs, we have hormone treatments. Many couples in the west will often forego children for cosmetic reasons, however,, this technology could lead to women being more enthusiastic about having children. This iopportunity that you can just wait until your late 40s or 50s to have children will cause people to put off having children when they’re younger. Even if you’ve been married for decades you’ve adapted to the bachelor and bachelorette livbving together on a permenant basis. The longer you give people the option to wait, the longer they will put off having children. Not to mention this technology costs over 100,000 dollars, people might not even want to have children because of that cost. Overall, it’s not a paradigm shift, it’s just more of whatwe already have.

ARTIFICIAL WOMBS AND THE FUTURE OF CHILDBIRTH

It is almost 40 years since the first IVF baby, Louise Brown, was born. While this amazing breakthrough was highly controversial at the time, IVF is today commonplace. So how is conception and childbirth likely to change over the next 40 years and beyond?

The rapid pace of research in the areas of fertility and reproduction raises some mind-boggling questions about the future. Will we conceive and grow babies entirely in laboratories – making sex and pregnancy a thing of the past? And will all future babies be “genetically designed”?

One of the real game changers will be women’s ability to preserve their fertility and have children later in life. The procedure of freezing eggs was once fairly unsuccessful. But these days 80-90% of the eggs survive and women have a 97% chance of having a baby if they freeze 40 or more eggs before they turn 35. Another option is for women to freeze ovarian tissue at a young age, which can be thawed and put it back in the body several years later. This is still being researched but babies have been born using this method, and it is only going to get better with time.

Scientists have also successfully created sperm from stem cells and there is no reason why the same cannot be done for eggs. So in 40 years, women will most likely have several viable options to help them preserve their fertility. Hopefully, this will also be socially accepted and an affordable thing to do by then – empowering women to have children when they are ready.

But will these changes result in IVF taking over as the main way of reproduction? Despite an enormous amount of research, only a third of women are able to have a baby following IVF today – something that is unlikely to change in the next 40 years. This is partly down to age and the fact that even the healthiest-looking embryo has around a 30% chance of having an abnormal genetic make-up, which can cause miscarriage or genetic defects. Genetic screening before implantation is already used to identify these embryos, but future, improved “non-invasive” testing of the fluid the embryo has grown in will significantly boost IVF rates. Indeed, a century from now IVF is highly likely to be the “normal” way to conceive, making those who conceive naturally look like radical risk takers.

8-day embryo. ekem, Courtesy: RWJMS IVF Program

Of course, all this testing may inevitably lead to “designer babies”. Indeed, genetic defects will – or rather can – be eliminated in 40 years. We already have the ability to not only look for the most common chromosomal problems, like Down’s syndrome, but at each and every gene as well as the areas between the genes. In 40 years tests will be more accurate and the results available immediately, making it possible to identify embryos with disease or a high risk of developing problems later in life. While there are certainly ethical difficulties about this, it is hard to argue against choice if it is informed.
Hopefully by 2056 – and certainly within 100 years – we will also have the ability to correct abnormal genes either in the embryo or foetus using gene editing techniques like CRISPR. The foetal genome can be cut at any desired location and abnormal genes removed or new normal genes added. In this way, babies could be “treated” in the uterus, giving them a chance of a healthy life. The ethics aren’t straightforward but it could be argued this is in fact better than current screening programmes designed to identify and exclude rather than save embryos with problems.

Pregnancy And Childbirth

In the 1920s, scientist J B S Haldane famously predicted that by 2074 more than 70% of humans would be born from an artificial womb. We are still a long way off that, however babies are coping with spending an increasing amount of gestation time outside the human body. Fertilisation can occur in the lab, as can the first two weeks of the embryo forming. Babies can also survive despite being born at 22-24 weeks – something that was unthinkable in the 1970s.

Even if artificial wombs become possible, it is likely to be highly regulated and restricted to a minority of women who cannot carry a pregnancy or those whose lives would be at significant risk. But as things stand there are already options for these women, such as surrogacy. For that reason, it is unlikely we’ll be growing babies in laboratories in the next 40 years. However, as the technology gets tried and tested, couples 100 years from now may well be watching their babies grow in artificial incubators with 24/7 live updates.

Caesarian sections may replace vaginal birth. wikimedia,CC BY-SA

Are all women likely to have caesarean sections rather than natural birth in the future? An increasing number of studies are indeed showing that having a planned “elective” caesarean section is the safest way to have a baby – there can never be a guarantee that a labour will go to plan.

But there are risks. Repeated c-sections can cause the placenta in future pregnancies to attach itself so strongly to old scars that it won’t come off after delivery. This can lead to significant bleeding and the need for blood transfusion or hysterectomy. Nevertheless, it’s a rare condition which is more common in women who have had more than two c-sections. And given that UK families are only having 1.8 babies on average today, the argument for “caesarean delivery for all” will not go away. The fact that many obstetricians choose to give birth in this way shows there is more to it than being “too posh to push”. The chances are that attitudes will change in the future and that caesareans will become the norm.

Of course, exactly what will happen by 2056 and beyond is impossible to predict accurately. While history has taught us that things will not stand still, we can be certain that the social and ethical debate is likely to be just as complex as the science.

The Conversation

Nicholas Raine-Fenning, Director Nurture Fertility, The Fertility Parnership and Reader/Associate Professor in Reproductive Medicine and Surgery, University of Nottingham, University of Nottingham

This article was originally published on The Conversation. Read the original article.

MOST SUCCESSFUL ARTIFICIAL WOMB YET

Among modern medicine’s achievements, one of the most dramatic has been a steep reduction in infant mortality. Yet, even today, there are exceptions. Babies born prematurely often have to battle to stay alive. Our best technology isn’t enough.

Scientists recently took a small step towards changing that. A team of doctors from Children’s Hospital of Philadelphia was successfully able to bring eight premature lambs to full term in an artificial womb outside their mother’s body. Researchers dubbed the fake womb a “Biobag,” a good term to describe what’s basically a big plastic bag equipped with a circulation system and filled with a liquid that mimics amniotic fluid.

After being born at just over half their gestation period—the equivalent for a human baby would be 22 weeks—the lambs spent up to four weeks in Biobags before being transferred to ventilators.

According to the researchers’ paper, which was published this week in Nature Communications, extreme prematurity is the leading cause of neonatal mortality in the developed world—more than a third of infant deaths in the US are due to prematurity. Even when preemies survive, they often end up battling complications related to underdeveloped organs.

More specifically, premature babies most often have respiratory problems related to their lungs being forced to transition from liquid to air ventilation before they’re ready. An artificial womb like the Biobag allows the lungs and other organs to continue developing more closely to the way they would inside a mother’s body.

Obviously, though, a plastic bag is a far cry from a uterus, no matter how many advanced systems it’s outfitted with. During pregnancy, a mother’s blood flows to her baby, giving the baby oxygen and clearing its lungs of carbon dioxide. This isn’t an easy process to re-create, not least because the blood pressure has to stay within a narrow range to avoid damaging the baby’s heart.

To clear these significant hurdles, researchers connected the lamb fetus’s umbilical blood vessels to an apparatus that oxygenated them. The baby’s heartbeat was able to power blood flow, eliminating the need for an external pump.

Besides the oxygenator, the Biobags have two other crucial components: continuous fluid exchange and an umbilical cord connection. Each Biobag is a single-use, closed, sterile environment, with liquid continuously flowing out of the bag to be purified—just as a mother’s kidneys would do during pregnancy.

Finally, the research team developed a new technique to connect umbilical cord vessels to an external nutrient source.

Biobag system design. Image Credit: Nature Communications

The baby lambs that spent several weeks in the Biobags were compared to lambs born by C-section at full term, and the differences in crucial organs like lungs and brain were minimal.

“These results are superior to all previous attempts at extracorporeal support of the extreme premature fetus in both duration and physiologic well-being,” according to the paper.

Lambs and humans are, of course, not the same, and this project’s success doesn’t mean Biobags will necessarily work for human babies. But that’s the direction the team is planning to take their research.

“We believe that the animal data that we have reported in this manuscript really supports translating our system into a clinical therapy for human babies,” according to Emily Partridge, a researcher Children’s Hospital of Philadelphia.

Besides helping bring preemies to full term in a way that’s healthier for them, Biobag-type technology could be used to treat babies whose mothers have an insufficient placenta or to correct congenital heart or lung issues. In general, the technology offers a way to help premature babies without causing additional health risks to mothers.

It doesn’t end there, though. The authors of the paper state that their system “offers an intriguing experimental model for addressing fundamental questions regarding the role of the mother and placenta in fetal development.”

Could the mother one day be removed from the equation altogether (after providing an egg, that is)? Is that a desirable scenario, or would it render one of the most intimate parts of life too sterile and impersonal?

It will be years or even decades before we find out, but women who have had complicated pregnancies or agonizing deliveries—or those who simply didn’t enjoy being pregnant—will welcome advancements in a technology that would free them from being nature’s vessel of life. It would pack a serious punch to gender equality, too.

Image Credit: The Children’s Hospital of Philadelphia/YouTube

FIRST ARTIFICIAL WOMBS, USED TO GROW PRE-TERM LAMBS

In an amazing advance in medical science, researchers have developed an artificial womb that is able to grow preterm lambs for up to a month.

The researchers, from the Center for Fetal Diagnosis and Treatment at the Children’s Hospital of Philadelphia, have in effect created an artificial womb far more developed than anything produced previously. After going through several iterations of the system (including glass incubators) over a period of three years, they eventually settled on one that utilizes a plastic film bag connected to gas exchange machines and sensors.

The system effectively mimics the conditions within the womb, with the container being filled with a unique lab-produced liquid that replicates amniotic fluid. As the developing lungs are unable to breathe atmospheric oxygen, this step allows the developing fetus to breathe the artificial amniotic fluid that flows in and out of the bag. It also contains all the necessary nutrients and growth factors for healthy development.

Advances in medicine in recent years have seen an incredible increase in the survival rate of preterm babies, with infants born at just 23 weeks of gestation given a 30 to 50 percent chance of survival. But there is a difficult pay-off, as such infants often face a reduced quality of life. They have a staggering 90 percent chance of mortality, while half of all cases of cerebral palsy are due to prematurity.

“These infants have an urgent need for a bridge between the mother’s womb and the outside world,” explains Alan Flake, lead author of the paper published in Nature Communications. “If we can develop an extra-uterine system to support growth and organ maturation for only a few weeks, we can dramatically improve outcomes for extremely premature babies.”

In the latest study, the researchers tested the new system on preterm lambs, which were the equivalent to a 23-24 week gestation human infant. Placed in the fluid film bag, the umbilical cords were then attached to an external oxygenator that mimicked a mother’s placenta. This allowed the fetus’ own heart to pump the blood around the body and out of the womb, without the need of an external pump – the pressure of which can overload underdeveloped hearts with fatal consequences.

The lamb was sealed in the bag, isolated in the sterile environment, and protected from changes in pressure and light for an impressive 28 days, during which time they remained healthy and developed naturally, breathing normally, opening eyes, moving, and even growing wool.

The researchers are now working on adapting the system, including downsizing it for human infants who are typically around a third of the size of the lambs. It’s hoped that this research will set a precedent for how preterm babies are treated and cared for.

FIRST ARTIFICIAL WOMBS USED TO GROW PRE-TERM LAMBS

In an amazing advance in medical science, researchers have developed an artificial womb that is able to grow preterm lambs for up to a month.

The researchers, from the Center for Fetal Diagnosis and Treatment at the Children’s Hospital of Philadelphia, have in effect created an artificial womb far more developed than anything produced previously. After going through several iterations of the system (including glass incubators) over a period of three years, they eventually settled on one that utilizes a plastic film bag connected to gas exchange machines and sensors.

The system effectively mimics the conditions within the womb, with the container being filled with a unique lab-produced liquid that replicates amniotic fluid. As the developing lungs are unable to breathe atmospheric oxygen, this step allows the developing fetus to breathe the artificial amniotic fluid that flows in and out of the bag. It also contains all the necessary nutrients and growth factors for healthy development.

Advances in medicine in recent years have seen an incredible increase in the survival rate of preterm babies, with infants born at just 23 weeks of gestation given a 30 to 50 percent chance of survival. But there is a difficult pay-off, as such infants often face a reduced quality of life. They have a staggering 90 percent chance of mortality, while half of all cases of cerebral palsy are due to prematurity.

“These infants have an urgent need for a bridge between the mother’s womb and the outside world,” explains Alan Flake, lead author of the paper published in Nature Communications. “If we can develop an extra-uterine system to support growth and organ maturation for only a few weeks, we can dramatically improve outcomes for extremely premature babies.”

In the latest study, the researchers tested the new system on preterm lambs, which were the equivalent to a 23-24 week gestation human infant. Placed in the fluid film bag, the umbilical cords were then attached to an external oxygenator that mimicked a mother’s placenta. This allowed the fetus’ own heart to pump the blood around the body and out of the womb, without the need of an external pump – the pressure of which can overload underdeveloped hearts with fatal consequences.

The lamb was sealed in the bag, isolated in the sterile environment, and protected from changes in pressure and light for an impressive 28 days, during which time they remained healthy and developed naturally, breathing normally, opening eyes, moving, and even growing wool.

The researchers are now working on adapting the system, including downsizing it for human infants who are typically around a third of the size of the lambs. It’s hoped that this research will set a precedent for how preterm babies are treated and cared for.

SCIENTISTS CREATE MOST SUCCESSFUL ARTIFICIAL WOMB YET

Among modern medicine’s achievements, one of the most dramatic has been a steep reduction in infant mortality. Yet, even today, there are exceptions. Babies born prematurely often have to battle to stay alive. Our best technology isn’t enough.

Scientists recently took a small step towards changing that. A team of doctors from Children’s Hospital of Philadelphia was successfully able to bring eight premature lambs to full term in an artificial womb outside their mother’s body. Researchers dubbed the fake womb a “Biobag,” a good term to describe what’s basically a big plastic bag equipped with a circulation system and filled with a liquid that mimics amniotic fluid.

After being born at just over half their gestation period—the equivalent for a human baby would be 22 weeks—the lambs spent up to four weeks in Biobags before being transferred to ventilators.

According to the researchers’ paper, which was published this week in Nature Communications, extreme prematurity is the leading cause of neonatal mortality in the developed world—more than a third of infant deaths in the US are due to prematurity. Even when preemies survive, they often end up battling complications related to underdeveloped organs.

More specifically, premature babies most often have respiratory problems related to their lungs being forced to transition from liquid to air ventilation before they’re ready. An artificial womb like the Biobag allows the lungs and other organs to continue developing more closely to the way they would inside a mother’s body.

Obviously, though, a plastic bag is a far cry from a uterus, no matter how many advanced systems it’s outfitted with. During pregnancy, a mother’s blood flows to her baby, giving the baby oxygen and clearing its lungs of carbon dioxide. This isn’t an easy process to re-create, not least because the blood pressure has to stay within a narrow range to avoid damaging the baby’s heart.

To clear these significant hurdles, researchers connected the lamb fetus’s umbilical blood vessels to an apparatus that oxygenated them. The baby’s heartbeat was able to power blood flow, eliminating the need for an external pump.

Besides the oxygenator, the Biobags have two other crucial components: continuous fluid exchange and an umbilical cord connection. Each Biobag is a single-use, closed, sterile environment, with liquid continuously flowing out of the bag to be purified—just as a mother’s kidneys would do during pregnancy.

Finally, the research team developed a new technique to connect umbilical cord vessels to an external nutrient source.

Biobag system design. Image Credit: Nature Communications

The baby lambs that spent several weeks in the Biobags were compared to lambs born by C-section at full term, and the differences in crucial organs like lungs and brain were minimal.

“These results are superior to all previous attempts at extracorporeal support of the extreme premature fetus in both duration and physiologic well-being,” according to the paper.

Lambs and humans are, of course, not the same, and this project’s success doesn’t mean Biobags will necessarily work for human babies. But that’s the direction the team is planning to take their research.

“We believe that the animal data that we have reported in this manuscript really supports translating our system into a clinical therapy for human babies,” according to Emily Partridge, a researcher Children’s Hospital of Philadelphia.

Besides helping bring preemies to full term in a way that’s healthier for them, Biobag-type technology could be used to treat babies whose mothers have an insufficient placenta or to correct congenital heart or lung issues. In general, the technology offers a way to help premature babies without causing additional health risks to mothers.

It doesn’t end there, though. The authors of the paper state that their system “offers an intriguing experimental model for addressing fundamental questions regarding the role of the mother and placenta in fetal development.”

Could the mother one day be removed from the equation altogether (after providing an egg, that is)? Is that a desirable scenario, or would it render one of the most intimate parts of life too sterile and impersonal?

It will be years or even decades before we find out, but women who have had complicated pregnancies or agonizing deliveries—or those who simply didn’t enjoy being pregnant—will welcome advancements in a technology that would free them from being nature’s vessel of life. It would pack a serious punch to gender equality, too.

Image Credit: The Children’s Hospital of Philadelphia/YouTube

ARTIFICAL WOMBS AND THE FUTURE OF CHILDBIRTH

It is almost 40 years since the first IVF baby, Louise Brown, was born. While this amazing breakthrough was highly controversial at the time, IVF is today commonplace. So how is conception and childbirth likely to change over the next 40 years and beyond?

The rapid pace of research in the areas of fertility and reproduction raises some mind-boggling questions about the future. Will we conceive and grow babies entirely in laboratories – making sex and pregnancy a thing of the past? And will all future babies be “genetically designed”?

One of the real game changers will be women’s ability to preserve their fertility and have children later in life. The procedure of freezing eggs was once fairly unsuccessful. But these days 80-90% of the eggs survive and women have a 97% chance of having a baby if they freeze 40 or more eggs before they turn 35. Another option is for women to freeze ovarian tissue at a young age, which can be thawed and put it back in the body several years later. This is still being researched but babies have been born using this method, and it is only going to get better with time.

Scientists have also successfully created sperm from stem cells and there is no reason why the same cannot be done for eggs. So in 40 years, women will most likely have several viable options to help them preserve their fertility. Hopefully, this will also be socially accepted and an affordable thing to do by then – empowering women to have children when they are ready.

But will these changes result in IVF taking over as the main way of reproduction? Despite an enormous amount of research, only a third of women are able to have a baby following IVF today – something that is unlikely to change in the next 40 years. This is partly down to age and the fact that even the healthiest-looking embryo has around a 30% chance of having an abnormal genetic make-up, which can cause miscarriage or genetic defects. Genetic screening before implantation is already used to identify these embryos, but future, improved “non-invasive” testing of the fluid the embryo has grown in will significantly boost IVF rates. Indeed, a century from now IVF is highly likely to be the “normal” way to conceive, making those who conceive naturally look like radical risk takers.

8-day embryo. ekem, Courtesy: RWJMS IVF Program

Of course, all this testing may inevitably lead to “designer babies”. Indeed, genetic defects will – or rather can – be eliminated in 40 years. We already have the ability to not only look for the most common chromosomal problems, like Down’s syndrome, but at each and every gene as well as the areas between the genes. In 40 years tests will be more accurate and the results available immediately, making it possible to identify embryos with disease or a high risk of developing problems later in life. While there are certainly ethical difficulties about this, it is hard to argue against choice if it is informed.
Hopefully by 2056 – and certainly within 100 years – we will also have the ability to correct abnormal genes either in the embryo or foetus using gene editing techniques like CRISPR. The foetal genome can be cut at any desired location and abnormal genes removed or new normal genes added. In this way, babies could be “treated” in the uterus, giving them a chance of a healthy life. The ethics aren’t straightforward but it could be argued this is in fact better than current screening programmes designed to identify and exclude rather than save embryos with problems.

Pregnancy And Childbirth

In the 1920s, scientist J B S Haldane famously predicted that by 2074 more than 70% of humans would be born from an artificial womb. We are still a long way off that, however babies are coping with spending an increasing amount of gestation time outside the human body. Fertilisation can occur in the lab, as can the first two weeks of the embryo forming. Babies can also survive despite being born at 22-24 weeks – something that was unthinkable in the 1970s.

Even if artificial wombs become possible, it is likely to be highly regulated and restricted to a minority of women who cannot carry a pregnancy or those whose lives would be at significant risk. But as things stand there are already options for these women, such as surrogacy. For that reason, it is unlikely we’ll be growing babies in laboratories in the next 40 years. However, as the technology gets tried and tested, couples 100 years from now may well be watching their babies grow in artificial incubators with 24/7 live updates.

Caesarian sections may replace vaginal birth. wikimedia, CC BY-SA

Are all women likely to have caesarean sections rather than natural birth in the future? An increasing number of studies are indeed showing that having a planned “elective” caesarean section is the safest way to have a baby – there can never be a guarantee that a labour will go to plan.

But there are risks. Repeated c-sections can cause the placenta in future pregnancies to attach itself so strongly to old scars that it won’t come off after delivery. This can lead to significant bleeding and the need for blood transfusion or hysterectomy. Nevertheless, it’s a rare condition which is more common in women who have had more than two c-sections. And given that UK families are only having 1.8 babies on average today, the argument for “caesarean delivery for all” will not go away. The fact that many obstetricians choose to give birth in this way shows there is more to it than being “too posh to push”. The chances are that attitudes will change in the future and that caesareans will become the norm.

Of course, exactly what will happen by 2056 and beyond is impossible to predict accurately. While history has taught us that things will not stand still, we can be certain that the social and ethical debate is likely to be just as complex as the science.

The Conversation

Nicholas Raine-Fenning, Director Nurture Fertility, The Fertility Parnership and Reader/Associate Professor in Reproductive Medicine and Surgery, University of Nottingham, University of Nottingham

This article was originally published on The Conversation. Read the original article.

Advertisements