Will science ever be able to create an artificial womb?

AAre you interested in having kids, but turned off by the whole pregnancy thing? Well, there may be an option available in the not too distant future. The artificial womb or at least the ability to create one is making its way towards us. The big question is whether or not the company is ready.

The obstacles to ectogenesis fetal development outside a mother from fertilization to term infancy will soon be dominated more by legal and ethical issues than by technological and medical limitations. Those who wholeheartedly embrace technology may be waiting with open arms. But there are sure to be others who will find the prospect unsettling.

State of the technology

Currently, survival rates are low for babies born less than 23 weeks gestation. The all-time record age for survival is 21 weeks and 5 days, which happened in Canada in 1987 (and again in 2010). The main problem for newborns at that early stage of development is their lungs: they are simply not strong enough to support life. This also happens when the fetus is treated before birth to accelerate lung development and then supported with mechanical ventilation.

The lungs, in fact, are the basis of the concept of fetal viability, a concept that has come into play for decades in legal issues relating to abortion policy. But lung-assist devices currently under development could greatly expand the survival window, making the modern concept of feasibility obsolete.

Normally, at birth, blood circulation switches from the fetal to the postpartum pattern. In the fetus, venous blood returning from body tissues travels through a pair of umbilical arteries to the placenta. From there, blood passes through the mother’s veins to the right side of the mother’s heart, and then to her lungs, where oxygen and carbon dioxide (CO2) is released. The left side of the maternal heart pumps oxygenated blood through the maternal arteries to the placenta. From there it travels through the umbilical vein and back to the fetus. Freshly oxygenated, this blood mainly bypasses the fetal lungs, which are closed by high pressure.

Screenshot at AMAt birth, the pressure in the fetal pulmonary circulation suddenly decreases and the lungs inflate. This allows the newborn to oxygenate its blood, provided the lungs are mature enough. If the lungs are underdeveloped, mechanical ventilation can compensate to some extent, but otherwise lung inflation fails and the baby dies.

The current equation changes if researchers can bring better lung assist devices into play. They actually call them “artificial placentas,” because they take on a large part of the job description of the mother’s natural placenta and lungs.

The devices, still in development, would be used when standard interventions — such as speeding lung development, spraying “surfactants” into the lungs (agents that keep the surface tension between liquid and air low) and putting the baby on a ventilator — prove inadequate. The artificial placenta would be linked to the blood supply of the newborn. If done soon after birth, the connection could be through the umbilical blood vessels. If you’ve ever witnessed a birth, you’ve seen the umbilical cord clamped and cut soon after the baby was born. But if left untrimmed, the vessels can remain open and functional for a few days, even in a child with no respiratory problems.

Initially, the role of an artificial placenta would be to complement other treatments in preterm infants born near that 23-week danger zone, where survival is currently only 17%. This figure is expected to rise once the lungs are no longer the primary factor determining survival.

Actually, the placenta has other tasks than managing the exchange of oxygen and CO2. Among other things, it removes toxins from the blood and regulates blood sugar levels, tasks that will later be taken over by the liver, kidneys and pancreas. And this is where new hurdles arise if doctors are able to extend safe gestation rates to 20 weeks or less by fixing the lung problem. Other organs will not be ready to do their job.

But we only discussed the artificial placenta version 1.0. Once that version is perfected, there will be refinements and improvements. Blood dialysis machines and other procedures that we already understand and routinely employ will be used alongside Artificial Placenta 1.0, leading to versions 2.0, 3.0 and beyond.

A developing embryo

And while scientists continue to look for ways to increase survival rates in early gestation, other researchers are looking at it from the opposite direction: How long can we allow a fertilized egg to develop in a laboratory setting before uterine implantation? ? Recently there is an important advance, published in the magazine Naturein which researchers demonstrated that embryogenesis could proceed outside the uterus under laboratory conditions for 13 days.

What is not known is how long it could have lasted. This is because the 13 day period is not a technical limit. The team had to halt the experiment due to an international agreement against research on human embryos aged 14 days’ gestation or older.

And as science advances on both the premature birth and implantation fronts, there will be a point where the two paths come together. Eventually, it may be possible for the entire gestation to occur outside the natural uterus. Whether that happens sooner or later, incremental advances are on a collision course with current paradigms surrounding biomedical policy debates, including abortion and human stem cell research.

With this in mind, I brought up the question of the politics of ectogenesis to Zoltan Istvan, a transhumanist author who sought to give the transhumanist movement some sort of political organization. This could allow ectogenesis and other body-altering ideas to enter the radar screen of politics.

“The current political dialogue is not yet addressing this controversy, but they are on a paradigm that will need to be adjusted,” said Istvan, who ran for president in the 2016 election, hoping to attract mainstream politicians to biotech issues.

David Warmflash is an astrobiologist, physician and science writer.BIO. Follow him on Twitter@CosmicEvolution


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Image Source : geneticliteracyproject.org

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