Ectogenesis

By Jack Sewell

The concept of ectogenesis, or in vitro pregnancy, is an interesting one, with huge ethical and social implications. Essentially it involves the use of an “artificial womb” machine that would facilitate the development of a foetus, by replicating the processes that normally happen during a natural pregnancy. This includes the provision of maternal blood or a suitable substitute, which could supply oxygen and nutrients to the foetus, as well as remove waste materials. To achieve this, an artificial placenta would have to mediate the transfer of these substances to and from the foetal circulation. Research in this field began in the 1980s, when in 1989 a human embryo was implanted in ex vivo uterus for the first time¹, though this line of study was quickly halted due to ethical concerns. Further advancements have been made since then, but currently there is no technology which is capable of supporting foetal development from conception through to birth.

Taken from motherboard.vice.com.

There are two potential uses for ectogenesis technology. The first would be as an improvement on current technology for the incubation of premature babies, which would likely give a much greater survival rate by more closely imitating the final stage of gestation. At present, incubators are only effective for babies born after at least 24 weeks of gestation¹. The second use is as an alternative to natural pregnancy, in which the majority or entirety of the gestation could be completed within the machine. An advantage that this could have over a natural pregnancy is the ability to monitor the developing foetus more closely throughout the process, perhaps as though it were on life support. This may be useful if the unborn baby is known or suspected to have a condition that would benefit from close monitoring. It could also make prenatal diagnosis tests safer and more viable, as the current tests (amniocentesis and chorionic villus tests) pose a small risk to the foetus.

Unsurprisingly, this technology raises significant ethical issues relating to the role of the mother and the reliance on technology as a substitute for a natural human process. As with many other scientific controversies, just because science can do something doesn’t necessarily mean that it should. Therefore, we must ask who - if and when this technology becomes available - should be allowed to use it to facilitate an entirely ex vivo pregnancy. For instance, should it only be available to those who cannot carry a child naturally, such as women with damaged uteri or gay men? In these cases, it would remove the need to find a willing surrogate mother, which is currently their only option if they wish to have a biological child. On the other hand, if the technology were made available to everyone, one could imagine that a pregnant woman may be offered the choice to transfer the embryo into an artificial womb for the remainder of the gestation. One ethical issue that arises here is whether this could mean taking away the control that women have over their own body and their own pregnancy. It may even lead to a world where artificial gestation is medically advised or legally enforced, due to reasons such as the poor health of the unborn child or the unfitness of the mother to take care of it during the pregnancy. Therefore, as this technology develops, there are serious decisions that lawmakers must prepare to make concerning the ethics of its use. For now though, there is plenty of time as it is estimated that the necessary technology for a full ex vivo pregnancy will not exist for several decades.

References

1. Bulletti, C., Palagiano, A., Pace, C., Cerni, A., Borini, A. and de Ziegler, D. The artificial womb. Ann. NY Acad. Sci. 1221, 124-128 (2011).