Overview

Imagine a world where all infants are born from incubators that mimic the womb. In this universe, technology and research have advanced to the point where artificial wombs can be mass-produced, and everyone you know, including yourself, was born in a controlled and artificially prepared setting at a gestation clinic. This sounds straight out of a sci-fi novel, but it has been far from being just fiction; in fact, it could become an everyday reality in the coming decades.

The science and other stuff to know

The idea of ​​gestating humans in artificial environments without a mother’s womb has haunted the minds of bioengineers for decades. The current approach is as promising as it is controversial.

Ectogenesis is the method by which a living being is nurtured from fertilization to birth in a device that does not require the intervention or aid of a female body: a genuine artificial uterus. This word was coined by the British biologist J. B. Haldane, who was one of the first to raise social and intellectual issues about birth control for the population, abortion, and the use of contraceptive technologies, nearly a century ago.

In 1993, a revolutionary study for the field was published: a group of Japanese researchers successfully terminated the pregnancy of a goat by extracting the fetus from the womb and placing it in an artificial placenta made by experts in the laboratory. The difficulties they encountered during the procedure shed light on the difficulties and limitations of the current technology intended to carry out artificial pregnancies; pulmonary and cardiac insufficiency were the most pertinent, as the fetal organs were not yet sufficiently developed to fully rely on the support mechanisms provided by the mother’s uterus.

A team of researchers led by Helen Hung-Ching Liu, Director of the Reproductive Endocrine Laboratory at the Center for Reproductive Medicine and Infertility at Cornell University, succeeded in developing a mouse embryo almost to full term in 2003 by adding artificial endometrial tissue to a bio-engineered, extra-uterine “scaffold.” The researcher then raised a human embryo in an artificial womb for ten days, due to a regulation that limits research initiatives of this type to 14 days. Her goal is to create a functioning external womb.

The time required for a fetus to attain a particular level of autonomy over these systems is known as viability. Currently, neonatology experts are capable of continuing the gestation of a human fetus outside its mother’s uterus from 22 weeks—current viability—and the forecast indicates that in the coming years they will be able to do so earlier. In other words, we are currently capable of reproducing partial ectogenesis, and it may not be much longer before we succeed in recreating the biological environment of a human womb.

Current research continues to focus on perfecting the artificial environment for gestation. Meanwhile, the ethical debate on the consequences of ectogenesis is rapidly expanding and refining.

So what?

The implications of achieving the feat of ectogenesis are diverse and the subject of extensive debate. Some of the benefits could include the possibility of surgical interventions in fetuses with some degree of dysfunction, as well as significant improvements in neonatal care, and the possibility that homosexual couples can have children without having to rent a womb and face the immense emotional challenge that this practice entails. It could also be adopted by fertile women who prefer not to go through pregnancy.

For infants who are born before 23 weeks of development, negative health outcomes are exceedingly likely.  The mortality rate alone is greater than 50 percent, and the infants that do survive have a 70 to 90 percent chance of experiencing severe complications. Cerebral palsy, significant mental impairment, and blindness are just some of the issues they face. Artificial wombs could remove this concern.

Some experts argue that advanced partial ectogenesis could eliminate the need for abortion, given that if the woman decides that she does not want to give birth, the fetus could be transferred to an artificial uterus where it would continue to gestate under clinical supervision.

Of course, there are critics of the technology. Some have pointed out that artificial wombs would make it easier to create “designer babies” and further the divide between the rich (who can afford the technology) and the poor (who can’t). Specifically, some claim that by combining this technology with gene editing, scientists could create a world similar to what we see in Aldous Huxley’s dystopian novel Brave New World. In the text, humans are grown in test tubes to the exact specifications desired and natural human evolution is effectively brought to a standstill.

Whether this is, in fact, a problem is obviously subjective. And experts note that we are nowhere near realizing Huley’s world, but it is very highly debated and has strong camps on both sides.

Experts also note that artificial wombs would prevent contact between parent and child. This is a potentially pressing issue, as science has shown that such contact is extremely beneficial both emotionally and physically. Speaking to the New York Times, Trish Ringley, a neonatal intensive care nurse in San Luis Obispo, California, noted these concerns and said that further research in this area is needed. Maureen Sander-Staudt made similar claims in an article published in Brill, stating that “an increased biological, emotional, and physical distance between mothers and children, and hence to society in general.”

What’s next?

The science behind ectogenesis continues to make advances in bioengineering, neonatology, and the field of assisted fertilization. Back in 2019, scientists in the Netherlands announced they are within 10 years of developing an artificial womb that could save the lives of premature babies.

More recently, a study published in the journal Nature in August of this year reported how scientists successfully created a synthetic mouse embryo without utilizing either eggs or sperm. They used a variety of stem cells instead and were able to grow synthetic and natural embryos side by side in the lab. However, while the synthetic mouse embryos appeared to be identical to their natural counterparts, their development stalled at eight and a half days, which makes it difficult to predict whether they would continue to grow normally.

“This is very strong evidence that we will one day have this power, and it will be possible [to create synthetic life],” Max Wilson, a molecular biologist at the University of California, Santa Barbara, who was not involved in the study, told Inverse. “Whether we decide to do that or not because of ethics or even the potential upsides — that’s a question for society at large.”