An artificial womb? Thanks to extrauterning fetal incubation or EUFI, artificial wombs are now being created. Some researches in Tokyo have been using goat fetuses to place in incubators with amniotic fluid which is artificial and is heated to the proper body temp. This is a huge step as it shows that the fetus can now be accessed and not locked away and prevented from medical interventions if necessary.
Human reproduction medicine include neonatology, fetal surgery, assisted reproduction, and in-vitro fertilization, which are all relatively new. Of course the ethics behind each are have been in question. Where the future of human reproductive medicine is headed can seem very scary on the ethical side of things.
Neonatology basically involves doctors resuscitating 16-17 week-old early born infants who usually weigh less than a pound, with a survival rate of 10%. Further research hopes to push the boundaries more by looking to reduce the rates of death of the extreme premature babies who do survive.
Liquid ventilation involves ventilating babies with a liquid that holds a lot of oxygen, resulting in a safer way to take the immature lungs of premature’s to the point necessary for them to breath air, preventing issues like Baratrauma which is damage caused to the lungs by forced air out of a ventilator. Liquid can preserve the lung function as well as structure according to Thomas Shaffer, professor of physiology and pediatrics at the School of Medicine at Temple University, who has been working with premature babies since he was postdoctoral student. Liquid ventilation has been his focus for nearly 30 years.
Is the whole idea crazy? Many people thought so not too long ago. Shaffer and his team where the only ones working on this process. Fast forward to now and neonatologists consider this a big step towards premature infant treatment.
Liquid ventilation was given to infants in 1989 during the first human studies. These infants were not expected to survive through conventional therapy. Larger trials are now taking place, inspired by the promising results of the ’89 studies.
Shaffer says that by putting liquid into the lung, the lung sacs can be expanded at much lower pressure. A pharmaceutical company has now developed a fluorocarbon liquid which can carry a large amount of carbon dioxide and dissolved oxygen.
Shaffer believes this technology could be the standard and may be used in large centers. Eventually a liquid-dwelling and liquid-breathing in between stage could be the norm for eliminating damage to prematures.
Performing surgery on a fetus.
This was first pioneered by Michael Harrison at the University of California in San Francisco. In 1981 he reported that it was possible to perform surgery on a fetus to relieve urinary tract obstruction.
Before birth is when damage occurs often to the organ systems resulting in malformations. Getting to the problem at the onset is the best way to prevent the damage, thus it would make sense to treat life-threatening malformations before birth occurs, according to N. Scott Adzick who is a surgeon in chief at the Children’s Hospital of Philadelphia, and has trained with Harrison.
Some of the issues which arise when helping families make choices in these difficult situations, involve the question of whether to terminate a pregnancy or carry on a pregnancy with the knowledge that death will likely occur for the fetus or major surgery will need to be attempted. And there is the possibility of fixing the problem in utero, while allowing normal growth and development to occur.
Felicia Rodriguez, from West Palm Beach, Fla.,was 22 weeks pregnant, and ended up having the first fetal surgery at Children’s Hospital. Ultrasound revealed her fetus had a mass growing in the chest, which could lead to compression of the heart, killing the fetus and possibly the mother. Felicia when to Philadelphia and the surgeons there made a C-section type cut, performing a hysterotomy, and opening the aminiotic sac to expose the part of the chest that needed to be addressed. The mass was then removed. The pregnancy continued and the mother gave birth at 35 weeks’ gestation (which was 13 weeks after the surgery, 5 weeks before her original due date). The baby was healthy when born, and the mother experienced no problems as well.
It’s an amazing technology and all of those working to become the next generation of fetal surgeons are all enthusiastic for the field and the possibilities of saving lives.
In-vitro fertilization.
This seemed to be all the tabloid rage many years ago. The idea of test-tube babies and the unsure future of where this would lead. Now it is considered standard therapy and widely understood by many. You can see ad’s in mainstream papers for egg donation programs. It is still amazing to think how you can have your own fertilized egg carried by a surrogate or carry an embryo formed from someone else’s egg.
Becoming pregnant is a huge goal for many women, and they will go to great lengths to make it happen. An artificial womb could likely be yet another option expecting mothers will take advantage of. Taking it further, one wonders if it could someday become the norm. Some would argue that the unique mother-baby relationship developed before birth would be deprived. Yet the drive to “become a mommy” is so strong in so many women, which brings up another question on whether this is a biological urge or more of a cultural urge with the usual pressures and pre-programmed leanings for motherhood as a child.
The director of the Center for Bioethics at the University of Pennsylvania, Arther L. Caplan leans toward a future where a movement against all of this “unnatural” and “unnecessary” technology will take place, but with the artificial womb and much more becoming inevitable, technological acceptance through demand will be significant.
Should we evolve with technology? How artificial do we allow things to get? Should technology be accepted with the focus on saving fetuses with life threatening ailments? Yet what are the effects of the extreme evolution of these types of technology?
All important questions that will have to be faced as these type of technologies continue to evolve.