Thursday, November 7, 2013

The Artificial Womb Is Born And The World of the Matrix Begins

49 comments


”One by one the eggs were transferred from their test-tubes to the larger containers; deftly the peritoneal lining was slit, the morula dropped into place, the saline solution poured . . . and already the bottle had passed on through an opening in the wall, slowly on into the Social Predestination Room.” Aldous Huxley, ”Brave New World”

The artificial womb exists. In Tokyo, researchers have developed a technique called EUFI — extrauterine fetal incubation. They have taken goat fetuses, threaded catheters through the large vessels in the umbilical cord and supplied the fetuses with oxygenated blood while suspending them in incubators that contain artificial amniotic fluid heated to body temperature.

Yoshinori Kuwabara, chairman of the Department of Obstetrics and Gynecology at Juntendo University in Tokyo, has been working on artificial placentas for a decade. His interest grew out of his clinical experience with premature infants, and as he writes in a recent abstract, ”It goes without saying that the ideal situation for the immature fetus is growth within the normal environment of the maternal organism.”

Kuwabara and his associates have kept the goat fetuses in this environment for as long as three weeks. But the doctor’s team ran into problems with circulatory failure, along with many other technical difficulties. Pressed to speculate on the future, Kuwabara cautiously predicts that ”it should be possible to extend the length” and, ultimately, ”this can be applied to human beings.”

For a moment, as you contemplate those fetal goats, it may seem a short hop to the Central Hatchery of Aldous Huxley’s imagination. In fact, in recent decades, as medicine has focused on the beginning and end stages of pregnancy, the essential time inside the woman’s body has been reduced. We are, however, still a long way from connecting those two points, from creating a completely artificial gestation. But we are at a moment when the fetus, during its obligatory time in the womb, is no longer inaccessible, no longer locked away from medical interventions.

The future of human reproductive medicine lies along the speeding trajectories of several different technologies. There is neonatology, accomplishing its miracles at the too-abrupt end of gestation. There is fetal surgery, intervening dramatically during pregnancy to avert the anomalies that kill and cripple newborns. There is the technology of assisted reproduction, the in-vitro fertilization and gamete retrieval-and-transfer fireworks of the last 20 years. And then, inevitably, there is genetics. All these technologies are essentially new, and with them come ethical questions so potent that the very inventors of these miracles seem half-afraid of where we may be heading.

Between Womb and Air

Modern neonatology is a relatively short story: a few decades of phenomenal advances and doctors who resuscitate infants born 16 or 17 weeks early, babies weighing less than a pound. These very low-birthweight babies have a survival rate of about 10 percent. Experienced neonatologists are extremely hesitant about pushing the boundaries back any further; much research is aimed now at reducing the severe morbidity of these extreme preemies who do survive.

”Liquid preserves the lung structure and function,” says Thomas Shaffer, professor of physiology and pediatrics at the School of Medicine at Temple University. He has been working on liquid ventilation for almost 30 years. Back in the late 1960′s, he looked for a way to use liquid ventilation to prevent decompression sickness in deep-sea divers. His technology was featured in the book ”The Abyss,” and for the movie of that name, Hollywood built models of the devices Shaffer had envisioned. As a postdoctoral student in physiology, he began working with premature infants. Throughout gestation, the lungs are filled with the appropriately named fetal lung fluid. Perhaps, he thought, ventilating these babies with a liquid that held a lot of oxygen would offer a gentler, safer way to take these immature lungs over the threshold toward the necessary goal of breathing air. Barotrauma, which is damage done to the lungs by the forced air banging out of the ventilator, would thus be reduced or eliminated.

Today, in Shaffer’s somewhat labyrinthine laboratories in Philadelphia, you can come across a ventilator with pressure settings that seem astoundingly low; this machine is set at pressures that could never force air into stiff newborn lungs. And then there is the long bubbling cylinder where a special fluorocarbon liquid can be passed through oxygen, picking up and absorbing quantities of oxygen molecules. This machine fills the lungs with fluid that flows into the tiny passageways and air sacs of a premature human lung.

Shaffer remembers, not long ago, when many people thought the whole idea was crazy, when his was the only team working on filling human lungs with liquid. Now, liquid ventilation is cited by many neonatologists as the next large step in treating premature infants. In 1989, the first human studies were done, offering liquid ventilation to infants who were not thought to have any chance of survival through conventional therapy. The results were promising, and bigger trials are now under way. A pharmaceutical company has developed a fluorocarbon liquid that has the capacity to carry a great deal of dissolved oxygen and carbon dioxide — every 100 milliliters holds 50 milliliters of oxygen. By putting liquid into the lung, Shaffer and his colleagues argue, the lung sacs can be expanded at a much lower pressure.

”I wouldn’t want to push back the gestational age limit,” Shaffer says. ”I want to eliminate the damage.” He says he believes that this technology may become the standard. By the year 2000, these techniques may be available in large centers. Pressed to speculate about the more distant future, he imagines a premature baby in a liquid-dwelling and a liquid-breathing intermediate stage between womb and air: Immersed in fluid that would eliminate insensible water loss you would need a sophisticated temperature-control unit, a ventilator to take care of the respiratory exchange part, better thermal control and skin care.

The Fetus as Patient

The notion that you could perform surgery on a fetus was pioneered by Michael Harrison at the University of California in San Francisco. Guided by an improved ultrasound technology, it was he who reported, in 1981, that surgical intervention to relieve a urinary tract obstruction in a fetus was possible.

”I was frustrated taking care of newborns,” says N. Scott Adzick, who trained with Harrison and is surgeon in chief at the Children’s Hospital of Philadelphia.

When children are born with malformations, damage is often done to the organ systems before birth; obstructive valves in the urinary system cause fluid to back up and destroy the kidneys, or an opening in the diaphragm allows loops of intestine to move up into the chest and crowd out the lungs. ”It’s like a lot of things in medicine,” Adzick says, ”if you’d only gotten there earlier on, you could have prevented the damage. I felt it might make sense to treat certain life-threatening malformations before birth.”

Adzick and his team see themselves as having two patients, the mother and the fetus. They are fully aware that once the fetus has attained the status of a patient, all kinds of complex dilemmas result. Their job, says Lori Howell, coordinator of Children’s Hospital’s Center for Fetal Diagnosis and Treatment, is to help families make choices in difficult situations. Terminate a pregnancy, sometimes very late? Continue a pregnancy, knowing the fetus will almost certainly die? Continue a pregnancy, expecting a baby who will be born needing very major surgery? Or risk fixing the problem in utero and allow time for normal growth and development?

The first fetal surgery at Children’s Hospital took place seven months ago. Felicia Rodriguez, from West Palm Beach, Fla., was 22 weeks pregnant. Through ultrasound, her fetus had been diagnosed as having a congenital cystic adenomatoid malformation a mass growing in the chest, which would compress the fetal heart, backing up the circulation, killing the fetus and possibly putting the mother into congestive heart failure.

When the fetal circulation started to back up, Rodriguez flew to Philadelphia. The surgeons made a Caesarean-type incision. They performed a hysterotomy by opening the uterus quickly and bloodlessly, and then opened the amniotic sac and brought out the fetus’s arm, exposing the relevant part of the chest. The mass was removed, the fetal chest was closed, the amniotic membranes sealed with absorbable staples and glue, the uterus was closed and the abdomen was sutured. And the pregnancy continued — with special monitoring and continued use of drugs to prevent premature labor. The uterus, no longer anesthetized, is prone to contractions. Rodriguez gave birth at 35 weeks’ gestation, 13 weeks after surgery, only 5 weeks before her due date. During those 13 weeks, the fetal heart pumped normally with no fluid backup, and the fetal lung tissue developed properly. Roberto Rodriguez 3d was born this May, a healthy baby born to a healthy mother.

This is a new and remarkable technology. Children’s Hospital of Philadelphia and the University of California at San Francisco are the only centers that do these operations, and fewer than a hundred have been done. The research fellows, residents working in these labs and training as the next generation of fetal surgeons, convey their enthusiasm for their field and their mentors in everything they say. When you sit with them, it is impossible not to be dazzled by the idea of what they can already do and by what they will be able to do. ”When I dare to dream,” says Theresa Quinn, a fellow at Children’s Hospital, ”I think of intervening before the immune system has time to mature, allowing for advances that could be used in organ transplantation to replacement of genetic deficiencies.”

But What Do We Want?

Eighteen years ago, in-vitro fertilization was tabloid news: test-tube babies! Now IVF is a standard therapy, an insurance wrangle, another medical term instantly understood by most lay people. Enormous advertisements in daily newspapers offer IVF, egg-donation programs, even the newer technique of ICSI intracytoplasmic sperm injection as consumer alternatives. It used to be, for women at least, that genetic and gestational motherhood were one and the same. It is now possible to have your own fertilized egg carried by a surrogate or, much more commonly, to go through a pregnancy carrying an embryo formed from someone else’s egg.

Given the strong desire to be pregnant, which drives many women to request donor eggs and go through biological motherhood without a genetic connection to the fetus, is it really very likely that any significant proportion of women would take advantage of an artificial womb? Could we ever reach a point where the desire to carry your own fetus in your own womb will seem a willful rejection of modern health and hygiene, an affected earth-motherism that flies in the face of common sense — the way I feel about mothers in Cambridge who ostentatiously breast-feed their children until they are 4 years old?

I would argue that God in her wisdom created pregnancy so Moms and babies could develop a relationship before birth, says Alan Fleischman, professor of pediatrics at Albert Einstein College of Medicine in New York, who directed the neonatal program at Montefiore Medical Center for 20 years.

Mary Mahowald, a professor at the MacLean Center for Clinical Medical Ethics at the University of Chicago, and one of her medical students surveyed women about whether they would rather be related to a child gestationally or genetically, if they couldn’t choose both. A slight majority opted for the gestational relationship, caring more about carrying the pregnancy, giving birth and nursing than about the genetic tie. ”Pregnancy is important to women,” Mahowald says. ”Some women might prefer to be done with all this — we hire our surrogates, we hire our maids, we hire our nannies — but I think these things are going to have very limited interest.”

Susan Cooper, a psychologist who counsels people going through infertility workups, isn’t so sure. Yes, she agrees, many of the patients she sees have ”an intense desire to be pregnant but it’s hard to know whether that’s a biological urge or a cultural urge.”

And Arthur L. Caplan, director of the Center for Bioethics at the University of Pennsylvania, takes it a step further. Thirty years from now, he speculates, we will have solved the problem of lung development; neonatology will be capable of saving 15- and 16-week-old fetuses. There will be many genetic tests available, easy to do, predicting the risks of acquiring late-onset diseases, but also predicting aptitudes, behavior traits and aspects of personality. There won’t be an artificial womb available, but there will be lots of prototypes, and women who can’t carry a pregnancy will sign up to use the prototypes in experimental protocols. Caplan also predicts that ”there will be a movement afoot which says all this is unnecessary and unnatural, and that the way to have babies is sex and the random lottery of nature a movement with the appeal of the environmental movement today.” Sixty years down the line, he adds, the total artificial womb will be here. ”It’s technologically inevitable. Demand is hard to predict, but I’ll say significant.”

It all used to happen in the dark — if it happened at all. It occurred well beyond our seeing or our intervening, in the wet, lightless spaces of the female body. So what changes when something as fundamental as human reproduction comes out of the closet, so to speak? Are we, in fact, different if we take hands-on control over this most basic aspect of our biology? Should we change our genetic trajectory and thus our evolutionary path? Eliminate defects or eliminate differences or are they one and the same? Save every fetus, make every baby a wanted baby, help every wanted child to be born healthy — are these the same? What are our goals as a society, what are our goals as a medical profession, what are our goals as individual parents — and where do these goals diverge?

”The future is rosy for bioethicists,” Caplan says. 
Perri Klass’s most recent book is ”Baby Doctor.” She is a pediatrician at Boston Medical Center.

Source: NY Times







49 comments:

  1. Replies
    1. WOW LET'S DISPLAY OUR DISAPPOINTMENT BY TYPING IN CAPS, VERY RAGE, SUCH ANGER.

      Now seriously, women who can't carry children do to a disease or physical limitation now can.

      I don't know if this website is for real or not, but I'm just saying if this is true.

      Delete
    2. If this is true, and no reason why it cannot be true... It does not spell the End of Days, the bringing on of a Singularity where machines take over and eslave humanity, or any other religious wackjob impetus. It is humanity redefining reality. It isn't anything new and something like this can not only help those that cannot conceive children naturally or go to full term childbirth... but it may also one day allow us to see the benefit used to reach other planets for colonization. Our future as a species depends on us getting off of this little blue marble we call earth before the next mass extinction event.

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    3. the only little blue marble here is in your ferkin head you moron!!! i hate you filthy high tech trendies, you think anything should be allowed there are no barriers or moral dilemmas for your sort as you walk hand in hand with darkness.

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    4. COMPLETELY AGREE!!! :'(, this is so wrong.

      If it doesn't work on normal situation than leave it!!!!!!!

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    5. Why is that? Caps lock is showing that you're a dolt and you probably turn to religion for every problem you have.

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    6. James - the simpleton with little moral and ethical depth, willfully ignorant of the greater good, turning to 2k year old moral dogma from the desert to rationalize 21st century scientific discovery. Away with your type! We will not have your witch hunts and cross burnings here in the age of post-enlightenment!

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    7. It seems like the time fro outrage is past. Considering this "news" is almost 20 years old . . .

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    8. Manus J. Huijgen
      November 8, 2013 at 3:57 AM
      COMPLETELY AGREE!!! :'(, this is so wrong.

      If it doesn't work on normal situation than leave it!!!!!!!

      ---------------------------

      lol DAFAQ so like tell this to every person kept alive artificially, and good luck with that. =P

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    9. I agree, we are moving into the world where pregnancy will no longer be necessary. For some this is scary, why I am not sure and I am not sure that those who find it scary even know why they do.

      As a species we always move forward and evolve, that is actually our only purpose.

      Personally I can't wait for this technology to be fully functional.

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    10. Interesting they chose a goat??

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    11. yes,idd. a piece of the puzzle.

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    12. written in 1996 http://www.nytimes.com/1996/09/29/magazine/the-artificial-womb-is-born.html?pagewanted=all&src=pm

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  2. Huxley didn't write Brave New World about evil technology, he wrote about class division and the dangers of allowing a government full power and control. This is a relevant message.

    The article is about a breakthrough which has the potential to provide all humans with the opportunity to reproduce in optimum conditions with lowest risk to life and no irrevocable damage and pain done to the female or the infant. A world where a woman may have a child without having to endure a torn clitoris or a prolapsed uterus? And it's disgusting to consider this work as amazing?

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    1. This comment has been removed by the author.

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  3. "This is wrong" "This is wrong" "This is wrong"

    So is that your only argument? At least add some more detail as to why your wrong opinion is so short.

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  4. "By the year 2000, these techniques may be available in large centers."

    So these newly discovered techniques may be available almost 14 years ago?

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  5. I think in terms of helping those who otherwise unable to have natural birth then this is what they are looking for.

    But it does pose moral questions to if a person should be born from a test tube or not at all or even with life crippling disability from a birth defect, i guess it depends how you view humans as to how you react to science such as this.

    Personally I think its a good thing but only if it is regulated properly.

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  6. This is a wonderful idea, premature babies being saved, women and men who couldn't carry children can now have biological children without the mess of surrogates (men will still need donor eggs) and easier pre-birth operations can be performed without risk to the mother. Keep it up science :D

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    Replies
    1. Yeah! Agree :) This is a major breakthrough, I don' t know what everyone is so scared of.

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  7. as for solving birth complications... there's adoption...

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    Replies
    1. adopted baby's are not the same, you cant have share traits or dna with an adopted baby, the feeling of looking at a kid and knowing its all their own is missing when the kid is not really their own.

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    2. @blipblipblur - That is an absolutely disgusting way to look at adoption. To choose to carry and bring another baby into this already overpopulated world instead of opening your home to one of the many orphaned or abandoned children across the globe--all because of a "feeling" not being the same because it's not "my own"--is a clear sign that the person in question shouldn't be a parent of any kind.

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    3. people can choose to adopt if they wish, it would help make use of space and give a child a real chance to have a good life, but people are allowed to have there own kids, if wanting to nurture and raise your own flesh and blood is an immoral thing then maybe we should all not be parents.

      The disgusting thing is people who have kids knowing that they cant provide and care for them leading to adoption and suffering in overpopulated areas.

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    4. loling @ "people are allowed to have their own kids" haha.

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  8. Why do people have to announce progress with a connection to the nightmares we write for ourselves? We are here, alive today, living in the worlds we have made for ourselves, in healthy bodies protected by modern medicine, in cozy houses made convient and safe by science, typing on the itnternet, talking to people far away on our telephones, because of scientific progress. You are taking advantage of science while berating it. People 200 years ago would envy what is available to us. What we can do is amazing. What we will yet do is more amazing still.

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  9. B- B- BUT THIS IS WRONG

    Muh morals! Muh values!

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  10. This is plagiarized
    http://www.nytimes.com/1996/09/29/magazine/the-artificial-womb-is-born.html

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    Replies
    1. There's a source link at the bottom, silly.

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    2. All of the info copied & pasted from the NYT is from 1996....

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    3. direct copy... i think that's called plagiarism... even with that weak-ass link at the bottom

      Delete
  11. Making humans redundant, doesn't strike me as a great idea for the future of we, humanoids...lol

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  12. This would solve a lot of the controversy with abortions. Now, unwanted pregnancies can be transferred to an artificial womb rather than ended altogether

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  13. Now we just have to figure out how to 3D print these artificial wombs...

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  14. Wrong . our DNA is so weack beacause natural selection is removed... so, this type of sience does NOT help pregnacy or disease treatment, only raise the number of weaknesses and disease that human will experience. See history ...
    For those who agree this sience abomination, just think about that : new child will not know his mother heartbeat .... ( and that is only one problem )

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  15. If you'd actually read the doctor's goals, they don't want to eliminate pregnancy. They are working to save lives, like my daughter, who was born over 5mo premature. If this technology had better funding she might still be with us.

    As an adoptive father, I love my son but having him doesn't bring my daughter back. Anyone who thinks adoption is a way to replace a deceased child should never have kids, adopted or otherwise.

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  17. If this is true it is the most important advance in the history of mankind. Millions of couples who can´t have their children due to diseases etc can now have a light of hope. Premature fetus or some diseases of the fetus will be properly cured.

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  18. Cue the beast, the two witnesses, the horsemen, and Jesus.

    Time for the beast to suffer it's death blow.

    I'm thinking, perhaps there will be no more delay.

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  19. Haha! You women are so miserable! You say its wrong because it would make everything independent from women! Nobody ever would really a wife for anything! And your role would be equal to nothing you fucking cheating evil scumbags!

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    Replies
    1. I hate this selfish pregnancy thing by women. They think that they are irreplaceable and just use men for it but after that they bore the child they just care for it. I puke from women! It was TImE to invent it!

      Delete
  20. Ladies,
    Feel that tingling in your fingers?
    That's your relevance slipping away.

    ReplyDelete
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    ReplyDelete