Last week, the hosts of one my favorite Podcasts introduced an amazing story that might hit home for expecting mothers, or for anyone fascinated by advances in reproductive and childbearing technology.
Reporter Kelley Benham of the Tampa Bay Times chronicled the remarkable story of giving birth to her daughter, Juniper, at just 23 weeks and 6 days. Benham recounts the seemingly impossible technological, moral, and medicinal hurdles that emerged with a vengeance throughout the early stages of Juniper’s life. From conception to delivery and beyond, Benham and her doctors straddled some incredibly trying lines between medicine and that which cannot be explained by science, during the process of childbearing as we know it today. Her story sheds light on advancements in fertility science that make it seem as if we're approaching the era of Brave New World or Gattaca.
Here are four advancements that are about to change childbearing paradigms.
During the radio interview, Benham mentioned the invention of an artificial lung surfactant, which, in its natural state, is a fluid that helps lubricate the walls of a developing fetus lungs and prevents them from collapsing.
In the late 70s, the artificial surfactant was introduced, challenging a precedent set up during Roe v. Wade, where scientists determined that a fetus was viable outside of the womb at 28 weeks. Thanks to the artificial lung surfactant, a fetus could then be considered “viable,” or able to live outside of the mother’s body at week 24, when air sacks form in an embryo’s lungs. Today, however, different hospitals have different weeks at which they consider the medical possibility of fetus viability — it all depends on the medical advancements or precedents of that particular hospital, according to research from the podcast. This is why Benham’s daughter’s birth was so controversial — she had Juniper at 23 weeks and 6 days — one day short of what is considered “viable” by most medical standards.
One of the world’s leading researchers in reproductive endocrinology, Cornell University’s Hung-Ching Liu has made strides towards developing elements of an artificial womb. Adding to the canon of ex vivo research, which began in Italy as far back as 1982, Liu’s team successfully combined epithelial and stromal cells (both cells necessary to develop connective tissue) to cultivate an artificial endometrium, or the inner lining of the uterus, which blooms during pregnancy to form the placenta. In theory, a blastocyst, or the primordial juices that eventually form into an embryo, would be implanted into endometrium, mimicking the natural (or IVF-induced) procedure that occurs after an egg has been fertilized. The artificial endometrium is the first step and the fundamental physical enclosure that would make possible the gestation of an ex vivo fetus.
Scientists at Kyoto University in Japan have developed a way to genetically reprogram skin cells into eggs that produce baby mice. If successfully applied to humans, this could mean that women could have birth later than the prime and suggested age because they wouldn’t necessarily be relying on ovulation to produce eggs. Alternatively, women who are infertile could use this technology to convert their skin cells into viable eggs. Katsuhiko Hayashi, a co-author of the study, however, says that this method is entirely unlikely to be applied to humans. Aside from the ethical barriers, the method is inefficient, and it is not yet clear how biologically close the cells in question are between mice and humans. The same Kyoto University researchers have also worked with cells from male mice to produce sperm.
Since 2009, many women have been turning to a different in vitro procedure than the one we're used to hearing about. In vitro maturation, or IVM, the egg is matured outside of the ovaries instead of inside, as is done with in vitro fertilization (IVF). As the maturation process is done synthetically and outside of the body, women do not need to inject themselves daily with the hormones necessary to encourage egg maturation from within the body, making IVM cheaper and a less intrusive procedure. While advances over the years have increased IVM success rates, it is still statistically less viable at around 32%, compared to IVF at around 40% for pregnancy on the first try.