From the creation of the 1st wheel to the invention of the automobile as a whole; from studying evolution to accidentally discovering penicillin; from designing the 1st microscope to solving the most prized question of biology, the DNA; science has come far ahead contributing to the betterment of humans.
But, can you imagine, recently a team led by a surgeon named Alan Flake at Philadelphia designed an artificial womb system to sustain premature babies. They named it “Biobag” and published their findings in their research paper released by Nature Communications in April 2017. It focused on the successful use of artificial womb for sustaining fetal lambs.
Within 100 years, artificial reproductive technology would master the in vitro development of the human fetus. –Henri Atlan in the book L’Uterus Artificiel
Being the center of the discussion for many, surely this concept was successful enough to catch some worldwide attention. So without jumping to any conclusion lets first try to understand the current scenario, its different aspects and reality.
The very first attempt of supporting the human embryos outside the human body was conducted in Italy, in 1982 and was continued in New York City’s Mount Sinai Hospital in 1983. The first results were published in 1986. Due to several ethical issues and strong opposition of political community, the experiment in Italy was stopped.
Currently, with the advancement of Neonatal Intensive Care (NIC), the survival rate of babies with preterm birth at or before 28 weeks has significantly improved. Now, the infant incubators have also sustained preterm born as early as 21 weeks and 6 days, however, the survival rate is too low. Those who survive often develop complications causing severe disability or death. It is estimated that 50% of neonates born at 26 weeks have severe long-term impairments, whereas, the risk increases to 75% for those who are born at 23 weeks.
The major issues were underdeveloped lungs, respiratory problems, circulatory problems resulting in low blood pressure and problem in swallowing or sucking. Nevertheless, these issues can be managed by providing oxygen, mechanical ventilation, external pumps for circulation and nasogastric feeding but all of these carry several risks and limitations. This is why experts believe that all the possibilities of NIC have been exhausted and possible alternatives should be developed which can mimic the uterine environment effectively.
The Biobag Concept
This experiment was conducted by Alan Flake, a surgeon at The Children’s Hospital of Philadelphia, and his team. In simple terms, it is a zip lock bag type system which is filled with fluid and blood to support the growth of fetal lamb mimicking the womb of their mothers. The team used 8 premature lamb fetuses equivalent to human’s preterm babies of around 24 weeks and grew it for the incubation period of 4 weeks. Along with the lamb, sealed bag consisted of a ‘pump-less oxygenator circuit’ and umbilical cord access.
The Biobag lambs performed very well, even better than sheep grown the old fashioned way. – A. Flake
Its sealed system helped in minimizing the risk of infection and there was the regular exchange of amniotic fluid with all necessary water and nutrients required for the fetus. Circulation for the fetuses was maintained by the oxygenator working with subject’s heart to maintain the sufficient oxygen and blood pressure. After the incubation period, all the fetuses were delivered and survived without the risk of underdeveloped lungs, circulatory problems and infection.
Although it is not tested on humans, various assumptions are made by the experts from the experiment conducted on lambs. Both NIC and Biobag support underdeveloped babies, however, Biobag provides more comprehensive supports. It doesn’t rely on artificial ventilation system avoiding several risks and complications.
Biobag has the capabilities to completely replace the human womb providing better care then NIC. Some experts argue that NIC is not helpful in rescuing extremely premature infants, while Biobag has the potential to save an extremely premature infant.
Another very important factor is the environment. In conventional NIC, human interaction with the infant is very much possible, whereas, Biobag’s environment is similar to the mother’s womb making it less stressful for the development of the infants. Apart from all these, it is indeed a unique method whose outcomes on human trials are unknown but for sure, it will be different than the conventional NIC methods.
Future of Biobag
Various repeated studies, refinement and safety validations are required for the Biobag before anticipating its clinical use. In spite of its use on lamb, there is a high possibility that its testing on human subjects is just a few years away. Researchers believe that they are already seeing its clinical application if animal testing continues to yield positive results.
Once Biobag results ensure the consistent and healthy survival of the infants, then there might be an immediate call from practitioners and parents to aid the preterm births and to avoid the complications. It will be a better alternative for those women to whom there is the risk from their pregnancy and still they don’t want an abortion.
There is also the possibility that after its success, some women might opt it to avoid certain pregnancies related symptoms like morning sickness and others. Additionally, it might also provide an alternative option to women for pregnancy without risking the loss of their reproduction.
Despite having so many benefits over NIC, especially for extreme preterm births, it can also lead to several ethical issues, controversies, doubts and debates among many. For some people, it will be the ray of hope for their preterm born babies and pregnancy risks but for many, it will also raise numerous questions. Questions like, Could artificial wombs seriously be a reality for humans? If yes, then how far we will take this concept? What would be the role of a mother in the development process? Would you agree to grow your baby in an artificial womb? Or the most important one, Are we ready for artificial womb?? Whatever happens in the near future, one thing is sure that our society will be significantly changed as it is changing since the very beginning.
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