The issues of surrogacy and the possibilities of artificial wombs

01 February 2013

In 1924, evolutionary biologist JBS Haldane coined the term ectogenesis to describe how pregnancy in humans could be provided through an artificial womb. In a fictional account, he had two future scientists describe the birth of the world’s first ectogenic child. “Now that the technique is fully developed, we can take an ovary from a woman, and keep it growing in a suitable fluid for as long as twenty years,” one of the characters announced. This, by the character’s calculations, would result in “a fresh ovum each month, of which 90 percent can be fertilized, and the embryos grown successfully for nine months”, at which point they could be “brought out into the air”. Haldane imagined that artificial wombs might become so popular by 2074 that only a small minority, “less than 30 percent of children”, would then “be born of woman”.

With 62 years to go until Haldane’s sci-fi scenario, many researchers in the field are now confident that, despite the inherent complications and difficulties, the technological perfection of an artificial womb is actually achievable. The French biologist Henri Atlan predicts that, within a hundred years, science will master the complete development of the human foetus from conception. In the meantime, Carlo Bulletti, a professor of reproductive biotechnology at the University of Bologna, says that partial ectogenesis—growing foetuses between 14 and 35 weeks of pregnancy—is already within our reach if we were to use all of the knowledge and technology at our disposal.

An artificial womb that can sustain and continue the development of extremely young foetuses could completely reinvent the parameters of neonatal medicine, but regardless of such gains, a fully functional artificial womb will also present entirely new ethical dilemmas, including some we may not be ready to negotiate.

What if a foetus that would otherwise have been aborted could be removed from its mother’s body and gestated artificially? Would that improve the chances of adoption for a child, given that many couples prefer to adopt a baby rather than an older child? Would aborted pregnancies be viewed as a prospective joyful miracle in the tradition of the first test-tube babies, or would they be seen as supplanting the placement of older children needing a home?

How will this new technology alter the identity of a mother, a role that would cease to trigger a biological bond, even if her own egg is used? For instance, there has been a great deal of research into the hormones oxytocin and arginine vasopressin. In mammals, the levels of these hormones are elevated in mothers’ brains. Oxytocin levels also increase during labour and reach a peak at the time of delivery. Both oxytocin and vasopressin have been linked to the instinct towards maternal care and mother-child and other affectionate, family bonding. The hormones have even been seen to rise when mothers engage in other supportive and bonding behaviours, long after pregnancy, though it is not known how and why this occurs. If a mother did not experience the increase in hormones related to pregnancy, would it make a difference later in life? Would it be possible to give a mother a dose of the hormones in place of this natural release? It is apparent, from the experiences of many adoptive mothers, that a mother-child bond forms even in the absence of pregnancy, but it may be that those who choose to adopt happen also to have a strong instinct for maternal care.

Keywords: evolution biology surrogacy donor