A few days ago, the topic of “male pregnancy becoming a reality” hit the hot search on Weibo and stayed at the top for a long time. What? Artificial uterus is almost a reality? Can women really be spared from childbirth?
Image Source: Weibo screenshot
However, upon closer examination of the specific research, it will be disappointing to find that this topic is purely sensational. The research project is indeed impressive, but the idea of “mechanical artificial uterus without the need for a mother’s body” is still far from being realized as believed!
What is the “artificial uterus” at Zhengzhou University First Affiliated Hospital?
We all know that the vast majority of the process of developing a healthy baby from a fertilized egg is completed within the uterus, but how does the uterus support the development of the embryo into a large baby?
After the embryo is implanted, some cells differentiate into the placenta, closely adhering to the functional layer of the uterus lining, exchanging blood with the spiral arteries in the lining. The placenta eventually resembles a palm-sized lotus leaf, with the stem of the lotus leaf being the umbilical cord, connecting to the baby’s belly button.
The umbilical cord has two umbilical arteries and one umbilical vein. During the fetus’s development, its own blood flows to the placenta through the two umbilical arteries, branching in this “lotus leaf,” and finally exchanging blood with the mother’s uterine lining at the contact surface between the placenta and the lining, carrying the baby’s metabolic waste into the mother’s blood for disposal.
At this point, through respiration and the intake of oxygen, glucose, and various nutrients, the mother’s bloodstream is also transferred to the placental blood of the baby through the umbilical vein, supporting the baby’s growth and development.
Image source: Copyrighted image from the picture library, reprinting may involve copyright disputes
According to the news content, the team at Zhengzhou University First Affiliated Hospital removed premature fetal lambs and created a “premature lamb.” After being “delivered prematurely,” the baby lost the placenta responsible for substance exchange. To simulate the intrauterine environment and allow the lamb to continue to develop as much as possible in a way similar to inside the mother’s body, the team at Zhengzhou University First Affiliated Hospital created an artificial uterus, placing the lamb in artificial amniotic fluid, and connecting the blood vessels of the umbilical cord to the mother sheep’s blood vessels, allowing the mother sheep to continue supplying blood to the lamb through the umbilical cord, thereby sustaining the growth and development of the baby.
Ultimately, the fetal lambs survived for 90 minutes, indicating that the idea of supporting fetal lamb development using a mother sheep might have certain possibilities that are worth further exploration.
The concept of “artificial uterus” is not new
As early as 2017, a subjournal of Nature published a successful “artificial uterus” experiment conducted at the Children’s Hospital of Philadelphia in the United States.
Image source: Reference [1]
The basic idea of this experiment is to place premature fetal lamb babies into a support system that simulates the intrauterine environment, using a bag made of special biological materials to mimic the amniotic sac, with artificial amniotic fluid inside, maintaining a constant temperature. The umbilical cord blood vessels connecting the lamb baby were constructed to form a new circulatory system for gas exchange and nutrient supply.
After multiple attempts and improvements by the research team, technical challenges such as fetal infection, mismatches in blood vessel pressure, and umbilical vessel spasms were overcome. Eventually, baby lambs equivalent in size to 23-24 weeks of human gestation survived for 670 hours (approximately 28 days) outside the mother’s womb, equivalent to a month of pregnancy. With the successful precedent of this study, several countries worldwide have followed suit, attempting to research and develop similar extracorporeal support systems.
Both the Children’s Hospital of Philadelphia and Zhengzhou University First Affiliated Hospital teams chose lamb babies as experimental subjects not by coincidence. The development process of lamb fetal lungs is very similar to humans. If this experiment progresses smoothly, this technology may have promising applications for premature human babies in the future.
Last September, six years after the publication of the article in the Nature sub-journal, the U.S. Food and Drug Administration (FDA) finally convened an independent advisory meeting to discuss whether the first global “artificial uterus” technology for human clinical trials should be approved from legal, ethical, medical feasibility, and long-term health risk perspectives. If successful, the first human clinical trial may be conducted this year.
Rescuing premature infants will be the primary use of the “artificial uterus”
By now, you may have noticed that whether it is the attempt at Zhengzhou University First Affiliated Hospital or the research project at Children’s Hospital of Philadelphia, the expectation for artificial uterus is merely to allow accidentally premature babies to continue developing for a period of time in an environment close to the womb’s, rather than starting from scratch to gestate a fetus.
Therefore, the current technology is still far from the vision of industrialized assembly line production of babies and providing women with the opportunity to be relieved from childbirth labor.
Image source: Copyrighted image from the picture library, reprinting may involve copyright disputes
However, this experimental approach is still remarkable and holds important prospects for clinical applications.
The amniotic environment and maternal support are important conditions for the development and maturity of multiple systems in the fetus. When extremely premature babies are born, despite efforts to provide care and support therapy in neonatal intensive care units, existing support systems still cannot compare to the mother’s physiological environment, and these extremely premature babies still face high mortality rates and long-term complication risks.
Over the years, many medical teams have been dedicated to the development of artificial placentas, with little success. The success of the artificial uterus in animal experiments has brought hope for rescuing premature infants. If extremely premature babies can continue to develop for a period of time in an environment similar to the mother’s, the risks of complications and mortality rates will significantly decrease.
If this technology can be successfully tested in humans in the future and gradually mature, it will bring revolutionary changes for unavoidable premature multiple pregnancies, patients with cervical insufficiency, pregnant women unable to continue due to illness, and fetuses requiring intrauterine surgery. Pregnant women may no longer have to make difficult choices between treatment and maintaining the pregnancy.
Therefore, although the “artificial uterus” currently cannot replace humans in completing the entire reproductive process, its technological advancement is still worthy of our earnest anticipation.
Author: Ke Chen, Doctor
Review: Deputy Chief Physician Lan Yibing, Department of Obstetrics and Gynecology, Affiliated Hospital of Zhejiang University School of Medicine
Planning: Fu Sijia
Editor: Fu Sijia
Proofreader: Xu Lai, Lin Lin
