The New Era of Reproductive Medicine

Reproductive Medicine

Biomedical technology is advancing in leaps and bounds. Two generations ago, electronic fetal monitoring was pure science fiction. As for learning the gender of your fetus, this was just becoming practical and happening only for expecting mothers who needed special tests. Today, however, prenatal monitoring is standard-of-care and fetal gender is something you just find out along the way –unless, of course, you choose to wait for a surprise.

Go back still further in time and the advances are still more striking. In the 19th century, a woman had about 1 in 20 chance of dying from infections or bleeding in connection with childbirth. That was here in the US and it sounds high enough. You wouldn’t board a plane that had 1 in 20 chance of crashing, but mothering up to eight children or more was common in that era. This means that dying eventually of childbirth was nearly typical in those days. Jump to the early 1900s and survival got a little better for mothers, but infant mortality —the percentage of children dying within the first year of life— was still a whipping 15 percent.  A century ago, ‘vaccination’ meant protection only against smallpox. Vaccines for diphtheria, pertussis, measles, polio, and many other infectious diseases were not invented yet, so couples would also have many children on purpose, expecting that some of them would die young.

Preventing and treating diseases that used to kill babies and children in large numbers changed the parenting experience, but what else is coming?  There are many things on the horizon and some may sound science fiction-like, but they could be real for your grandchildren. Here are a couple of examples:

Off-world birth

Colonization of the Moon, Mars, and other destinations is still sci-fi, but technology innovator-entrepreneur Elon Musk has drawn up plans to settle thousands of humans on Mars by mid century. Technology for engines and life support is developing quickly, but reproduction is rather important if humans plan to stay on a new world and we don’t know whether a human embryo will develop normally in a low gravity environment, such as the Martian surface, where you weigh just 38 percent of what you weigh on Earth. But people are gearing up to go anyway and your kids might be among them.

The artificial womb

Current technology enables doctors to remove a fetus from a mother earlier in pregnancy than the usual 40 weeks of gestation and keep the newborn alive. But this becomes really difficult to pull off below 24 weeks or so, mostly because the lungs are not ready. However, new devices that freshen the fetal blood with oxygen and remove carbon dioxide are on the brink of pushing back the limit. The devices are expected to evolve into an artificial placenta over the next several years. This will lead to a situation in which an egg can be fertilized and developed to a healthy infant, completely outside of the mother’s body. Medicine will have developed the artificial womb.

In future posts, I will discuss more about these and other potential reproductive developments, including how they may interact with genetic technologies and inventions outside biomedicine.

David Warmflash
Dr. David Warmflash is a science communicator and physician with a research background in astrobiology and space medicine. He has completed research fellowships at NASA Johnson Space Center, the University of Pennsylvania, and Brandeis University. Since 2002, he has been collaborating with The Planetary Society on experiments helping us to understand the effects of deep space radiation on life forms, and since 2011 has worked nearly full time in medical writing and science journalism. His focus area includes the emergence of new biotechnologies and their impact on biomedicine, public health, and society.

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