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Birthing an ethical dilemma

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Researchers in Israel recently took a significant leap from science fiction to reality in developing mice in a lab-based artificial uterus. Scientists removed the embryos from a mom mouse early in pregnancy and grew them in the lab in glass bottles. Amazingly, they were able to keep the embryos alive through the first half of "pregnancy," watching as the tiny organs and limbs developed.

One goal of this research is to answer questions about how a fertilized egg develops into specialized cells, tissues, organs, and ultimately, a whole animal.

This is a medical marvel to be celebrated, along the lines of the development of COVID-19 vaccines amid a pandemic.

Research like this can help us better understand why many pregnancies fail to implant in the uterus and discover new clues about how poor maternal nutrition may affect fetal development. By experimenting on how baby mice develop in a transparent "uterus," we finally have the lens to see how alcohol, drugs, or heavy metals affect fetal development. This research can hold the keys to many important and unanswered questions and could lead to improved methods of caring for premature babies.

But this scientific advance also raises serious ethical concerns. While this work has started with mouse embryos, human embryos could be next — putting into question the role of women, surrogacy and fundamental human rights. This research may also lead to using stem cells to develop embryos without humans (in the absence of sperm and eggs). By taking a person’s stem cell to develop an embryo, we wouldn’t need women.

While we have seen women born without uteri or those who have had hysterectomies go on to carry and deliver a baby via uterine transplants, the development of artificial uteri, and ultimately babies, is something very different.

When we combine creating life-forms in a mechanical womb with advancements like gene editing (CRISPR), the idea of designer babies takes on a whole new meaning.

As a scientist, I understand and value the need to explore and discover some of life’s biggest mysteries. We are taught to question everything and not to easily give up our search for the truth. But we need to consider the ethical, legal and safety issues and develop guidelines for reproductive biotechnology research.

If research like this continues unharnessed, we could face results of rogue science similar to the gene-edited CRISPR babies born in China in 2018. An international panel of scientists, doctors, ethicists, lawyers, parents and aspiring parents must be part of the dialogue to keep research like this on track. We need ethical and safety guardrails to help scientists understand all the implications of their work intended to improve the health and well-being of humankind.

While we should all applaud scientific advancements, this is an excellent time to take a step back and reassess what makes us human. There is a fine balance between pushing our minds' limits, questioning our surroundings, and what makes us, us. But while asking those questions, we need to ensure human rights are protected and our science is used as a tool for good.

Christine Metz is a professor focusing on women’s health at the Feinstein Institutes for Medical Research in Manhasset.