Ectogenesis

Tube Be or Not Tube Be?

Olivia Echerd
GN 301: Genetics in Human Affairs
Section: 10:15

April 17, 2002

I have neither given nor received unauthorized aid on this assignment: _________________________

Part A:

Genetic engineering is the process of altering or adding specific genes to the genetic material present in an embryo to allow that embryo to have certain characteristics that it wouldn't have had otherwise (Silver, 1997). One way this is accomplished is with In Vitro Fertilization, abbreviated IVF. IVF is fertilization outside of the body in a laboratory (CancerWeb). Because the sperm and egg unite outside of the body, it allows scientists to alter the zygote and then implant it into the uterus. However, something that may happen in the near future is that not just the zygote will be outside the body. A scary possibility is that ectogenesis may occur. Ectogenesis is the development of an embryo or embryonic tissue in vitro or within an artificial environment (CancerWeb). Therefore, the term 'test tube' babies may indeed become a reality. The novel Brave New World, written by Aldous Huxley in 1932, suggests a hypothetical scenario of this:

"Drop by drop onto the specially warmed slides of the microscopes; how the eggs which it contained were inspected for abnormalities, counted and transferred to a porous receptacle; how this receptacle was immersed in a warm bouillon containing free-swimming spermatozoa-at a minimum concentration of one hundred thousand per cubic centimeter; and how, after ten minutes, the container was lifted out of the liquor and its contents reexamined; how, if any of the eggs remained unfertilized, it was again immersed, and, if necessary, yet again; how the fertilized ova went back to the incubators...one by one the eggs were transferred from their test tubes to the larger containers; deftly the peritoneal lining was slit, the morula dropped into place, the saline solution poured in" (Huxley 5).

This of course is fiction, but it was written in 1932 when the mere thought of such a thing scared everyone. Now, this isn't so far-fetched. In vitro fertilization today hasn't reached this 'factory' level but it might someday. Right now, there are several types of IVF. IVF itself is just the uniting of an egg and sperm in the lab and then it is implanted into the uterus through the cervix (Awadalla). The first baby born through IVF was

Louise Joy Brown on July 25, 1978 in Oldham, England (Silver 1997). The next type of in vitro is GIFT or gamete intrafallopian transfer. This is the mixing of egg and sperm outside the body and immediately implanting it in the fallopian tubes for fertilization (CancerWeb). And the last type is ZIFT, zygote intrafallopian transfer, which is in vitro fertilization with a transfer of the zygote into the fallopian tube (CancerWeb). It is a combination of in vitro fertilization and gamete intra-fallopian transfer. It is rather complex therefore it is not used as often (Awadalla).
There are several steps in IVF. First, the ovaries are shut down. This is done with a medication known as a GnRH agonist (Genetics, 2002). The most common drug used is Lupron. Then the ovaries are stimulated. When the eggs are ready for harvesting, they are retrieved in a process called ultrasound guided vaginal retrieval (Awadalla). A doctor uses a thin needle and passes a short distance into the ovaries and the eggs are suctioned from the follicles. Typically 5-15 eggs are collected. One scientists says, "The aim is not to clone but to provide more eggs...our dream is to ripen some of the thousands of eggs in a young woman's ovaries, most of which normally go to waste" (Gosden, 1999). On average a woman has 500,000 to 750,000 eggs but only about 500 of those are released (McKenzie, 10). A technique to accelerate ripening is called the Podsnap Technique. It has been attempted several times but they have been unsuccessful (Gosden, 1999). One of the last stages of IVF is that the eggs are fertilized by adding approximately 100,000 motile sperm to each egg. In some cases, the sperm will not fertilize the eggs naturally so intracytoplasmic sperm injection (ICSI) is performed (Awadalla). This procedure involves puncturing the egg directly under a microscope and injecting one sperm in the egg.

Another technique mentioned in Brave New World is the use of a nutrient rich broth to feed the growing cells in an outside environment. The novel speaks of a "rich blood surrogate" and "corpus luteum extract" (Huxley, 12). Henry Leese did an experiment using such a concept. He gave cells a nutrient broth to see which cells ate the most. He expected the strongest embryos to have the largest appetites. However, he discovered that the weakest embryo did seem to eat the least amount but that not all genes reveal themselves that early in development so he couldn't really pick the strongest embryo overall (Gosden, 1999). So this technique wasn't beneficial to IVF researchers.

However, techniques for ectogenesis are still in the making. At a conference in Tulsa, OK in February 2002 two new procedures were discussed. According to Oklahoma State University professor Scott Gelfand, "the first procedure would involve filling a square tank full of artificial amniotic fluid. A fetus would be placed in the tank, connected to tubes that would act like a placenta" (Smith, 2002). He also describes the second possible procedure saying "cells would be extracted from the mother's womb, allowing them to grow into a web-like material" (Smith, 2002). The interesting thing is that the second version was actually completed at Cornell University, but they had to terminate the embryo after a few days (Smith, 2002). In early February of this year an announcement came that researchers at Cornell University's Center for Reproductive Medicine and Infertility created a simple artificial womb in which in-vitro fertilized embryos could attach (Butler, 2002). The lining was created from actual endometrium cells. These cells were grown on a type of frame made in the shape of the uterus (Butler, 2002). The frame is biodegradable and once it dissolves, nutrients and hormones were added. Embryos placed inside can then attach themselves to the

endometrium as in a real internal pregnancy (Butler, 2002). So you see that with the rapid advancement in technology today there is a possibility of completely external pregnancies in the near future.

Part B:

Ectogenesis is not so far fetched as some may lead you to believe. It has actually been tried before. Denis New and Robert Edwards at Cambridge Laboratories began working on growing rat fetuses in a test tube in the 1970's. They gave the fetuses a nutrient broth, and they grew normally until they reached the halfway mark and then growth ceased (Gosden, 1999). If you really think about what it means for an embryo to develop inside of a bottle as compared to in the womb, there are some advantages. First and foremost, the baby is safe in the bottle. This would keep the baby from being harmed through pure ignorance or carelessness of the parents. Also, in a test tube environment, proper sterilization can be used to ensure pathogenic bacteria or viruses aren't passed to the fetus (Deneen, 2001). Gaining access to the fetus would make performing blood tests, injecting drugs, and administering hormones easier because there is direct contact to the fetus. Yet, perhaps the largest advantage to man though is that the fetus could be monitored like never before. Ectogenesis would provide a great opportunity to increase our knowledge about development and what is considered one of nature's last great secrets (Gosden, 1999). As Roger Gosden puts it, "the womb is no longer a secret place" (1999). A benefit of ectogenesis to women is that the anxiety about the timing of labor and premature birth would be a thing of the past. Doctors would decide the time of the delivery when they felt the baby was at its ideal weight and had reached maturity with respect to organ development such as the heart and lungs (Deneen, 2001).

However, as great as this sounds, there are still many concerns with ectogenesis. If this were to happen, many feel that woman would gain the power to completely control reproduction. Right now, men are still needed to contribute their sperm, however with the advancements in cloning, they might not be needed at all (Silver, 1997). Others say that it would give the mother and father a more equal role in parenting a child. Without the baby growing inside the mother, she would have less of a connection and then the father could witness the grown of the baby and in a sense become more connected (Gosden, 1999).

Other concerns with IVF and ectogenesis are that they are compared to eugenics, which is improving the human race through scientifically breeding humans (Masci, 2001). There is a technology already available to patients undergoing IVF to select the sex of their embryos (Gosden, 1999). Some feel that gender selection violates male-female equality and should therefore be banned (McCuen, 1990). What is really scary is the seeking of the "perfect child." It is thought by some that soon scientists will be able to identify genes that control aspects of intelligence in any embryo (McCuen, 1990). It is pointed out that intelligence is "the distinguishing and perhaps most desired feature of our species" (Gosden, 1999). While many people think that they can make their children intelligent upon genetic alterations, Dr. Marvin Frazier, the Director of Life Sciences at the US Department of Energy, points out that it depends a significant degree on nurture instead of nature (Deneen, 2001). While seeking the perfect child, why stop at perfecting intelligence? In today's society, a beautiful baby is thought to be a reflection of its parent's qualities and so why not change the physical appearance of the fetuses too? (Gosden, 1999). Lee M. Silver, a Princeton University

microbiologists, says "a few centuries from now there will be two species of humans-the standard-issue 'Naturals' and the 'gene enriched' elite class whose parents consciously bought them designer genes" (Deneen, 2001). Our quest in making 'designer babies' is often paralleled to Nazi Germany's quest for elimination of the Jewish race (Masci, 2001). For that reason, along with others, many people are against the idea of altering genes for aesthetic benefits. Dr. Frazier says "to change a baby's eye color or hair color within a fertilized egg would be a very expensive and a dangerous proposition for such trivial purposes" (Deneen 2001). That's why many people feel alterations such as intelligence, athletic ability, sex, and cosmetic changes are wrong. One ethicist acknowledges, "We all want our kids to be happy, but if we make them smarter, does it necessarily translate into more happiness? Children with Down's syndrome are happy, and many very smart people aren't" (Masci, 2001). This reminds me of when Rachel Gillen came to talk to our class. She was a very happy child, and you could tell her parents loved her immensely. What would Rachel have been like if they had genetically altered her genetic code to remove the extra chromosome? Would she still have the loving personality she has now? Why risk happiness for the possibility of perfection? It's just not worth it in my opinion.

A major concern with ectogenesis is the fear that genetic engineering will get into the wrong hands. In Brave New World, the government used technology to control the people and actually formed caste systems by giving less oxygen to some embryos so that they would be less intelligent (Huxley, 1932). In the novel it happens like this, "we predestine and condition...the surrogate goes round slower; therefore passes through the lungs at longer intervals; therefore gives the embryo less oxygen. Nothing like oxygen-shortage for keeping an embryo below par"

(Huxley, 1932). While this example is extreme, something similar may be lurking in our future. Some say, "to whom, in this new era, would we entrust the authority to decide what is a good gene that should be added to the gene pool and what is a bad gene that should be eliminated?" (Rifkin, 1998). Gregory Pence, a professor of bioethics at the University of Alabama, says "we can trust people to make the best decisions for themselves and their children, just like they do now" (Masci, 2001). He also feels confident that this technology will be used by educated parents, not bureaucrats or doctors who want control (Masci, 2001). However, Jeremy Rifkin urges, "today, the ultimate power is within our grasp, the ability to control, at the most fundamental level, the future lives of unborn generations by engineering their biological life processes in advance, making them partial hostages of their own architecturally designed blueprints" (1998). This quote absolutely blows my mind. To think that our generation can completely control the destiny of future generations by what we do with technology and the alteration of genes is unfathomable. Pence continues to argue that concerns similar to this were voiced when IVF was first mentioned. He says that there was a fear the babies would be regarded as products and people were wrong then, and are wrong now (Masci, 2001). Maybe so, however, people feel that genetically engineering humans should be banned because it is "playing God." On the opposite end of the spectrum is James Watson, former head of the Genome Project. He interjects, "If scientists don't play God, who will?" (Deneen, 2001). One embryologist states that in the IVF clinic they try to choose two or three of the best embryos to implant. He says we pick the best apples from a bin, so why not the best embryos? (Gosden, 1999). This leads Leon Kass, a bioethics professor at the University of Chicago to his point. He emphasizes, "It is presumptuous for us to say that we are

wise enough to know what an improvement of the human species is" (Masci, 2001). Adding or deleting a gene could cause a rippling effect that might end up hurting us instead of helping us (Masci, 2001). Therefore, you can see that this is an issue with a lot more research needed before a decision can be made. Indeed, it is argued both ways; however, I'm sure the battle will only get more heated in the coming years as ectogenesis becomes more of a reality.

In all of the research I have done on IVF, ectogenesis, and genetic engineering, I still feel strongly against altering genes for our benefits. I think that God has things happen for a reason; therefore, if I have the gene for breast cancer, I'm going to deal with it. I do think it is great to be tested so that you can increase your awareness, however I would never have something like the breast cancer gene removed. Likewise, if I got pregnant, I wouldn't have genetic tests done because I would love my child no matter if it is a Down's baby or has spina bifida. Call me old-fashioned, but I just don't think it's morally right for us to alter what God has given us. Yet, through all of this, the advances in genetics excite me. I just believe that we need to be careful how we use them. Leon Kass best sums this up by saying, "We stand today fully on the threshold of that gateway. How far and how fast we travel through this entrance is not a matter of chance or necessity but rather a matter of human decision-our human decision" (1992). We can decide how far we let genetics go. I really hope we don't abuse science and cross the ethical and moral lines that science is so closely associated with. Could all of these advances be a Pandora's Box? Some feel it is and that box is already open (Deneen, 2001). I don't think it has gotten quite to that point, but if we aren't careful, it certainly might be.

Bibliography

Part A:

Awadalla, Sherif. "In Vitro Fertilization." Cincinnati Institute for Reproductive Health.

Available: www.fertilitynetwork.com/articles/articles-ivf.htm

Butler, Craig A. "Ectogenesis Solution to Abortion." Daily Lobo Newspaper.

University of New Mexico. 20 February 2002.

Available: www.uwire.com/content/topops022002002.html.

"CancerWeb: The Online Medical Dictionary." Available: http://cancerweb.ncl.ac.uk.

Gosden, Roger. Designing Babies: The Brave New World of Reproductive Technology.

New York: W. H. Freeman and Company, 1999.

Huxley, Aldous. Brave New World. New York: Perennial Classics, 1932.

"In Vitro Fertilization Program." Genetics and IVF Institute. 2002.

Available: www.givf.com/ivf.cfm.

McKenzie, Wendell. Genetics in Human Affairs. Dubuque, Iowa: Kendall/Hunt

Publishing Company, 2001.

Silver, Lee M. Remaking Eden: Cloning and Beyond in a Brave New World.

New York: Avon Books, 1997.

Smith, Melissa. "Artificial Womb Sparks Ethical Debate on Campus." 14 February

2002. Available: www.ocally.com/issues/2002Spring/021402/debatewomb.html.

Part B:

Deneen, Sally. "Designer People." E Magazine: The Environmental Magazine.

Jan/Feb 2001. Volume 12. Issue 1.

Gosden, Roger. Designing Babies: The Brave New World of Reproductive Technology.

New York: W. H. Freeman and Company, 1999.

Huxley, Aldous. Brave New World. New York: Perennial Classics, 1932.

Kass, Leon. "Meaning of Life-In the Laboratory." The Ethics of Reproductive

Technology. Ed. Kenneth D. Alpern. New York: Oxford University Press, 1992.

Masci, David. "Designer Humans." CQ Magazine. 18 May 2001. Vol. 11 Issue 19.

McCuen, Gary E. Hi-Tech Babies: Alternative Reproductive Technologies. Hudson,

Wisconsin: Gary E. McCuen Publications Inc., 1990.

Rifkin, Jeremy. The Biotech Century: Harnessing the Gene and Remaking the World.

New York: Penguin Putnam Inc, 1998.

Silver, Lee M. Remaking Eden: Cloning and Beyond in a Brave New World.

New York: Avon Books, 1997.