- Artificial intelligence is analysing embryos and assessing sperm quality
- In the future, we will be making babies from skin cells
- Pod babies: will fetuses soon gestate outside of the human body?
- Ethical considerations and final thoughts
Pregnancy and childbirth have always been profound and transformative experiences, shaping the course of human existence. However, the landscape of reproductive technology is rapidly evolving, presenting innovative possibilities that once existed only in the realm of science fiction. From the integration of artificial intelligence (AI) in IVF treatment to the tantalising prospects of creating babies from skin cells, the future of pregnancy and childbirth seems poised to revolutionise the very essence of human reproduction. The integration of AI in IVF treatment has ushered in a new era of assisted reproductive technology. AI-powered fertility tools offer personalised insights and optimise embryo selection, which increases the chances of successful pregnancies and reduces the emotional, physical, and financial burden for hopeful parents. Scientists involved in stem cell research have successfully reprogrammed adult skin cells that can be coaxed into developing into any cell type, including eggs and sperm, opening up a realm of opportunities. Another astonishing advancement is the ‘baby pod’ or biobag — innovative technology that mimics the environment of the womb and supports the development of premature infants. Without further ado, let’s delve into the future of human reproduction.
“There simply won’t be enough skilled embryologists to address this rising demand”.
Dr Gerard Letterie, Seattle Reproductive Medicine
Artificial intelligence is analysing embryos and assessing sperm quality
The journey of in vitro fertilisation (IVF) — a process that’s been successfully helping couples with fertility and conception since the 1970s — consists of several sequential stages. Firstly, the clinician thoroughly evaluates the underlying causes of infertility. Then, the process progresses to the stimulation phase, where the doctor carefully determines the optimal ovarian stimulation protocol. Following this, eggs and sperm are collected and used to facilitate the fertilisation of eggs, ultimately resulting in the formation of embryos. These embryos are then diligently cultured within the clinic environment. Once this stage is complete, the embryos are transferred to the mother’s womb, and after several months, a live birth occurs. As IVF outcomes heavily depend on decisions made by experienced embryologists during the clinical process and to address the acute challenge of embryo analysis, more and more embryologists are turning to AI. “There simply won’t be enough skilled embryologists to address this rising demand”, says reproductive endocrinologist and partner at Seattle Reproductive Medicine, Dr Gerard Letterie. Various startups, such as Fairtility and ALife, have now come up with AI-based fertility solutions to analyse embryos, assess sperm quality, and personalise IVF treatment plans.
CHLOE, the innovative tool developed by Fairtility, operates as a cloud-based system and serves as a decision-support tool for the AI-driven selection of embryos. The tool seamlessly integrates with time-lapse imaging (TLI) systems to offer continuous predictions throughout the different stages of embryo development — from fertilisation to the blastocyst stage. By utilising TLI images, CHLOE automatically identifies, segments, and conducts pixel-level analysis of embryos. Moreover, CHLOE’s AI model plays a crucial role in accurately quantifying various attributes like shape, area, size, symmetry, and proportion — tasks that are beyond the capabilities of human experts. This infusion of precise information, combined with implantation probability, empowers embryologists to make data-driven decisions for each embryo that is cultured in the time-lapse imaging device. According to research presented at the ESHRE conference, CHLOE’s algorithms exhibit impressive predictive capabilities. They achieve 96 per cent accuracy in blastulation prediction, 71 per cent accuracy in implantation prediction, and 69 per cent accuracy in determining the genetic health of embryos. These results significantly enhance embryologists’ ability to assess embryo viability, surpassing the current prediction rate of approximately 65 per cent. CHLOE’s AI tool also assists embryologists in detecting anomalies that may otherwise go unnoticed, such as pronucleate abnormalities, severe fragmentation, or irregular cleavage patterns. Consequently, CHLOE substantially increases the chances of selecting healthy embryos, ultimately optimising the outcome of assisted reproductive technologies.
The startup ALife also makes use of AI to streamline the clinic workflow and provide patients with a more personalised experience. The firm recently released AI software to help fertility clinics to optimise and support decision making during the IVF process. ALife’s AI software operates through its suite of products called Alife Assist, which offers data-driven insights for embryologists, clinicians, and clinic managers. This platform consists of three products, all of which are supported by collaborations with leading clinics and scientific research. One of these products, Stim Assist, makes use of AI-powered clinical decision-support tools to assist reproductive endocrinologists in selecting the best possible medication dosages and determining the right timing for maximising the retrieval of eggs. By analysing a vast and diverse IVF dataset with millions of data points from previous patient cycles, these tools are able to provide insights into the most effective treatments for similar patients. The company’s Embryo Assist tool enables embryologists to digitally capture, grade, organise, and report embryo grading data and has a real-time connection with electronic medical records. By reducing patient visits and minimising testing costs, AI-powered fertility technology increases accessibility to fertility care. It enables personalised fertility treatment, leveraging genomics advancements to enhance reproductive risk factor screening, facilitate truly personalised medicine, and improve the selection of healthy embryos.
“In 20 to 40 years, people will still have sex. But when they want to make babies, they’ll go to a lab”.
Henry T. Greely, Stanford University
In the future, we will be making babies from skin cells
Stanford University Professor Henry T. Greely predicts that in 20 to 40 years, we will still have sex, but babies will be made in a lab. It’s strange to think that this might be the future of human reproduction, but ‘designer babies’ are much closer than we realise. In in vitro gametogenesis (IVG) — a new reproductive process that’s still being researched and developed, not to be confused with in vitro fertilisation (IVF) — sperm and egg cells are created in a lab. Adult skin or blood cells are used to reverse engineer induced pluripotent stem cells (iPSCs) — cells that have been genetically reprogrammed into an embryonic state. This means that they can transform into any type of cell, such as muscle tissue and kidney cells, or even sperm or eggs. During an IVG process, cells obtained via a skin biopsy would be reprogrammed into induced pluripotent stem cells, which would then be used to create eggs or sperm. The rest of the reproductive process would be very similar to IVF in that embryos would be created in vitro, after which viable ones would be placed in a patient’s womb.
With the reproductive options of IVG being virtually unlimited — as anyone with skin could potentially produce eggs or sperm — the process could even eliminate the necessity of egg and sperm donors altogether. It would enable post-menopausal women to generate viable eggs, allow same-sex couples to create their own biological family, and offer options to those at risk of passing genetic disorders to their offspring. It could also offer a pathway for preserving fertility in cases of medical treatments that compromise reproductive function, such as chemotherapy. However, IVG also raises ethical dilemmas. The ability to create babies from any individual’s cells could blur the boundaries of traditional reproduction, leading to questions about the nature of parenthood, family structures, and the potential for designer babies. The ethical implications surrounding the use and disposal of excess embryos in IVG processes also require careful consideration. While IVG holds immense promise for human reproduction, its implementation must be accompanied by robust ethical guidelines, regulatory frameworks, and public dialogue to ensure that its benefits are harnessed responsibly and with due regard for individual rights and societal values.
Pod babies: will fetuses soon gestate outside of the human body?
While the concept of babies in pods has long been the topic of many a sci-fi scenario, recent scientific developments could soon make this a real possibility — even in our lifetimes. The Biobag, for instance, is an innovative technology designed to mimic the environment of the womb and support the development of premature infants. It consists of a synthetic, fluid-filled bag where the premature baby is placed, connected to a machine that provides oxygen and nutrients. The Biobag offers an alternative to traditional incubators and provides a more natural and womb-like environment for the baby’s growth and development. The benefits of an artificial womb are numerous. It potentially reduces the risks and complications associated with premature birth, such as respiratory issues and underdeveloped organs. It could offer a gentler transition from the womb to the outside world, promoting better physiological development and potentially improving long-term outcomes for premature infants. Women who face high pregnancy risks due to conditions like epilepsy could still experience the joy of having biological children, and they could provide an opportunity for women with infertility or same-sex couples to have children without encountering the challenges often associated with surrogacy.
Even for healthy women, artificial wombs like the Biobag hold the promise of mitigating the substantial risks inherent in pregnancy. By shifting the gestational process to outside the body, artificial wombs offer the potential for safer childbirth experiences. Artificial wombs like the Biobag however also raise significant ethical implications. Some concerns include the definition of viability and the potential for extending the limits of fetal viability. It blurs the line between prenatal and postnatal care, raising questions about the moral and legal status of the fetus. There are also concerns regarding the long-term effects of gestating in an artificial environment and the potential psychological implications for the child. Careful consideration of the ethical ramifications is crucial to ensure the responsible and compassionate use of this technology. Robust guidelines, informed consent procedures, and ongoing research are necessary to navigate the complex ethical landscape surrounding innovations like the Biobag and their implementation in neonatal care.
“Only through careful consideration can we strive for responsible and equitable implementation of these technologies, while prioritising the wellbeing of individuals and respecting diverse perspectives on the future of human reproduction”.
Richard van Hooijdonk, trendwatcher and futurist
Ethical considerations and final thoughts
In this article, we’ve explored the current developments and future prospects of fertility, pregnancy, and childbirth, shedding light on the transformative impact of AI in IVF treatment and the remarkable potential of creating babies from skin cells. The integration of artificial intelligence in predicting pregnancy risks and outcomes has demonstrated its role in ensuring safer pregnancies and childbirth. By examining these groundbreaking advancements, we gain valuable insights into the implications of and develop a more informed perspective on the future of human reproduction. Undoubtedly, new reproductive technologies offer a multitude of benefits, both now and in the future. They hold the potential to enable biologically-based reproduction for infertile individuals or same-sex couples, mitigate pregnancy risks, enhance neonatal care for premature infants, and more.
However, as these technologies progress, the ethical landscape becomes increasingly complex, as technology assumes greater control over biological processes and human involvement is reduced more and more. As the boundaries of reproductive technology continue to expand, critical questions emerge concerning the ethical implications, long-term consequences, and potential risks associated with these futuristic advancements. It is therefore imperative to foster ongoing dialogue, establish robust ethical guidelines, and conduct thorough research to navigate the intricate intersection of technology and human reproduction. In the words of renowned trendwatcher and futurist, Richard van Hooijdonk: “Only through careful consideration can we strive for responsible and equitable implementation of these technologies, while prioritising the wellbeing of individuals and respecting diverse perspectives on the future of human reproduction”.
