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The artificial uterus: on the way to ectogenesis

Published online by Cambridge University Press:  26 June 2023

Francesco Maria Bulletti ,
Romualdo Sciorio Open the ORCID record for Romualdo Sciorio [Opens in a new window] ,
Antonio Palagiano Open the ORCID record for Antonio Palagiano [Opens in a new window]  and
Carlo Bulletti Open the ORCID record for Carlo Bulletti [Opens in a new window]
Francesco Maria Bulletti
Affiliation:
Department Obstetrics and Gynecology Lausanne, Switzerland
Romualdo Sciorio
Affiliation:
Edinburgh Assisted Conception Programme, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
Antonio Palagiano
Affiliation:
Reproductive Science Pioneer, Assisted Fertilization Center (CFA), Naples, Italy
Carlo Bulletti*
Affiliation:
Extra Omnes, Assisted Reproductive Technology (ART), Center in Cattolica, Italy, and Associate Adjunct Professor, Department of Obstetrics, Gynecology, and Reproductive Science, Yale University, New Haven, Connecticut, USA
*
Corresponding author: Carlo Bulletti; Email: carlobulletti@gmail.com
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Summary

The inability to support the growth and development of a mature fetus up to delivery results in significant human suffering. Current available solutions include adoption, surrogacy, and uterus transplantation. However, these options are subject to several ethical, religious, economic, social, and medical concerns. Ectogenesis is the process in which an embryo develops in an artificial uterus from implantation through to the delivery of a live infant. This current narrative review summarizes the state of recent research focused on human ectogenesis. First, a literature search was performed to identify published reports of previous experiments and devices used for embryo implantation in an extracorporeally perfused human uterus. Furthermore, studies fitting that aim were selected and critically evaluated. Results were synthesized, interpreted, and used to design a prospective strategy for future research. Therefore, this study suggests that full ectogenesis might be obtained using a computer-controlled system with extracorporeal blood perfusion provided by a digitally controlled heart–lung–kidney system. From a clinical perspective, patients who will derive significant benefits from this technology are mainly those women diagnosed with anatomical abnormalities of the uterus and those who have undergone previous hysterectomies, numerous abortions, and experienced premature birth. Ectogenesis is the complete development of an embryo in an artificial uterus. It represents the solutions for millions of women suffering from premature deliveries, and the inability to supply growth and development of embryos/fetuses in the womb. In the future, ectogenesis might replace uterine transplantation and surrogacy.

Keywords

artificial uterusectogenesisectogestationrecurrent preterm birthuterine anatomical abnormalities

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Type
Research Article
Information
Zygote , Volume 31 , Issue 5 , October 2023 , pp. 457 - 467
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© The Author(s), 2023. Published by Cambridge University Press

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