Issues of ectogenesis and creation of the extracorporeal system for fetal development

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Abstract

The idea of creating a system capable of supporting and ensuring the complete development of the human embryo dates back to the middle of the 20th century. The combination of factors, which are created artificially and are very close to the natural physiological ones, will give a chance to accomplish the development of the fetus without the involvement of the female reproductive organs. The fetus can develop in a separate environment where it is isolated from the possible harmful effects of maternal diseases or toxic substances. This paper presents an overview and summary of the data published on the issue. The creation of an extracorporeal system for fetal development (ESFD) is associated with a number of difficulties. One of the most important challenges is the reproduction of the optimal conditions for the development of the fetus in an artificial environment, where the fetus will have to stay throughout the entire period of its development. In order to avoid ontogenesis disorders and pathologies of organ systems when using ESFD, it is necessary to reproduce all the conditions specific to complete intrauterine development, which include not only the supply of nutrients to the growing embryo, but also the maintenance of parameters such as pH and temperature. Currently, there is a growing interest in creating a device that could allow a fetus to develop ex vivo. Over the past few years, the scientists have published numerous reports on the creation of the necessary components of the system (artificial placenta, amniotic fluid substitute, etc.). Life support systems are improved and supplemented with new elements that contribute to the reproduction of natural conditions which normally exist in the maternal organism.

Conclusion: The main aim of the research groups is to create artificial conditions for the development of the fetus simulating all the physiological parameters of the natural environment for the complete formation of the organism. The use of ESFD will make it possible to reproduce vital conditions for the growth and development of the fetus and it will help women who are unable to bear a child on their own. It can also influence the views of society on surrogate motherhood and the restoration of childbearing function using uterine transplantation. There is still no clear understanding of how such a method of gestation can affect the relationship between mother and child, which may compromise the creation and use of such a system from an ethical point of view.

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About the authors

Ksenia A. Yavorovskaya

Savelyeva City Clinical Hospital No. 31, Moscow City Health Department, Branch No. 3 Center for Assisted Reproductive Technologies

Author for correspondence.
Email: repro21@yandex.ru

Dr. Med. Sci., Professor, Head

Russian Federation, Moscow

Alexander A. Goryachev

Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: alexgoryachev2022@mail.ru

student

Russian Federation, Moscow

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