Dear Louise Brown,

On behalf of the future I would like to congratulate you on your birthday. It has been 40 years that you where born into this world on July 25th 1978, after conception by in vitro fertilisation, or IVF. A process envisioned and developed by Patrick Steptoe and Robert Edwards, who in 2010 won the Nobel Prize in Medicine for this amazing accomplishment. Please allow me to reflect on this special moment.

Louise, your birth was world news and ranked you among the first individuals to set foot on the moon. You didn't have to do anything to set this new standard; except from being born. After you, more than six million babies have been born worldwide thanks to IVF. This technology is now widely accepted, and has become vital for want-to-be parents dealing with infertility. With IVF, the boundaries of what we accept as ‘natural’ have shifted; we have adopted a Next Nature.

IVF is not the first reproductive technology, and it most certainly won’t be the last. Throughout history, humans have invented many methods to increase their chance of pregnancy — or to reduce it. Let’s face it, pregnancy and childbirth are impactful events on peoples lives, but especially on women and their bodies. Reproductive abilities are not equally distributed in this world, nor are the economic circumstances under which to raise a child. There are plenty of reasons for people wanting to control their reproduction.

Paradoxically, in our quest to control our biological reproductive system, we seem to disconnect our bodies from the process itself; during the mid-20th century, the introduction of the oral contraceptive pill (aka ‘The Pill’) disconnected reproduction from intercourse, which paved the way for what we now refer to as the ‘sexual revolution’. IVF brought along a similar revolution, while at the same time it disconnected infertility from having babies. What more can we expect in this field?

In 1924, the process of ectogenesis was envisioned by the Britisch scientist J.B.S. Haldane. Ectogenesis (from the Greek ecto, "outer," and genesis) is the growth of an organism in an artificial environment outside the body in which it would normally be found, such as the growth of an embryo or fetus outside the mother's body, or the growth of bacteria outside the body of a host. In 1955, the first artificial uterus was patented by Emmanuel Greenberg. In 2017, on March 25th a video was released on YouTube that showed a lamb fetus growing in a ‘biobag’. The scientists behind the movie described it as "a plastic bag containing amniotic fluid connected to tubes that regulated the circulation of nutritiants and oxygen." Technically, what we’re looking at is a working prototype of an 'artificial womb'. The future is already here, as we are living in the Next Nature; the nature caused by humans.

Whenever I present this clip to students or people I meet in workshops, I get a fifty-fifty response: Half of the people are appalled by the graphic image of the lamb fetus writhing in the plastic bag, the other half reacts with awe, amazed by the natural process of growth that they now see in its full transparency; it causes a strong emotional effect on them, as they are confronted with the fragility of life.

Similar to how for the first time. astronauts where able to see our blue planet from outer space, many of them reported to be struck by this image in such a positive way. During the early ’70s, reproductions of the first photographs of Earth as seen from space made their way into the media. It contributed for a large deal to a new understanding of the planet we inhabit, and the environmental concerns that come with that. And so, a newly adopted standard was set, not only in terms of technology, but more so in global awareness. Yet it was technology that helped us in doing so.

It may sound far fetched, but I feel that emerging reproductive technologies too, could bring along a new understanding of who we are: Think how a technology such as CRISPR-cas9 makes advanced modification of genetic material possible; it can be applied to embryos in order to weed out inheritable diseases and undesired physical traits. Moreover, research suggests that the skin cells of women and men can be used to produce sperm and egg cells. These are just two examples to raise an eyebrow over our reproductive future. But what will happen when all of these technologies are combined?

Dear Louise, with your birthday we celebrate a major milestone in reproductive technology. Yet at the same time we realize that many questions are still to be explored in the coming 40 years:

If we don’t need the other sex to reproduce, and if we can be fertilized in vitro, while manipulating the genetic material of our offspring and are able to carry a pregnancy outside our bodies, regardless our gender or age, what will this mean to our self-perception? But also: What will the families of the future look like? How will we build and value relationships? How will we experience intimacy?

Will we live in a world where our reproductive culture is fully standardized and thoroughly commodified, driven by market demand and exclusively for the ultra-rich? I hope not. Or will we live in Reprodutopia, a world where our reproductive abilities are more equally distributed, and celebrate diversity and imperfection? Let's certainly hope we will! Either way, we have the great responsibility to reevaluate and think about what it means to produce new generations of humans in the Next Nature.

In 2058 you will turn 80. I hope you will live the day to see some of these questions answered. Perhaps we will be able to meet the first person born outside the human body. I wish you and them a good health, a happy life and a bright future. Happy birth!

Hendrik-Jan Grievink

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