Special Section: THE BODY: From Baby Hatcheries To Xeroxing Human Beings

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AT PRESENT, THE woman who learns through amniocentesis that she is carrying a seriously deformed fetus has only two choices: abortion or the heartbreak of delivering a hopelessly defective infant. But the mother whose unborn baby is found to have one of several hereditary enzyme deficiencies has a more acceptable alternative, for medicine has developed techniques for treating many such illnesses. An amniotic test for fetal lung maturity, for example, has helped warn doctors when a child may be born with hyaline membrane disease, which blocks proper breathing. In those cases, birth can be delayed by sedation until tests show the baby ready to breathe on its own. Tests that permit prompt postnatal detection of PKU give doctors an opportunity to place babies so affected on special diets that prevent the accumulation of the deadly toxins and allow them to live relatively normal lives.

Some treatments are even possible before birth. Physicians routinely perform intrauterine transfusions on fetuses suffering from Rh disease, a genetic condition that results from the incompatibility of maternal and fetal blood.

Artificial insemination, once the exclusive province of livestock breeders, also offers escape from some genetic mishaps. An estimated 25,000 women whose husbands are either sterile or carry genetic flaws have been artificially inseminated in the U.S. each year, many of them with sperm provided by anonymous donors whose pedigrees have been carefully checked for hereditary defects. Some 10,000 children are born annually of such conceptions.

Doctors also see possibilities in artificial inovulation, a procedure in which an egg cell is taken directly from the ovaries, fertilized in a test tube and then reimplanted in the uterus. By carefully scrutinizing the developing embryo in the test tube, doctors could spot serious genetic deficiencies and decide not to reimplant it, thus avoiding an abortion later on. If the embryo is normal, it could even be reimplanted in the womb of a donor mother and carried to term there, enabling the woman either unable or unwilling to go through pregnancy to have children that were genetically her own.

Even test-tube babies, once the stuff of science fiction, are now not only possible, but probable. Dr. Landrum Shettles of Columbia University and Dr. Daniele Petrucci of Bologna, Italy, have shown that considerable growth is possible in test tubes. Shettles has kept fertilized ova growing for six days, the point at which they would normally attach themselves to the lining of the uterus. Petrucci kept a fertilized egg alive and growing for nearly two months.

INDEED, ONLY development of an "artificial womb" capable of supporting life stands in the way of routine ectogenesis, or gestation outside the uterus, and now even this problem may yield to solution. Scientists at the National Heart Institute have developed a chamber containing a synthetic amniotic fluid and an oxygenator for fetal blood, and have managed to keep lamb fetuses alive in it for periods exceeding two days. Once their device is perfected, the baby hatchery of Aldous Huxley's Brave New World will be a reality and life without birth a problem rather than a prophecy.