Womb Transplant from Mother to Daughter: Groundbreaking First, but Ethical?

Womb Transplant surgery may offer infertile women a way to bear children, but it has numerous moral implications.

The surgeons who performed the first mother-to-daughter womb transplant in Sweden talk about the procedure during a press conference. (Photo: Scanpix/Reuters)

Sep 20, 2012

Swedish doctors have performed what they say are the first mother-to-daughter live donor womb transplants that could allow the infertile daughters to bear children. While considered a medical milestone by some, others say the procedure may prove to be an ethical minefield.

Surgeons at the University of Gothenburg performed the womb transplants Saturday and Sunday. The procedures, according to a university news release, involved two mothers donating their wombs to their daughters, and are the result of more than a decade of Swedish and international research and collaboration. One daughter had her uterus removed due to cervical cancer and the other was born without a uterus; both have gone through IVF treatments.

"More than 10 surgeons that had trained together on the procedure for several years took part in the complicated surgery," team leader Dr. Mats Brannstrom, professor of obstetrics and gynecology at the university, said in the release.

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The donating mothers, he said, were up and walking and were expected to be released within a few days. The patients were doing well, but resting after the surgery. Both procedures were performed without complications, the university says.

Before the surgery, eggs were harvested and fertilized from each of the daughters. The embryos are now frozen. In about 12 months, embryo transfer will be attempted, according to press reports.

The estimated birth date of the first child from the new fertility procedure would be about 21 months from now, and will be the ultimate proof that the transplant worked.

Brannstrom got the idea of transplanting a uterus in 1998, when he removed the uterus of a woman with cancer. After telling her the news that she would not be able to carry a baby, she suggested a womb transplant.

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Brannstrom and others began working on the idea soon after. Their first mouse pregnancy after womb transplant occurred in 1999. Since then, they have moved on to larger animals.

If successful, the surgery on humans could provide a way for infertile women to have children without the use of a surrogate.

But bioethicist Arthur Caplan of NYU's Langone Medical Center points out that despite the medical advances, womb transplantation carries with it a variety of ethical and societal issues.

Among those issues, he tells TakePart, is pressure on the potential donor when asked to give up her womb. "I have a feeling if you said no, you might not be sitting at the Thanksgiving dinner table," he says.

Besides pressure on the donor, Caplan says, there are other possible downsides. "You have to use powerful drugs to keep the uterus from rejecting," he says. This exposes the developing fetus to the drugs. Being on immune suppressants can affect people's health, as they increase the risk of infections, among other potential problems.

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According to the university, the transplanted uterus will be removed after a woman gives birth, unless she wishes to have more children.

Caplan also wonders if the uterus of an older woman can do the job typically reserved for that of a younger one. "A transplanted uterus sounds good, but it has to withstand some enormous forces," he says.

Other risks, both to the recipient of the uterus and the unborn baby, are somewhat unknown, he says.

He sees it as not quite ready for prime time: "I'm not convinced they have done this enough in animals to merit going to human trials yet."

The human womb transplant should be treated as hugely experimental, he says. "It requires very close oversight by research ethics committees.” The lives of three people can potentially be affected, he adds.

The milestone will also trigger reassessment of current laws governing organ donations, Caplan predicts. When signing a donor card, he says, a woman is not likely to be thinking about her uterus. On the plus side, he says, the procedure, if perfected, could help women who live in areas where surrogate mothers are not allowed or available.

The procedure may ultimately help thousands of women, according to the university. In Sweden about 2,000 to 3,000 women of childbearing age cannot bear children because they don't have a uterus.

Do you think womb transplants are a viable way for infertile women to give birth? Let us know in the comments.

Kathleen Doheny is a Los Angeles journalist who writes about health. She doesn't believe in miracle cures, but continues to hope someone will discover a way for joggers to maintain their pace.

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