Womb Transplants

[JumpingPumpkin]

Just heard the news on R4 of a successful pregnancy from a womb transplant in this country. Paid for by a charity “womb transplant U.K.”. Finished the report with a question as to the ethics and “it gives women an alternative to surrogacy or adoption”.

This just seems unethical to me.

Why! No more so than a kidney transplant

Well we all know where this is going to lead don't we...?
( there's already a thread about this in AIBU btw, with lots of women expressing concerns)

Depends how they get the womb...

It was her sister’s.

Kidney transplants are life saving. The ethics of taking a spare kidney from someone with two currently healthy ones are dubious to me, depending on the risk to that person in later life.

A womb transplant required a donor - one unnecessary hysterectomy, a high risk pregnancy whilst on anti-rejection drugs, followed by more surgery to remove the womb again.

It seems quite dodgy to me so I’m interested to hear what others think.

I’ll have a look in AIBU thanks.

Oh it's a bit different to a kidney transplant reasonably isn't it?

For a start there are three people involved and not two, and one didn't consent. And that's the one taking a hell of a lot of the risks if not the lion's share.

The double standards of barely permitting women pain relief or anything else during pregnancy out of concern for the child, and some countries actually putting that child's right to life above the mother's, is all a bit at odds with the huge amount of drugs that will have to be pumped through the mother to sustain this for both of them and make it possible. Nor at this point is anything known about the lifelong impacts for the child of having done this. What was the Tavistock's comment about 'building the plane while flying it' when talking about experimental treatments of children?

And yes, women who are thinking about being donors after their death would need to be very aware if this was a possibility. I would not consent to my potential involvement in something potentially very harmful to a child, which as yet is unknown ground. Even if it might make an adult very happy.

Just because we can doesn't mean we should. Building the plane while flying it^^ - very appropriate. So many uneasy parallels with gender-affirming medicine.

I am concerned for the future health of the children in these procedures. Plus if the future health has been ever tracked of healthy women donors of healthy uteruses.

I know someone who has incredibly complex health issues that seem to stem from IVF treatments. None of her doctors know what is causing her life shortening health issues nearly two decades later. None of her specialists seem even interested in the cause because they are focused on keeping her alive now. So how much tracking is being done on those women who are either egg donors or IVF patients long term?

I think there are many questions around this procedure but they should start with what are the negative impacts over the life of the child.

And the cost!! It took 30 medics 17 hours or something - for what is effectively a lifestyle
choice. IVF is expensive I’m sure but it seems much less risky than this and therefore the cost v risk analysis stacks up better.

I definitely feel that this is a step beyond what doctors should be doing.

'It took 30 medics 17 hours or something - for what is effectively a lifestyle
choice'

I agree completely about the lifestyle choice aspect. It feeds into the idea that having babies is a human right, and worth any amount of cost, pain etc

To my knowledge the woman didn’t have a womb but had ovaries. Her older sister donated her womb.

Whilst this is an amazing medical achievement, I’m not convinced that it’s something the cash-strapped NHS should be doing. (And yes, it might give hope to the delusioned ones).

It's important that science can achieve this types of procedures, but the only benefit from this is a woman being able to experience pregnancy herself, she could've had the same biological child via surrogacy.

I think surrogacy is the better option.

I think the medical profession are doing this to stay cutting edge. If they dont offer surgeons the chance to experiment they will go elsewhere, or other countries will overtake Britain in terms of R&D.

And i know this research can inform a wide range of medicine.

But we know how this can be abused, and women and children arent consider other than being purchasers and commodities.

Surgery seems to be expanding from life saving and removing of physical pain, to creating the perfect human.

I know how desperate we can be to have children, though, and what we are willing to do.

This is the natural culmination of the "me, me, me" age.

Kidney transplants, liver transplants, heart transplants happen because of medical need. I am not aware of any medical need that might exist for a uterus. If there is one, maybe someone can explain it to me and then I might reconsider my view, which is that this sounds like a woman using two other parties, one of whom is unable to consent, to enable a lifestyle / emotional choice.

I think accepting you can't have children is a better option than surrogacy.

My gut instinct is that whilst it's amazing, it's wrong. Very little concern for the donors long term health. It's been shown that women who have hysterectomies go into menopause sooner than they would have (and if premature, there are increased risks of osteoporosis, dementia, heart disease, Parkinson's etc). They die younger. There can be massive issues with scar pain and continence. Sex is affected.

No-one in this situation was ill.

A charity fronted the NHS costs as part of the clinical trial. The medical staff donated their time.

Hardly! In one case a sister undergoes life-changing and life-threatening treatment, in the other case an unknown woman undergoes life-changing, life-threatening treatment. Do you think surrogacy is better because the unknown woman is paid, rather than altruistic?

Has the sister offered to carry her sister's baby in altruistic surrogacy, with a very carefully managed transition of the baby from one mother to the other, then altruistic surrogacy could be considered the better option - for all of the mothers, and for the baby as well.

Why do you think experimenting on babies is ethical?
What antirejection meds were used?

Should a still viable transplanted organ remain or be removed after the reproduction "want" stops?

The BBC article states that all staff worked free on the occasion of the sisters' op. I assume that's because of the potential criticism about much more needed ops and appointments that people are waiting years for.
It's definitely very questionable ethically with potentially lifelong negative effects on both women's bodies.
I do think the NHS needs to prioritise funding for provide better services for more essential treatments and hope that we don't do stuff using a huge amount of resource just because we can.

illinivich
I think the medical profession are doing this to stay cutting edge. If they dont offer surgeons the chance to experiment they will go elsewhere, or other countries will overtake Britain in terms of R&D.

Tbh if the medics are modern mengele the UK health industry is better off without them.

Surgery seems to be expanding from life saving and removing of physical pain, to creating the perfect human.
And the the drive to merge computer tech will continue this ideology (once you are rich enough to pay for it)

One concern I have, similar to surrogacy, is the emotive use of a sister impacts the realities of consent. Hysterectomy has significant complications, and early hysterectomy massively increases the woman’s cardiovascular disease risk. But as with surrogacy, going through it “out of love for my sister” means an objective view of risk assessment isn’t valid.

This is also true of other organ donations also of course, but when a pregnancy and family is involved it seems to be more complicated. If a woman wouldn’t risk a 200+% increase in CVD for a stranger, but would for her sister, then emotion is driving that decision, which is ethically questionable in my view.

I don’t think it’s necessarily wrong on the part of the donor per se, because we would all take more risks for those we love, but it’s much more ethically questionable for doctors to allow people to take that risk for something that is not a life or death situation.

There's also the problem that within a family, it's not a simple yes/no decision. Huge pressure can be placed upon the donor depending on the family dynamics. There can be a heavy price to pay for refusing.