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.

How sad. IVF is a grueling enough process without chronic ill health as a (potential) side effect.

I agree. But the very severe osteoporosis, ligament issues, teeth falling out, pancreatitis and so on and so on sounds like the lupron effects that women were reporting. Yet, her specialists scratch their heads at what could be causing it and have not tried, as far as I know, to find the root cause.

Think it was probably that Rodrigo Alves who said that (the former human Ken doll). He has to say outrageous things because he earns money from the tabloid stories about him.

Once the press lose interest in him, he loses his income.

This case made me wonder about the family.

Firstly the original donor was supposed to be the mother. And when she was ruled out for being unsuitable the sister stepped up.

So she's potentially shortened her life - she already has her own children. Yet she risked this operation.

Then her sister had this operation. Again potentially risking her life.

Why do that instead of surrogacy unless it's about bragging rights for being the first and a self desire not just to have a baby but ALSO be pregnant. It's even more of a lifestyle choice than surrogacy. It's like wanting a Ferrari driving experience rather than wanting a baby and putting the interests of the child centred at all times.

The sister did an interview on the TV and declared that she thought 'she'd got even more out of the experience than the mother and father', which again strikes me as off and slightly unhealthy. Its a red flag for me

Then there's the baby, who has been exposed to all this and been deliberately delivered very early - which carries higher risks (including for surrogacy).

And the fact that the baby's mother will have to risk her life again in a few years to have the womb removed.

Im dead against surrogacy because I do think even altruistic arrangements are so vulnerable to coercion and unhealthy wider family dynamics. This is like that but on steroids. It's Frankenstein.

I don't think highly of any of the many adults involved in this.

Exactly

It makes me very uncomfortable too. It's a serious operation for the two women, and also I don't think medical resources should be used in this way, whoever paid for it. Of course, you could say the same for boob jobs, tummy tucks and other medical procedures which are lifestyle surgery, though I suppose surgery doesn't have to be life-saving, it could simply be life-enhancing, and I'm not sure where the acceptability (to me) of life-enhancing surgery begins and ends.

However, I don't know how much of my negative reaction is down to factors personal to me. Firstly, I am pretty squeamish and there is no way I would undergo major surgery unless it was literally life or death, or say a choice between being paralysed and not being paralysed. Secondly, though I have children, I would have been happy without them too - I wasn't desperate for children like some people are, and so I wouldn't have gone through this to have them.

Very good points.

Narcissism: a widely popular concept nowadays, that some people react against because it's "too mainstream". But I think narcissism, in this age and place, is the water we are swimming in. As you say, absolutely nobody in this situation has the child's interests at heart. That's equally heartbreaking and distressing. We're heading for the precipice.

Okay, sorry, me and my doomerism will go away now...

@RedToothBrush don't want to quote it cause it's a bit long but your post at 19:21 is everything I wanted to say but couldn't manage to be so articulate.

I do completely agree with your ethical qualms about either transplant. They both involve an act of altruism with risks to the donor.

However it is a misconception that renal transplant is always lifesaving. Kidney transplants are frequently not lifesaving, as many recipients have the alternative of living on dialysis for years or decades whilst awaiting a deceased donor kidney. They are however, life transforming.

If her sister has donated a kidney, so that she was able to come off dialysis and be well enough to undergo a pregnancy whilst taking immunosuppressants, how would you feel then? Black market kidney transplant is an enormous problem in many parts of the world, in theory somebody in the UK could feel pressured/coerced to donate, and no-one has the right to a kidney for any reason. And yet, if tomorrow it was your child who needed a kidney transplant and you were willing and able to donate, how would you feel about your freedom to do so being restricted?

It is important to strike a balance between the ethical constraints and individual autonomy (in this case, the autonomy of an individual to choose to do something altruistic for their loved one, which they themselves may also benefit from). I think of myself - I don't have any sisters but I do have a daughter, and for all I know it's possible she doesn't have a womb. I would like to have the freedom to do this within reasonable ethical constraints (psychological assessment, heath screening, absence of coercion and so forth as per other altruistic organ donations).

Just my perspective.

Women’s immune systems naturally damp down during pregnancy due to the baby being non self. Anti rejection drugs are used to treat recurrent miscarriage so well documented.

There are also plenty of women who have had successful pregnancies after organ transplant.

However, like others I’m not comfortable with womb transplants.

I'm okay with that as long as all parties are consenting and there's none or minor health risks involved.

Neither this nor surrogacy are possible without significant health risks to all 3 parties (2 with a deceased donor).

But she didn’t have a womb, so how would IVF help without one?

They didn’t pay for it, the charity paid all the costs back to the NHS, and the staff worked for free. They apparently have done 15 so far, and have the money for 2-3 more

Well lucky what other women choose to do is up to them and not people like you? Nobody cares what you think

Well lucky what other women choose to do is up to them and not people like you? Nobody cares what you think

What a persuasive, coherent argument.

www.fertstert.org/article/S0015-0282(13)02586-7/fulltext
According to this article there were 11,323 babies born via ART (IVF, GIFT and similar) in 1989. We're a similar length of time after the first baby born via transplanted womb and the total number delievered is around 100.

So it means that whatever there is to be learned about gestation and birth with a mother who has a womb transplant, it's going to be learned slowly (long term outcomes for mum, bub, wider social implications...). And I wonder if this will ever be anything other than cutting edge intervention.
@Womanofcustard "And I understand there is evidence for some babies conceived via IVF having health problems later in life. Just not publicised (for obvious reasons)."
I think we (the general public) get a real daytime TV movie version of alot of medical technologies. I did a unit on health ethics in a post-graduate nursing degree years ago. I fully expected to be challenged to think deeply about euthenasia, abortion, life support, gene editing, but the issue that took me by surprise was organ transplant. I thought it was an open and shut case, of course it’s always a good thing. I don’t know exactly what I believe now but I know it’s not straightforward.
I’m always nervous of the glitz and glamour around the FIRST EVER! medical intervention of any description.
I’m glad mother and baby are well and I wish them many years of unremarkable happiness.

I understand this procedure was funded by a charity, with the medical staff working 'pro bono'. My concern is that it will eventually find its way into an already overstretched NHS, similar to IVF. I don't think procedures like this should be available on the NHS - not when it can't cope with patients who are suffering illnesses that are life-threatening or impacting their ability to live a normal daily life. I feel the same about IVF being available on the NHS.

I don't have an issue with it being privately/charitably funded, as long as that funding does completely cover drugs, complications and aftercare, and as long as donors to the charity know exactly what they are paying for.

It'll always be an expensive procedure, so will probably never pass any cost effectiveness test for the NHS. The chances of a compatible donor is also going to be a factor.

The Human rights lawyers will get involved, though, especially if surrogacy continues to recognise the mother has the right to keep her baby.

I'll wait for the 'being prejudiced about growing potentially terribly ill and disabled children who'll have to live with the consequences so their mothers can do/have whatever they want (like take testosterone) is just ableism!' bit to turn up. I'm sure it will.

as long as that funding does completely cover drugs, complications and aftercare,

Yes - that's another thing, isn't it? For the trial as well as longer term. The charity my be funding the planned parts of implant, anti-rejection meds, cesarean and explant. But both short- and long-term complications will fall to the NHS - the latter especially. Infections, thromboses, cancers are already known risks of any transplant, plus whatever long-term effects there may be on the child from the meds, early delivery etc. These could occur years down the line when the charity may be long gone.

Is there medical evidence around that? The US babies born from womb transplants are all perfectly healthy so far.

It could be because the woman wants the experience of what most women take for granted, that if carrying a baby, growing ir, feelings it kick and move. I'm not saying it's something I'd do, I certainly wouldn't want the risk of all the anti rejection drugs on my baby, but it's not hard to imagine why a woman would want to do this (beyond "bragging rights").

Perhaps she doesn't want surrogacy as she's listened to people like the women on MN who are absolutely awful about it.

What studies have been done with what longevity? What are the risks? It's as with the Tavistock: no one knows yet. The plane is being built while they fly it.

Avoiding hearing something deliberately because you don't think you will like it, is a pretty good sign that deep down you know that it's reprehensible and that those people saying it have a very good point.

As for 'taking pregnancy for granted'. Wow just wow. I think there's a lot of women who actively fine the experience utterly traumatic in its own right. You know there are women that despite wanting a baby have terminated because they find the whole thing so awful? Well documented medically.

I’m not sure what studies can be done if the babies are healthy? There wouldn’t be much to study? Obviously the procedure hasn’t been around long enough to see any longevity but is it likely that perfectly healthy babies will suddenly decline years later due to medication they have been exposed to in utero? Many healthy babies have been born who were exposed to transplant medications via mothers who have had kidney and liver transplants, etc, and there’s no evidence to suggest that they somehow deteriorate years later, I can’t see why this would be different if it’s the same meds.