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.

Certainly there is an ethical question to be examined. One problem is that - like kidney transplants etc - womb transplants are open to abuse of women in poor countries, or who are poor since they will be seen as the demographic from which wombs can be harvested. This happens with other organs already and there is little legislation to deal with it or to control the criminal gangs or entitled people who trade in organs.

We need to acknowledge where these medical innovations can lead.

At the extreme, IVF has led to poor women around the world being used as incubators for the rich, and children having no contact with their mothers. Even if the vast majority of IVF treatment are ethical, there has been negative consequences that weren't imagined, or talked about, at the time. Its as if the right to be a parent is greater than the rights of poor women, and children.

The medical profession can make the procedures as safe as possible, but medical mistakes do happen - see the compensation NHS obstetrics, and they cannot control the supply and demand of the international market that is growing.

I think its unwise to not think these developments through, and instead be realistic about how they can be abused.

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A child that is known to be likely to be born prematurely with the health issues that come with that is an expected side effect to the drug interaction at the very least.

Yet, this side effect issue seems to be dismissed. It is unknown what the long term side effects are to the children born with mothers taking drugs to prevent rejection to these uteruses. But this is also dismissed. The ethics of these decisions need to also centre the child.

So you could not accept the fact and are lucky to have been able to use the medical tec to achive an outcome.

How honest do you feel that the medics involved were in outlining the health risks and the physical impact of the process on your body from the start?
Did it progress as you expected or did you find that parts were better or worse than explained?

My child was conceived with IVF and he and I spent the third month of his life in a mother-baby unit. I have alot of risk factors for post natal depression, but IVF was one of those risk factors and that needs to be acknowledged.
Even with a longed for child a mother can become depressed and need extra support.

These are not easy conversations to have and every one of us has a story of in/fertility that is of course the story of our life and important in that way. But I don't think personal validation should be at the centre of a conversation about ethics.

I also now cannot imagine how emotional coercion would not be a factor in the decision to offer to help a loved one with such a transplant if they know that the person they love is suicidal. It doesn’t have to be a deliberate act of manipulation.

So how would a donor be sufficiently screened for this once it is known just how distressed the person they are donating a uterus to is without a child?

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It if fair and reasonable to question the motives of women driven by their infertility and the doctors wanting to do cutting edge surgery. Like someone else said summarizing the feelings of how women feel who desperately want children and can’t, those feelings are so huge they drown out everything else, including the need to discuss the ethics of this. Based on that description, some women are not in a mental state to be able to look at this more objectively, from all sides, long term and take the baby into consideration.

It comes down to ‘I want’ and not ‘I need’.

No I couldn’t accept the fact. I chose to seek treatment. Just like if I had cancer I would seek treatment and not accept the fact. Infertility is a medical issue that can often be treated successfully.

My Doctors were very honest about the physical and emotional impact and I had access to free counselling throughout. I can’t say re. progress yet - I’ve had four rounds to make embryos and finally have 4. I’m in the very very early stages of pregnancy following my first transfer and I’m terrified every single day. And I’d do it all again.

I hope everything works out for you. I know the feeling of fear every single day - every trip to the toilet terrified of seeing blood, every twinge.... It's awful. Wishing you a healthy pregnancy.

Are you saying that in your opinion women who have a high risk of miscarriage shouldn't attempt a pregnancy?

Women have miscarriages all the time. Lots of women suffer with recurrent miscarriage. Should they stop trying in your opinion to stop any more fetuses being miscarried?

I know that fear too, it's hideous.

It's the women who don't know that fear that sit in their ivory towers judging us for needing help after long term studies have shown these treatments are safe.

Good luck @adviceneeded1990 , hopefully this is your time.

Sending good wishes to those women struggling with infertility. What you are describing is beyond heartbreaking.

And

It is still reasonable to want to discuss ethics of new treatments that could be open to abuse. The results of those discussions might well be - let's go ahead, it's worth it. But potential pitfalls need to be addressed. That doesn't mean that people are judging you, personally, although I realise those discussions may be especially painful to those with direct experience of infertility.

Exactly it's very easy to sit in that tower judging and pontificating when you haven't experienced it yourself.

That's mumsnet all over really.There are so many kind, lovely women who hold the hands of and give support and advice to other women who post here looking for help. But then there are the ones who jump onto threads about infertility, surrogacy etc sticking in and twisting the knife into posters who are already hurting. I wish MN would take more of a stance and just outright ban posters who behave in such a way but they don't.

You'll see that I used the word I throughout. Because i can't talk for other women. There are added risks with womb implantation for the woman receiving, the foetus/baby AND for the donor. I might take a risk on my own health. If I saw a baby as an extension of myself then I might even take a risk with multiple miscarriages but I wouldn't gamble another woman's life, health or happiness. I can't imagine the impact on an already suicidal woman in knowing that her sister/friend/mother died or became seriously unwell because they "wanted" to provide me with a chance to grow a baby. I imagine this is why people like you at your most I'll would not have been eligible for the research procedure. Because the risks aren't just yours and they are very, very different to IVF. And it would be highly unethical to carry out experimental procedures like this on such distressed and desperate women. As an aside, I'm absolutely delighted for you that everything worked out the way you wanted it to.

I’d imagine the women who are accepted onto the program face psychological testing first? As they should. A woman I follow on Instagram who is part of the USA program is coming to the end of pregnancy number 2 having used a dead donor and all seems well. Maybe this is the way to go in order to avoid the risks to a living woman.

But it is not judging you. I get that you are hurting but it is not about you. It is about ethics and morals and where do we as society draw the line. Please don't take it personal, it is not meant that way and it stops healthy debate about modern medicine and the opportunities it brings.

The UK programme is looking to use 10 donations from "brain dead" women. I'm not sure how I feel about that yet.

Could you please link us to these long term studies that you have read that show that the drugs used in the dosage required are safe for the child?

This isn’t new though is it? Obviously the womb part is but organ donation after brain stem death does make up a fair amount of all kinds of transplants already. This is obviously just my personal view but I’d hate to be lying there brain dead if there’s a possibility that my organs could be helping others. Not everyone is a donor though so I understand people will feel differently.

My heart goes out to the women who are struggling with infertility or repeated miscarriages - I cannot imagine how hard that is for you. And I think it is fine for these women to seek a treatment that might enable them to carry a pregnancy to term, especially if womb donations from cadaver donors become more widely available. My worry about live donations is the risks to the donor - but people who make live donations (kidney, part of a liver, uterus) are doing something pretty amazing, and I have great admiration for them.

My one concern with this development is that men who want to be women are going to try to obtain uterus transplants, to further colonise womanhood.

Its easy for everyone - surgeons, the medical establishment and women to get caught up with the positives of such medical breakthroughs, and not consider the wider implications.

If it remains that only close relatives can ever be donors, it puts tremendous pressure on women within families that is often hiden from society.

If the donors are eventually going to be from a wider circle, that comes with additional social implications. Its going to be like surrogacy - the rich using poor womens bodies.

Maybe the solution will be donors after death, but im not sure thats as feasible as life saving donations. The transplant process is very complicated, and requires full time workers to coordinate. Who will do that?

Wombs can only be taken from women, and these women will be taking extreme risks for no personal benefit. It can only succeed if women are pressured to be kind, or are financially rewarded.

With respect to financial reward, the women wont be paid anything like the money they should. Infertile women will say the procedure is life saving, surgeons will be paid a fortune, hospitals and drug company will make lots too. The women who donates are womb that makes all of this possiblr should be paid the most, shouldnt she?

That's standard for non-living donations. For almost all ¹ transplants the donor has to be 'brain dead' not 'dead dead' at the time of organ retrieval.

This isn't like the recent proposal to keep brain dead women hooked up to life support as surrogates.

¹ I think bones and possibly corneas remain viable for longer after death. Not sure about skin. But solid organs need to have blood still circulating.

This.

Some of the posts here, using suicide as a way to justify this are grim.

This is coercive. Using suicide as a bargaining tool is abusive.