The fourth baby born via a transplanted uterus isn’t just a medical success story – it bridges three generations of a family.
A woman in Sweden who lost her own uterus to cancer in her 20s has given birth to a healthy baby boy after receiving a transplanted womb donated by her mother.
The womb transplantation experiment began in September 2012 and each recipient – women, mostly in their 30s – was either born without a uterus, or had it removed as part of their treatment for cervical cancer. Dr. Mats Brannstrom, chair of the obstetrics and gynecology department at the University of Gothenburg and leader of this initiative explained that the transplanted uteruses were not connected to the women’s fallopian tubes, meaning that in order to become pregnant, their eggs were first retrieved and embryos were created using in-vitro fertilization, and then implanted in the transplanted uteruses. Complications following two of the womb transplant procedures resulted in the removal of the uteruses.
Brannstrom, who has delivered all four babies – with a fifth one on the way – said that there was something very special about this case: “It’s one uterus bridging three generations of a family.”
The parents determined that they will one day tell their son how he was conceived. “My thought is that he will always know how wanted he was,” the mother said in an interview with the Associated Press. “Hopefully when he grows up, uterus transplantation (will be) an acknowledged treatment for women like me and he will know that he was part of making that possible.”
One of the major concerns with the transplanted wombs was being able to effectively control the nutrients transferred to the fetus via the placenta, as well as ensuring that there was sufficient blow flow to the arteries. However, Brannstrom reported normal blood flow throughout all four pregnancies, resulting in four healthy babies.
Brannstrom is working with doctors in India, Singapore, Lebanon and Argentina on other experimental womb transplant procedures: one using wombs from recently deceased women, and the other employing robotic surgery to shorten the time of the 10-to-12 hour operations.
A January 2014 post on Ethics & Society examined the ethical issues surrounding the experimental uterus transplant procedure, asking “if it can be done, should it?”
The post enumerated the potential ethical concerns with the procedure:
First, should donors be permitted to undergo this procedure knowing that their donated organ is not required to save the recipient’s life? Is it within the donor’s right to autonomy to determine whether to take part in this experiment, despite the significant potential harms? Do the benefits for the recipient outweigh the possible risks of the several invasive and potentially risky procedures involved with womb transplantation and pregnancy? Are the risks worth a woman having the ability to gestate her own child, or should she consider adoption or surrogacy as alternatives?
The post concluded: “While womb transplantation for the purpose of pregnancy in the recipient is an interesting and exciting reproductive prospect…it is important to consider all the risks – particularly to the donor – of a procedure that does not result in saving a life, before any further experimentation occurs.”
At this stage we know that it is possible for a woman with a transplanted uterus to safely gestate and give birth to healthy babies. Additionally, there have been no reported complications to the womb donors – although that does not mean they haven’t experienced typical difficulties following a major surgery. Two of the nine transplanted wombs have been removed because of complications, but transplant procedures widely used in clinical practice are not without the potential for rejection and/or complications. As with all experimental procedures, the potential long-term side effects for the donor, recipient, and resulting child are not yet known.
Dr. Elizabeth Yuko is a bioethicist at the Center for Ethics Education at Fordham University, editor of Ethics & Society, and coordinates the HIV and Drug Abuse Prevention Research Ethics Training Institute. You can follow her on Twitter at @elizabethics.