Donor womb offers pregnancy hope
In a world first attempt to achieve a pregnancy following a womb transplant, doctors in Turkey are preparing to transfer a single frozen embryo into a 23-year-old woman whose uterus came from a brain-dead donor.
Human uterus transplantation is raising new questions about how far we’re willing to push the outer limits of procreation.
The transplants are allowing women with no uterus at all, or a “non-functional” one, the chance to experience pregnancy.
In September, doctors announced that two Swedish women had received new uteruses. The donors were their mothers.
The Swedish team plans to wait one year before attempting an embryo transfer. But Turkish doctors are already preparing their patient for her first chance at motherhood. Born without a uterus, the woman received one in 2011 from a multi-organ donor, the first such transplant of its kind. The embryo transfer could occur as early as Monday or Tuesday.
“We’re very excited and praying that nothing bad happens and that everything goes well,” Dr. Munire Akar, a professor of obstetrics and gynecology at Akdeniz University told Postmedia News in an interview from Turkey.
Eighteen months post transplant, the uterus is still functioning and the woman is menstruating, making it the longest living transplanted human uterus to date, Akar’s group reports.
But observers say the highly experimental procedure poses risks to both mothers and fetuses, and raises important moral and ethical questions.
Could a live “uterine donor” claim parental rights or access to the child? If the uterus came from a deceased donor, “would the relatives have any right to become engaged with any children that result?” asks bioethicist Arthur Caplan, of New York University Langone Medical Center.
Who is responsible should something go wrong? he wonders. “What’s the strategy for handling a stillborn baby, (or) a damaged baby?”
Experiments in rats, mice, sheep and goats have been promising, but “we’re taking a full-on run at this in humans without really understanding what it is we’re doing,” says Canadian reproductive biology expert Dr. Roger Pierson.
It has been estimated that, in the U.S., up to seven million women might be candidates for uterine transplants.
The first attempt involving a live donor was performed more than a decade ago in Saudi Arabia but the organ had to be removed three months later due to tissue death. In August 2011, Akar’s team performed the world’s first transplant from a multiorgan donor. Derya Sert was given the uterus of a young woman who had died in a car crash. Now, after waiting 18 months, the team is preparing to transfer one of eight embryos created and frozen, pretransplant, using Sert’s eggs and her husband’s sperm.
If pregnancy is achieved, the baby would be delivered via C-section and the uterus removed two months later so that the woman would not have to remain on antirejection drugs for life.