Muleskinner

Issue date: 2/8/07 Section: News

Doctors in a New York hospital are testing a new procedure that might allow women whose wombs have been removed or are defective to give birth.

The wombs would come from donors, just as other organs do, and would be transplanted into a recipient and removed after the woman gives birth, so she would not have to continue taking anti-rejection drugs her entire life.

The reason this procedure is being tested is to possibly give women, who otherwise have no chance, the ability to carry their own child for nine months.

Travis Raebel, a physicians assistant for Evanston-Northwestern Healthcare in Chicago, said the uterine transplant procedure is an important breakthrough in infertility medicine because, "it has brought to light just how large of a population is willing to invest large amounts of time, energy, money and health to bear their own child."

"Some people believe that being a woman means having a uterus and being able to bear children," said Jenny Lee, surgical physician's assistant at Glenbrook Hospital in Chicago.

"For women who are unable to do so, I believe there could be a justified need for a uterine transplant."

For many women, the ability to bear children is not a normal part of life.

Many women are born without uteruses, have infertility problems because of cancer treatments or have their uteruses removed due to complications from other surgeries.

Consuelo Tapia-Monterroso, a physicians assistant at Glenbrook Hospital, said "there are so many other ways to have a baby, and for those not able to carry their own child, there is still the option of having a surrogate mom or adoption."
Diana Herman, a Family Nurse Practioner at the Unversity Health Center, has been practicing for over 25 years and is an adoptive parent herself.

"Having a family is very important to a lot of people," Herman said.

She said she could understand why women would want to carry their own child.

"With adoption, there a lot of unknowns and things you can't control because of genetics," Herman said.

Another ethical issue with this procedure are the effects the anti-rejection drugs may have on the mother and the fetus.
Anti-rejection drugs are necessary for every transplant. OrganDonor.gov, the U.S. government's information on organ and tissue donation and transplantation states anti-rejection drugs are "immunosuppressant medications that stop the body from rejecting the transplanted organ and are an important part of life after transplant surgery. In general, the suppressed immune system can be slower in defending against germs."
This means transplant recipients are more vulnerable to infections, and it could be difficult to recover from certain infections and illnesses.

Another question is whether the procedure is ready.
"Although the uterine transplant has been successfully done with numerous species (including primates), an animal has never been impregnated," Raebel said.

The Washington Post reported doctors in Saudi Arabia in 2002 performed the first human uterus transplant on a 26-year-old woman whose womb had been removed six years earlier because of a clot after the birth of her first child.

The donor was a 46-year-old woman with an ovarian condition that required removal of her ovaries and uterus.

Doctors in the United States believe that clots could be avoided by transplanting larger arteries with the uterus.

But is this procedure ready to be performed?

"Ultimately, the goal of having a uterine transplant is to achieve pregnancy and bear a child, and I think this has not been done yet," Lee said.

"I personally believe more testing needs to be done with animals," Raebel said.

"To me, performing the uterine transplant without the ability to bear a child is rash, premature, trivial, and above all, reckless."
Questions of whether the procedure is ready for 'prime-time' are still being debated and the procedure will continue to be tested in New York and around the world.

More results from animal testing will probably have to be submitted before the uterine transplant becomes an approved procedure.

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