Carrying A Child In A Borrowed Womb

Nine women in Sweden have received womb transplants:

“This is a new kind of surgery,” Dr Mats Brannstrom said in an interview from Gothenburg. “We have no textbook to look at.” Brannstrom, chair of the obstetrics and gynaecology department at the University of Gothenburg, is leading the initiative. Next month, he and colleagues will run the first-ever workshop on how to perform womb transplants and they plan to publish a scientific report on their efforts soon. He said the nine womb recipients were doing well. Many had had periods six weeks after the transplants, an early sign that the wombs were healthy and functioning. One woman had an infection in her newly received uterus and others had some minor rejection episodes, but none of the recipients or donors needed intensive care after the surgery, Brannstrom said. All left the hospital within days.

Victoria Turk explains why the procedure is controversial:

[O]ne of the stickiest points in this particular study is the element of risk undertaken by the donors, and not just the receivers, of the transplant uteruses.

Because more blood vessels have to be taken from around the womb for it to have a better chance of functioning well, it’s a riskier operation than a regular hysterectomy. The question then, is whether it’s fair to let healthy people risk such medical complications for the non-life-saving benefit of someone else? The UK doesn’t think so, but there is a way around this. In a similar project planned for the end of 2014, doctors in Britain will instead use wombs from brain-dead donors whose hearts are still beating for transplants in five women. That’s more comparable to what usually happens in organ donation situations, and is a lot less controversial than asking a healthy person to go through the donation procedure.

Ultimately, however, all the risks for both parties—donor and recipient—must be weighed against the benefit of having a womb in the first place. Because the womb transplant won’t allow the women to have children the conventional way, and only through IVF, the only real advantage it offers is the chance to carry biological pregnancies. While that might seem a pretty slim benefit in itself, the problem is that right now, that’s pretty pivotal to having children at all. We’re not yet growing babies in Matrix-like pods. Sure, there’s adoption—but our widespread acceptance of IVF suggests we understand the desire to have our own biological children, so should women without a womb not also be given the same opportunity, if it’s at all possible?

George Dvorsky is more succinct:

This is all quite amazing — and it’ll truly be a major step forward for science and personal reproductive autonomy if and when the first baby is born as a result of this procedure. At the same time, however, it does feel a bit… privileged.