Organ transplants

First U.S. Uterus Transplant—Bioethicists Wring Hands

Why should not men be eligible for uterine transplants?

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UterusTransplant
HJOG

Cleveland Clinic announced the first uterine transplant surgery in the United States. Nine such transplants have taken place in Sweden, of which seven have been successful and from which five infants have so far been born. The Cleveland Clinic transplant is part of research project involving ten women who were born without uteruses. A Texas woman, age 26, was the first patient to receive a donated uterus. Some months from now, using IVF techniques, eggs taken from her ovaries will be mixed with sperm from her husband and then transferred into the transplanted womb. Once she has completed her childbearing, the transplanted womb will be removed and she will no longer need to take anti-rejection medications.

Although the Cleveland Clinic's institutional review board ruled that the surgery is ethical, some bioethicists are not pleased. Bioethicists Josephine Johnson and Eric Trump argue

…the wholly understandable desire to bear a child does not justify the significant risks to mother and fetus posed by uterine transplants, not to mention the enormous financial cost. Safer, less costly, and more certain ways to have children already exist. When it comes to uterine factor infertility, we must ask ourselves: What is more important, the experience of pregnancy or the health of a woman and her future child?

They point out the risks of transplant rejection, infection, blood clots and that two transplants in Sweden had to be removed before the women had a chance to become pregnant. In addition, the process involves at least three surgeries; one to transplant; a cesarean section to deliver the baby; and the eventual removal of the donated uterus. They note that four of the births from the donated Swedish uteruses were premature. These caveats notwithstanding, women generally are (and should be) permitted to take all kinds of risks with their pregnancies without interference from bioethical busybodies.

Still, Johson and Trump make the observation that surrogacy is an option for women who wish rear genetic offspring:

Surrogacy can be legally, ethically, and emotionally complex. But it is clearly safer for both mother and child than pregnancy following a uterine transplant. Surrogates are generally healthy women who have successfully given birth already. The risks to the surrogate and the child are those usually associated with normal pregnancy and birth.

That does not sound unreasonable, but, of course, surrogacy is illegal in many countries, e.g., Sweden, and some activists now want to ban surrogacy everywhere.

A final note: Tranplants of other solid organs between genders take place all of the time. So it has to be asked: Why should men not be eligible for uterine transplants?

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  1. What happened to adoption?

    1. Presumably the people doing this want their own biological offspring.

      1. And their own pregnancy.

        1. I’m sympathetic to the argument that a woman shouldn’t really endanger the survival of her offspring by getting a uterine transplant instead of a surrogate, but not to the argument that she shouldn’t care if her offspring is genetically related or not.

          1. Yeah, I guess that’s reasonable. Though I think she should care most that she isn’t causing more suffering in the world, period. There are already plenty of kids around.

            1. Yeah, I guess that’s reasonable. Though I think she should care most that she isn’t causing more suffering in the world, period. There are already plenty of kids around.

              1) Utilitarian, now? 2) Do you assume that people share your view that life is – on balance – suffering, and (its creation) thus to be avoided?

            2. Wait, you are pro open borders and anti-reproduction?

          2. Within a very small number of generations, your offspring have no meaningful genetic relationship to you, yet cultural relationship can remain strong.

            Not that this need be an entirely rational decision.

            1. I’m not anti-adoption either. I’m just saying that it’s totally reasonable for a women to want to have her own genetic offspring. It’s also reasonable to want to have her own pregnancy, but less so if there’s a high probability of a miscarriage. Especially when you consider how expensive it is just to get to the point of having a viable embryo to implant.

              If they can bring the risk down to the point it’s not much higher than a normal IVF cycle, then I would go for it though.

              1. WHich raises the question – what do they do if the fetus miscarries? It obviously has to be surgically removed…. which is yet another surgery.

            2. Within a very small number of generations, your offspring have no meaningful genetic relationship to you, yet cultural relationship can remain strong.

              Consider that each subsequent generation is linked by genetic relationship/similarity and that this link allows the creation of a “cultural” relationship, the establishment of a “family culture” unique to and shared by (genetically) distant ancestors. (Don’t be distracted by assortative matin

          3. but not to the argument that she shouldn’t care if her offspring is genetically related or not.

            Who are you, Maury Povich?

          4. I’m also sympathetic to that argument, but practice makes perfect (or at least better). How many other operations were once extremely dangerous, but are currently much lower risk? The first transplants for other organs probably had low success rates.

            Based on the arguments for why people would want to do this, they should be able to make the choice of whether they will accept the risk and cost.

            I admit this is different from something like a kidney transplant in that the goal is to produce another human. That obviously wades into the same minefield as abortion in terms of whether it is a case of the mother risking her own body or if she’s risking another life. There’s room for debate there, but there is also precedent.

    2. NUCGG: Actually, the transplantee and her husband have adopted 3 boys already.

      1. Wait, there’s no cap on that? Sounds like sex discrimination, too. That can’t be healthy.

      2. After the transplanted uterus has been removed, can it be retransplanted in the husband so he can get a divorce and marry himself ?

    3. Shop local dude!

      Them adopted kiddies are from real far away.

  2. “That does not sound unreasonable, but, of course, surrogacy is illegal in many countries, e.g., Sweden, and some activists now want to ban surrogacy everywhere.”

    Jesus Christ, I am so mad I clicked that link.

    “This week, Sweden took a firm stand against surrogacy. The governmental inquiry on surrogacy published its conclusions, which the parliament is expected to approve later this year. These include banning all surrogacy, commercial as well as altruistic, and taking steps to prevent citizens from going to clinics abroad.

    This is a ground-breaking decision, a true step forward for the women’s movement. Initially divided on the issue women came together and placed the issue higher up on the agenda. Earlier in February, feminist and human-rights activists from all over the world met in Paris to sign the charter against surrogacy, and the European Parliament has also called on states to ban it.”

    HAHAHAHAHHAHAA! Stopping women from willingly having surrogate children is a win for feminism! Brilliant.

    1. Most of the comments are good, but then there’s this asshole:

      “No, I don’t believe in “bodily autonomy”. The feebleness of your body means that you are entirely dependent on the society in which you live. If you don’t like having your “bodily autonomy” restricted in this very minor way for the benefit of that society then why not do something useful with your Autonomy. For example you could leave your clothes, your weapons and the rest of humanity and go an live alone and naked in the wilderness, preferably where there are plenty of hyaenas.”

      Wuuuuuuut

      1. “No, I don’t believe in “bodily autonomy”. The feebleness of your body means that you are entirely dependent on the society in which you live

        So xe’s in the ‘no’ column on ‘my body, my choice’. Noted.

      2. “No, I don’t believe in “bodily autonomy”. The feebleness of your body means that you are entirely dependent on the society in which you live. If you don’t like having your “bodily autonomy” restricted in this very minor way for the benefit of that society then why not do something useful with your Autonomy.

        So abortion restrictions are OK now? Your naughty bits, you didn’t build them?

    2. Stopping women from willingly having surrogate children is a win for feminism! Brilliant.

      Apparently so is stopping women from having children by hiring a surrogate.

      Apparently, infertile women should just suffer the punishment deemed by God. Feminism will not lift a finger to help them.

      1. It’s a win-win situation for feminism:
        The surrogate mothers are prevented from earning money and the biological parents are prevented from having children.

      2. I think what it really is is that extreme feminists are against motherhood, and this is the only angle of it that they can attack for now.

        1. Well, they think that the poor surrogate mothers are being exploited by evil rich women who want to have children – which shows that has nothing to do with feminism per-se, it’s just the same old leftist class warfare dressed up in feminist rhetoric.

        2. Well, they think that the poor surrogate mothers are being exploited by evil rich women who want to have children – which shows that has nothing to do with feminism per-se, it’s just the same old leftist class warfare dressed up in feminist rhetoric.

  3. I’m guessing a dude with a uterus that he plans to actually use is going to have to get a caesarean.

      1. I know. Christ, we do 5,000 deliveries a year just down the hall from my hospital.

        I was just thinking uterus – pregnancy -. delivery . . . uh oh.

    1. But will the dude get the cramps real hard?

    2. No respect for butt babies?

  4. Still, Johson and Trump make the observation

    Dammit! Another Trump article.

  5. does not justify the significant risks to mother and fetus posed by uterine transplants, not to mention the enormous financial cost.

    So, fuck you, five people already born from transplanted uteruses.

  6. Why should not men be eligible for uterine transplants?

    Would a narrowed gays be inappropriate here?

    1. Arnold was man enough to do it without a uterus.

  7. …the wholly understandable desire to bear a child does not justify the significant risks to mother and fetus posed by uterine transplants, not to mention the enormous financial cost. Safer, less costly, and more certain ways to have children already exist. When it comes to uterine factor infertility, we must ask ourselves: What is more important, the experience of pregnancy or the health of a woman and her future child?

    Huh… so bioethicists aren’t completely on board with full reproductive choice. Noted.

    1. I was nodding along up until they said “we must ask ourselves” instead of “each person must ask themselves”.

      1. Because apparently women lack the agency to weigh the risks and make their own decisions.
        And feminists agree with this? Can anybody explain why?

    2. Actually it is quite common for obstetricians to prioritize the health of the fetus over the mother’s health and preferences, which is one reason why nearly 1/3 of births are C-sections today. If there’s even the slightest risk of harm to the fetus the doctor will push to do a C-section, despite the long-term physical consequences for the mother.
      This is even if the woman is willing to take some risks to have a vaginal delivery. They also have a bias against natural childbirth, even though it reduces the risk of complications. Pretty much the whole medical establishment is lined up against women having any sort of right to experience pregnancy and childbirth if it increases risk to the fetus.

      1. C’mon Hazel, give up the act.

        We all know you are a shill for Big Bungee Birthing. According to you the only “natural” way to give birth is for the expectant mom to strap herself onto one of BBB’s and leap off a bridge. Sure, the newborn might get a real kick out of it and it does also result in the kid being born in water (which is also supposedly good), but maybe some women don’t want to do that.

        I don’t think you are in the right when you disparage these couch potato mom’s who simply want a doc to hack the baby out ASAP.

      2. Doctors’ initiative, or legally influenced?

        1. Fear of malpractice lawsuits, I suspect.

          1. Exactly. Any “bad baby” case will cost millions. Its entirely rational, from a purely economic perspective, to push for C-Sections if there is much chance at all of a bad outcome from a vaginal delivery.

            1. Except the odds would even out if women could successfully sue for unnecessary C-sections.

              One thing is that each C-section makes subsequent pregnancies riskier, which limits the number of children a woman can have. And one C-section tends to mean that every subsequent pregnancy is a C-section, so the first one makes a big difference. But nobodies ever gone back and said “that first C-section wasn’t necessary, and now I can’t have any more children, had to have hysterectomy” or whatever and sued the doctor. The downstream effects of it are too far in the future.

          2. Same. But cui bono (the law)?

      3. Actually it is quite common for obstetricians to prioritize the health of the fetus over the mother’s health and preferences, which is one reason why nearly 1/3 of births are C-sections today.

        Is this case of potayto vs. potahto? There’s been quite a bit of spilled ink about the C-section trend being related to frivolous/dubious lawsuits, so the C-section is more of a legal CYA as opposed to any actual medical calculation on the mother’s health.

        I guess what I’m asking, is this statistic coming from bioethicists or lawyers?

        1. Its coming from doctors. They are the only ones who can order or perform a C-Section.

          The rate used to be much lower, BTW (as in, single digits).

          1. My question was muddy: Are doctors making this decision in response to the lawyer lurking in the background or the bioethicist?

          2. Or sorry, the third option: Or is the doctor truly operating in a vacuum of pure, un-varnished medical evidence which in each and every case pointed to a clear need for a C-section?

            1. The doctors are responding to the economic/legal incentives they are presented with.

              None of them give a shit what the bio-ethicists have to say about anything.

            2. It is absolutely driven by fear of being sued over a stillbirth or some other birth injury. C-sections are safer from a fetal health perspective, just not for the mother’s health.

        2. I have a suspicion that you would find a strong segment of expectant mothers who prioritized this way as well. I agree the choice should be the mothers, and the risks each way should be explained as clearly as possible, just as I agree with that for any medical decision, but there seems to be a hidden assumption in this that these doctors are acting against the expectant mother’s wishes here, when they may well be acting in accord with those wishes.

          1. It’s really easy to convince an pregnant women who is in labor that she “has to” have a C-section, especially when you suggest that there is an “increased risk” of stillbirth or cerebreral palsy, or some other horrible outcome. Even if the risk is still miniscule.

            1. Forgive me if I am reading too much into what you are saying but it sounds like you are suggesting that the doctor should try to convince the mom to be the other way. If the expectant mother prioritizes avoiding minor risks to the baby over avoiding the harm and risk of a C-section (which are also relatively minor, albeit in many cases greater than the risks to the baby) to herself, isn’t that a choice we are bound to respect?

              I understand that the Doctors push for C-sections, and have heard of cases where they present it as necessary rather than explaining risks, and I am against that. However, granting the mother agency means respecting that she may well be willing, even eager to make the decision to undergo a C-section to reduce, even a little, the chance of death or lifetime disability to the baby.

    3. In my experience, bioethicists are pretty much opposed to anyone making their own decisions about health care.

      The entire discipline seems to be an exercise in denying people agency.

  8. Can we push for a ban on abortion in the us and say “because Sweden?” That seems an important touch stone for baby killers.

  9. So it has to be asked: Why should men not be eligible for uterine transplants?

    Mhm. Tough call between this and transdolphins.

  10. A final note: Tranplants of other solid organs between genders take place all of the time. So it has to be asked: Why should men not be eligible for uterine transplants?

    Stan finally has an answer when Reg tells him, “You haven’t got a womb! — Where’s the fetus going to gestate?! You going to keep it in a box?!”

  11. Why should not men be eligible for uterine transplants?

    NO! We are Devo!

  12. I’m curious that it’s presented as the uterus *has* to be removed after the birth, and not just will *probably* be removed. If it were just a “rejection” problem, I would expect it to be presented as such, and so would be surmountable (though perhaps not in these early trials).

    Maybe I’m just reading too much into an admittedly brief article.

    1. Admittedly I am also reading into the article but I took it that the removal post birth was because there are significant risks associated with the treatments needed to prevent rejection, as well as risks resulting from rejection, and once the mother has given birth she has gotten what she wanted from that uterus. The question would be if a women wanted to have a second child this way whether it would be safer to keep the transplant or try and redo it later.

  13. Jack Sammy is not going to like that at all dude.

    http://www.Anon-Net.tk

  14. The uterine transplant is the surgical procedure whereby a healthy uterus is transplanted into an organism of which the uterus is absent or diseased. As part of normal mammalian sexual reproduction, a diseased or absent uterus does not allow normal embryonic implantation, effectively rendering the female infertile. This phenomenon is known as absolute uterine factor infertility (AUFI). Uterine transplant is a potential treatment for this form of infertility.

    To know more details about Uterus Transplant visit this website:
    http://www.freedoctorhelpline……ransplant/

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