Uterus Transplants: The Wrong Kind of Risks

Episode: 
125

When I was a law student intern at Americans United for Life, we discussed the possibility of an artificial womb as a way to save fetuses that were destined for abortion. If we could transplant the fetus into an artificial womb, then the mother who doesn’t want to be pregnant could terminate her pregnancy, and the child could be saved.

A recently published study from Sweden focuses on the reverse situation: a woman who very much wants to be pregnant, but doesn’t have a functional womb. The solution? A uterus transplant.[1]

The nine women who participated in the research study were either born without a womb or had a hysterectomy due to cervical cancer. Each woman received a uterus donated by a relative, in some cases, her mother.

The study guidelines expect that the transplant will be temporary, and will be removed after a maximum of two pregnancies. This is so that the woman does not have to take anti-rejection drugs for the rest of her life. Also, due to the limitations of the transplant, these women cannot conceive naturally, but must use IVF.

Up until now, living donors have given organs, like a kidney, in order to save a life. Here, a uterus is donated in the hopes of creating/gestating a life. Higher risks can be tolerated for lifesaving procedures, but what about a procedure that some ethicists call a “quality of life” improvement?[2]

Uterus transplantation is riskier than surrogacy, adoption, or even other organ transplants.[3] The donor has the risks of major surgery. Risks to the woman include problems with anti-rejection drugs, risks of organ rejection, problems with blood supply, the woman’s response to hormones, and the possibility of infection, blood clotting, thrombosis, premature delivery, and rupture during labor and delivery, to name just a few.

There are risks to someone else: the child. In addition to the typical risks associated with IVF, which can include discarding some embryos,  the pregnancy might not succeed. Animal studies are not encouraging. Other risks include the effect of the anti-rejection drugs on the fetus, and the risk of maternal blood clotting, which could harm fetal development or even cause death.

Generally, we assume that parents—not children--are intended to bear the risks of parenthood. Yet, a uterus transplant means the parents intentionally initiate a pregnancy that imposes unusual risks on the developing child.  Long-term risks are completely unknown, but it is conceivable that a child may want to track down the womb donor. What if the donor is her grandmother, and the womb is the same one her mother grew in?

Infertility is heartbreaking, and the powerful desire to bear a child is understandable. But here, biomedical technology suggests a solution that is too costly/risky, for parents and for children.



[1] “Nine Swedish Women Undergo Uterus Transplants,” CBS News, January 13, 2014. http://www.cbsnews.com/news/nine-swedish-women-undergo-uterus-transplants/.

[2] Arthur L Caplan, Constance Perry, Lauren A. Plante, Joseph Saloma, and Frances R. Batzer, “Moving the Womb,” Hastings Center Report, May-June (2007): 18-20.

[3] Kavita Shah Arora and Valarie Blake, “Uterus Transplantation: Ethical and Regulatory Challenges,” Journal of Medical Ethics, June 12, 2013. doi:10.1136/medethics-2013-101400. http://jme.bmj.com/content/early/2013/06/11/medethics-2013-101400.abstract

 

 

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