Vincent, the very first baby to be born to a 36 year-old woman who had a womb transplanted from a loved one’s friend, has actually raised hopes for all the women considering womb transplant for the missing link in their lives. Vincent’s mother is part of a clinical trial of nine women, two more of whom are due to have babies by the end of the year.
There are thousands of women who either do not have a viable womb or who had to get their wombs removed following a serious illness like cancer. Womb transplant could actually prove to be a ray of hope for such tens of thousands of women.
Substantial research on womb transplantation has been in progress for over 15 years. The first human uterine transplant was reported in 2000, and although premature, it certainly paved the way for further research and clinical trials in this field.
A womb transplant or the uterine transplant is a surgical procedure whereby a female with an absent or diseased uterus is transplanted with a healthy uterus. For normal reproduction, a healthy uterus is requisite to allow normal embryonic implantation. A defective or absent uterus renders the female infertile, the phenomenon being known as absolute uterine factor infertility (AUFI). Womb transplantation is a potential treatment to this form of infertility.
The first step to uterus transplantation is to surgically remove the uterus of the donor. The wombs are then transplanted into recipient women. They then conceive through IVF because it is impossible to conceive naturally because of the surgery. The women can have two babies this way before the uterus will be removed. This is done to minimise the amount of time they are taking powerful drugs to stop their bodies rejecting the organ rather than any stress on the womb itself.
The women are advised to wait no longer than six months between the birth of their first child and getting pregnant with their second. They are advised to take their medicines continuously during pregnancy and this has shown to have no effect on baby’s growth and development in kidney transplant patients.
However, babies born to women with a womb transplant are to be followed up with for many years.
A woman who has been diagnosed with Absolute Uterine/Womb Factor between the ages of 16 and 42 can potentially consider a womb transplant. She would have to provide the fertility team with her own eggs, to allow embryo production. Sperm can be from either the patient’s partner or a sperm donor.
The team will have to get the embryo already produced and stored in a good condition prior to the transplant. The patient should be in a stable and loving relationship at the time of the procedure because a lot of support will be needed following the surgery.
There have been ethical considerations regarding the idea of womb transplantation ever since it has come up. The ethics of womb transplantation are essentially based on patient care requirements and the use of any innovative surgical procedures.
Fortunately, the concept of womb transplantation covers all aspects of medical ethics, the so-called four pillars: primum non nocere (non-maleficence), autonomy, beneficence and justice. Womb transplantation offers all of these four qualities to a patient suffering from Absolute Uterine Factor Infertility.
Regardless of the criticism, womb transplantation may become the only option for women who are unable to conceive for reasons such as cancers or infertility or in cultures where surrogacy is an unacceptable option for couples owing to religious or ethical reasons.
Vincent’s Swedish mother learned she did not have a womb at the age of 15 she said in an interview with Associated Press.
"I was terribly sad when doctors told me I would never carry my own child.
"Mats told us there were no guarantees, but my partner and I, maybe we like to take risks, we thought this was the perfect idea," she said.
The woman's mother had wanted to be a donor but wasn't a match. Instead, she received her new womb from a 61-year-old family friend, who had previously had two sons and has now been through the menopause.
The womb donor is now baby Vincent's godmother and her two sons have also come to visit the family.
"She is an amazing person and she will always be in our lives," the mother said. "And she has a very special connection to my son."
"It was a pretty tough journey over the years, but we now have the most amazing baby," the father said. "He is very, very cute, and he doesn't even scream, he just murmurs."
While today, the concept of womb transplant may be new and under trial, there would be a time in near future when it will be easily accessible and widely successful. Even getting a donor wouldn’t be so difficult. Women who have had their children might want to practise sisterhood and help other women to have the same joy.
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