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First baby born after deceased womb transplant
- random878 8y agoBrief overview of the article if anyone is interested. Very interesting case. Background Uterus transplantation from live donors became a reality to treat infertility following a successful Swedish 2014 series, inspiring uterus transplantation centres and programmes worldwide. However, no case of livebirth via deceased donor uterus has, to our knowledge, been successfully achieved, raising doubts about its feasibility and viability, including whether the womb remains viable after prolonged ischaemia. Methods In September, 2016, a 32-year-old woman with congenital uterine absence (Mayer-Rokitansky-Küster-Hauser [MRKH] syndrome) underwent uterine transplantation in Hospital das Clínicas, University of São Paulo, Brazil, from a donor who died of subarachnoid haemorrhage. The donor was 45 years old and had three previous vaginal deliveries. The recipient had one in-vitro fertilisation cycle 4 months before transplant, which yielded eight cryopreserved blastocysts. Findings The recipient showed satisfactory postoperative recovery and was discharged after 8 days' observation in hospital. Immunosuppression was induced with prednisolone and thymoglobulin and continued via tacrolimus and mycophenalate mofetil (MMF), until 5 months post-transplantation, at which time azathioprine replaced MMF. First menstruation occurred 37 days post-transplantation, and regularly (every 26–32 days) thereafter. Pregnancy occurred after the first single embryo transfer 7 months post-transplantation. No blood flow velocity waveform abnormalities were detected by Doppler ultrasound of uterine arteries, fetal umbilical, or middle cerebral arteries, nor any fetal growth impairments during pregnancy. No rejection episodes occurred after transplantation or during gestation. Caesarean delivery occurred on Dec 15, 2017, near gestational week 36. The female baby weighed 2550 g at birth, appropriate for gestational age, with Apgar scores of 9 at 1 min, 10 at 5 min, and 10 at 10 min, and along with the mother remains healthy and developing normally 7 months post partum. The uterus was removed in the same surgical procedure as the livebirth and immunosuppressive therapy was suspended. Interpretation We describe, to our knowledge, the first case worldwide of livebirth following uterine transplantation from a deceased donor in a patient with MRKH syndrome. The results establish proof-of-concept for treating uterine infertility by transplantation from a deceased donor, opening a path to healthy pregnancy for all women with uterine factor infertility, without need of living donors or live donor surgery.
- woliveirajr 8y ago> The uterus was removed in the same surgical procedure as the livebirth and immunosuppressive therapy was suspended. (from the lancet article) So not only the woman got an uterus, it was used specifically to get pregnant and was removed afterwards, so that the mother now doesn't need to get immunosuppressive drugs. It's amazing because, in the end, it wasn't the common approach to take material from the father, mother, implant in somebody's else body... it was somebody's else uterus, but this time it was implanted inside the mother. Amazing how much progress is done combining surgeries and drugs, until a new medical protocol is developed.
- hirundo 8y agoCould a womb be implanted into a male and be functional? Plan on a C-section to skip the birth-capable vagina transplant, which might not be even possible now. I wonder if the necessary hormone manipulations would be practical.
- jobigoud 8y agoThis must have been tried in animals… Maybe another case of negative results that didn't make it to publication. I wonder about the placenta and umbilical cord though.
- war1025 8y agoI apparently do not have a wild enough imagination for what researchers do in their spare time... this seems like something I wouldn't have expected anyone to do more than speculate about.
- TomMarius 8y agoWhy "in their spare time"? We're seriously researching things like that now, for a few years at least.
- war1025 8y agoI assume research just always takes place in spare time I guess :) I'm not up to date on the field and had never considered it is mainly the idea I was trying to get across.
- PhasmaFelis 8y agoThis is a really interesting question, in part because it raises the idea that trans women might be able to give birth someday soon. That could be very welcome news for a lot of people. Edit: I'm curious if people are downvoting this because they're anti-trans, or because they think I'm somehow anti-trans.
- 8y ago
- cyberwomb 8y agoAre you guys all delusional on the female anatomy? No, it could not by only transplanting the womb. Because HUMAN MALES don't have OVARIES. This mother had to have at least one menstruation - which means she had to have functional ovaries. They cannot produce that in males with drugs. A womb is just a womb - not the full set of organs and functions a female has to have to be able to get pregnant. Looking at women's bodies as spare parts, incubators, etc is the reason why you guys think this is doable on a human male. It's called misogyny.
- testvox 8y agoI think you are the ignorant one, people can get pregnant without functional ovaries, it happens all the time. It just requires an egg donor and in virto fertilization to be performed.
- isomorph 8y agoI take your point but it's an interesting issue, isn't it? What would the world look like if it was the norm for men to reproduce without women, and/or for women to reproduce without men?
- seszett 8y agoIt is indeed interesting (and reminds me of the axlotl tanks of Dune) but in this instance, the uterus ultimately comes from a woman anyway, so this particular medical feat (and the original question of this thread) doesn't really have much to do with it. It's also much more practical (and already technically possible, I think?) for females to reproduce without males than the other way round, so that's the most likely development for the future.
- pjc50 8y agoI was also thinking of the Vorkosigan series, in which external technologically-assisted gestation and birth is a key liberatory technology.
- 8y ago
- rodolphoarruda 8y agoBrazil, the most violent country in the world (60k violent deaths per year) is also capable of promoting life. I'm feeling a bit prouder of my country today.
- PhasmaFelis 8y agoReally not sure why this was downvoted. It seems like a reasonable sentiment.
- rodolphoarruda 8y agoThank you.
- pc86 8y agoAs an American, Americans have a habit of taking anything around pregnancy that mentions the word "life" to mean a pro-life/anti-choice stance, even if the context is from regions of the world without such a distinction. The response varies by audience, but the response on HN to anything approaching pro-life/anti-choice is usually downvotes.
- solveit 8y agoHN also seems to lean against patriotism (and for good reason in general, although this comment seems completely harmless), so that could also have played a part.
- Doxin 8y agoHN also seems to lean against patriotism for non-americans. There is plenty of patriotism to go around on HN, but don't try saying anything positive about countries other than the USA or it might just get interpreted as you saying the USA is bad.
- beaconstudios 8y agoAre we on the same website? For a US-centric site, I've always experienced HN as being pretty anti-US in keeping with the seemingly average Democrat attitude of thinking the US has been a detriment to the rest of the world for a long time. And that's coming from a Brit. I have no horse in the Democrat-vs-Republican fight.
- adrianN 8y agoI'm not sure why this is preferable to a surrogate mother. It seems like it's much less risky to implant a fetus into a surrogate mother than to implant it into a transplanted womb that is removed after the pregnancy.
- Operyl 8y agoIt’s one of those feelings, personally. Sure, surrogate mothers and adoptions are preferable, but it’s just not the same as giving birth _myself_. It’s all in my head, I guess.
- ryandrake 8y agoWouldn’t it be even better to just use the existing low-tech solution to infertility: adoption? With so many children out there without loving families, fertility treatment seems kind of crass and narcissistic.
- tspike 8y agoI generally agree with the sentiment, but there's no shortage of adoptive parents for infants. The desperate need is for older children, which is a very different kind of experience.
- capulate89 8y agoImagine that there is a neurotype that loves the idea of adopting (I have actually known people like this). So they adopt children in lieu of having quite so many of their own. Or they have none of their own at all. Nature, our harsh mistress, will weed people like this out of the gene pool very quickly.
- rlucas 8y agoNow imagine that such a neurotype is an environmentally-mediated part of the phenotype, not a strictly hereditary trait. Maybe it's called "Amazing Grace," or maybe it's called a principled commitment, or maybe it's called love. And experiencing it from others (maybe by being adopted by them) inspires it in you. Then, our harsh mistress would in fact tend to favor its expression and grow its prevalence among the population.
- trubbedstrullen 8y agoAt extraordinary expense, including the entire machine to provide the doctors, facilities, etc. This and tech like it only allow the elite to further separate themselves from anybody else.
- sandworm101 8y agoCool, and on an individual human level I'm happy for the parents. But at the larger societal level I find such procedures very disturbing. I don't mean to sound like a eugenicist, everyone has the right to have kids imho, but the resources spent to create this one kid were immense. There are far easier ways for these parents to have genetic children, a surrogacy being top of the list. The possibility of men carrying children is scientifically interesting, but again the human race is not struggling for kids. We are a growing population. I'd rather the resources spent on these procedures go towards vaccinations or the basic medical treatments that so many people lack on this planet.
- pc86 8y agoWe have enough scientists to work on multiple things concurrently. There is always something "more worthy" of research/funding/time/facility allocation/manpower than whatever it is you're working on at the moment.
- sandworm101 8y agoResearch is one thing, it advances human knowledge. My issue is with the procedure that comes from the research. I would not support this becoming a therapy, something to be used not to advance knowledge but to cure disease. I'm all for the experiment. I get worried when people talk about this as another answer to infertility, or those who suggest it as a means for men to carry babies. Similarly, I have no issue with some of the so-called "vampire" experiments, blood transfusions between young and old (ie moving blood both ways). Much can be learned through this (liver functions, immune cells etc). But I would very much against such a thing becoming a standard therapy beyond the lab.
- pc86 8y agoThis would be a surprisingly backward and anti-science viewpoint for the general public, let alone HN.
- jschwartzi 8y agoThe human race is not struggling for children, but many individual women certainly are. This is a technology that could help these women achieve something that they desire, and we shouldn't ignore that just because there are other problems to be solved too. Surrogacy is fraught with its own problems. Whomever you choose to be the surrogate has to carry the baby to term for 9 months. And they connect with the child while carrying it. If you ask a friend to do it, it puts a strain on the relationship regardless of whether they agree.
- accnumnplus1 8y agoI think if I was that kid I might feel a bit creepy.
- pc86 8y agoWhy?
- accnumnplus1 8y agoMaybe too much Lovecraft, horror channel, or Slayer, but there's an element of "born of dead womb". Certainly nice for the transplant recipient and partner, but I think I'd feel a bit weird having groen in a transplanted womb, even with downvotes telling me I'm not allowed to have an opinion.
- mLuby 8y agoShouldn't you feel the same way if your mother had a heart, kidney, or liver transplant? You'd be directly hooked up to it as a fetus and it's as "dead" as the womb in this case.
- andrewflnr 8y agoNo, because feelings don't work by strictly following nutrient flows.
- greedo 8y agoPeople said the same things about IVF.
- mr_overalls 8y agoThis kind of procedure could be a breakthrough for transgender women who want to bear their own children.
- presidentender 8y agoWould it be practical to keep the womb alive via a heart/lung machine and blood transfusions? Just remove human beings from the process altogether?
- XorNot 8y agoReally this is the question I'm interested in. Hopefully some animal models can be attempted in the near future. Given that we're getting better at growing body parts from stem cells, you could easily imagine in the nearish future being able to gestate an embryo in a womb grown from an individuals own stem cells and enough attached organs to provide the full environment.
- tspike 8y agoThis is a bit horrifying to me. Babies are quite familiar with their mothers' voices by the time they are born, among other influences; would we also attempt to artificially simulate that sort of pre-birth bonding?
- b_tterc_p 8y agoI presume that the children of mute mothers tend to turn out fine... but maybe not? Cursory search found nothing.
- tathougies 8y agoBaby's also bond to the sound of their mother's hearts, and yes, every baby carried by a woman with no heart beat is disadvantaged.
- tropo 8y agoHere, I'll crank it up a notch: instead of animal models, how about just gestating humans in animals? There is your artificial womb. It just requires a bit of anti-rejection drugs, or a bit of GMO effort for tissue similarity. Whales have the right body temperature. There is enough room to do dozens of babies at once. Cows are close enough. A cow can probably handle a half dozen babies.
- buboard 8y agoHow far are we from artificial wombs? afaik they can support the growth of lamb fetuses.
- btgis 8y ago>Dr Dani Ejzenberg Very surprised to see this last name doing this aberration to nature.
- Pica_soO 8y agoCould a men have a baby with such a transplant?
- adetrest 8y agoI... Don't get the point. How many orphans are there who will never be adopted? Why go to such length if you really want a kid? I find this a bit perverse personally. While the medical and scientific achievement is amazing, I don't know if it's a net positive overall.
- tathougies 8y ago> How many orphans are there who will never be adopted? In most developed countries, very, very few.