8 ms·

First womb-transplant baby born

85 points by forrest_t 12y ago

pygy_ 12y ago
Next up: m2w trans pregnancies, then just male pregnancies. Stem cells-derived gametes (of both types, regardless of the sex of the donor) are also around the corner. Exciting times :-)
- cherry_su 12y ago
  Thomas Beatie (a m2w trans) got pregnant in 2007. >>> Beatie chose to become pregnant because his wife Nancy was infertile, doing so with cryogenic donated sperm. https://en.wikipedia.org/wiki/Thomas_Beatie https://en.wikipedia.org/wiki/Thomas_Beatie
  - stormbrew 12y ago
    That's the other way around. Thomas Beatie was assigned female at birth. The GP is talking about someone assigned male at birth, I'm pretty sure. That's what 'm2w' or 'mtf' generally means.
    - meowface 12y ago
      Yeah, the inverse would be an amazing feat of science and medicine.
      - bjornsing 12y ago
        I agree, truly amazing.
fcoury 12y ago
May be a dumb question but in this case which genes will the baby inherit: the mom's or the womb donor's?
- maxerickson 12y ago
  The mom. Here's the portion explaining that: The identity of the couple in Sweden has not been released, but it is known the mother still had functioning ovaries. The couple went through IVF to produce 11 embryos, which were frozen. Doctors at the University of Gothenburg then performed the womb transplant. Which makes it sound like eggs from her ovaries were used for the IVF.
- lmkg 12y ago
  Genes of the baby are 100% determined by the fertilized egg. The genes will be from whoever donated the egg. This is usually the mother in practice, but since you need to do In-Vitro Fertilization anyways, there's no fundamental reason it couldn't be someone who is genetically unrelated to either the mom or womb-donor. Note that genetics are not 100% in control, and the conditions of the pregnancy affect the outcome of the pregnancy. We don't know the full effects of this, and we certainly don't know which aspects of it are from the womb specifically vs other biological aspects of the mother (e.g. blood chemistry). Health of the mother certainly has correlations with birth weight and developmental progress, but the extent & mechanisms are still pretty opaque.
  - car 12y ago
    Slight correction; the genome is 50% maternal (egg), 50% paternal (sperm).
    - pyre 12y ago
      Fertilized egg = unfertilized egg + sperm :)
      - car 12y ago
        Well, that read differently before.
    - possibilistic 12y ago
      Don't forget mtDNA. That's maternal. Edit: usually. As for nuclear DNA, keep in mind all of the weird crossover failures that are rather common in a large population. These typically result in gene dosing problems and can lead to fetus inviability. Then consider the epigenome, selected immune recognition, and microbiome. These can be/are environmental. 50/50 is the textbook story we teach before undergrad. It's easier to learn and still conveys the central idea of the model.
wyager 12y ago
People can be so insanely desperate to have children exactly in some arbitrary and specific way. I mean, this woman went through a very dangerous and expensive transplant surgery that then required the use of immunosuppressant drugs to prevent organ rejection, when she could have used a surrogate or, gasp, adopted. I hope they had to pay for this surgery with their own cash. There is absolutely no medical necessity behind it. Edit: This comment seems to be eliciting some disapproval. I'm curious why; please let me know what you're thinking.
- chrisseaton 12y ago
  Having children of their own is life goal number 1 for many people. Asking them to be rational about it is disregarding just how primal this drive is.
  - derefr 12y ago
    I would phrase that as "having children of their own is goal number one for [all adaptively-fit lifeforms that undergo sexual selection pressure]." The genes of all plants and animals alive today came from the subset of their species that wished to procreate. Or, to put it another way, among gene sequences that attain fixation through sexual selection pressure, any sequence that impels procreation as a terminal goal is going to be fixated more quickly than any other.
- kurokikaze 12y ago
  It's a scientific achievement.
  - dublinben 12y ago
    A completely unnecessary one. This is just progress for the sake of progress.
    - csallen 12y ago
      Seemingly unnecessary progress might inadvertently lead to important discoveries and useful knowledge.
bayesianhorse 12y ago
The amazing part here is that the immune system is very much involved in the early parts of the pregnancy. Successful "implantation" of an embryo in a transplanted womb with an immune-suppressed host is no mean feat...
- Amarok 12y ago
  I don't understand why the successful implantation of the embryo is amazing. Many women take immunossupressants while pregnant, and many undergo IVF to give birth, some of which to allogeneic embryos (egg donations). This last one doesn't seem to affect significantly implantation, with the main concern being a higher risk of pregnancy hypertension[1]. I expect conceiving with an allogeneic uterus would be similar, since in both the genetic differences between embryo and uterus are comparable. Succeeding in combining the two is just a matter of probability, which I don't think is that low. Especially if you consider that the uterus had to come from a compatible donor, so the number of HLA mismatches will be lower. 1. http://www.ncbi.nlm.nih.gov/pubmed/20543201 http://www.ncbi.nlm.nih.gov/pubmed/20543201
mrfusion 12y ago
Would she have the womb removed when she's done having children? Seems like that would be worth doing to get off immunosuppressants? And follow up, could the womb then be transplanted in someone else??
- gus_massa 12y ago
  Last sentence in the article: > The drugs used to prevent the womb being rejected would > be damaging in the long term - so the couple will either > try again or have the womb removed.
whiteshadow 12y ago
The only thing that made me weary here was having a baby on immunosuppressants, and the danger that could present for the fetus. Anyone knows if this can affect the baby on the long term (associated with premature birth)?
- 3rd3 12y ago
  http://www.news-medical.net/news/20131111/Women-taking-immunosuppressive-medications-during-pregnancy-do-not-put-their-babies-at-risk.aspx http://www.news-medical.net/news/20131111/Women-taking-immun...
- Amarok 12y ago
  During pregnancy the mother was on a triple immunosuppressant regimen: azathioprine, tacrolimus, and prednisolone (corticosteroid). The first is a Pregnancy Class D drug (some reports of human birth defects), and the two are class C (birth defects only in animal studies) A study on azathioprine use in early pregnancy found an increased risk of congenital malformations which wasn't statistically significant (from 4.7% to 6.2%) , and an association with preterm birth and low-weight[1]. But a later meta-analysis concluded only the increased risk of preterm birth was significant for this class of drugs[2] It's mentioned in the article that the mother developed pre-eclampsia (simply put, hypertension during pregnancy, which can lead to eclampsia, with seizures and coma). This should also be a concern for the other women in the study[3]: Firstly, immunosuppressants might increase pre-eclampsia, since the risk is about double in women with a kidney transplant (22%). Also, the age of the donated uterus should be considered: the risk increases seven-fold for pregnancies after 50, though it hasn't been shown the problem is in the uterus itself. Finally, the risk is higher for IVF conception. Given this accumulation of risk, I'm curious how the other pregnancies carry on.To understand what's at risk, being born preterm is associated with increased morbidity and mortality, as well as lower achievement in general. Some papers point towards epigenetic changes (DNA methylation) as the etiology. 1. http://www.ncbi.nlm.nih.gov/pubmed/19343728 http://www.ncbi.nlm.nih.gov/pubmed/19343728 2. http://www.ncbi.nlm.nih.gov/pubmed/22434610 http://www.ncbi.nlm.nih.gov/pubmed/22434610 3. http://press.thelancet.com/wombtransplant.pdf http://press.thelancet.com/wombtransplant.pdf (original paper)
usbreply 12y ago
Why is it called a "womb" transplant rather than a uterus transplant ? Womb is such a weird word to use.
- blahedo 12y ago
  In the US the word "womb" has a vaguely archaic or religious feel, but it seems to be much more current in UK English (and the link here is to the BBC). I've seen "womb" used regularly on UK sites. US-based news feeds (that I've seen) have indeed generally used the term "uterus transplant" about this story.
  - threedaymonk 12y ago
    I can confirm that 'womb' is a perfectly normal word here in the UK. It's no stranger than 'fortnight' or 'autumn'.

85 points by forrest_t 12y ago

pygy_ 12y ago

Next up: m2w trans pregnancies, then just male pregnancies. Stem cells-derived gametes (of both types, regardless of the sex of the donor) are also around the corner. Exciting times :-)

cherry_su 12y ago
Thomas Beatie (a m2w trans) got pregnant in 2007. >>> Beatie chose to become pregnant because his wife Nancy was infertile, doing so with cryogenic donated sperm. https://en.wikipedia.org/wiki/Thomas_Beatie https://en.wikipedia.org/wiki/Thomas_Beatie
- stormbrew 12y ago
  That's the other way around. Thomas Beatie was assigned female at birth. The GP is talking about someone assigned male at birth, I'm pretty sure. That's what 'm2w' or 'mtf' generally means.
  - meowface 12y ago
    Yeah, the inverse would be an amazing feat of science and medicine.
    - bjornsing 12y ago
      I agree, truly amazing.

fcoury 12y ago

May be a dumb question but in this case which genes will the baby inherit: the mom's or the womb donor's?

maxerickson 12y ago
The mom. Here's the portion explaining that: The identity of the couple in Sweden has not been released, but it is known the mother still had functioning ovaries. The couple went through IVF to produce 11 embryos, which were frozen. Doctors at the University of Gothenburg then performed the womb transplant. Which makes it sound like eggs from her ovaries were used for the IVF.
lmkg 12y ago
Genes of the baby are 100% determined by the fertilized egg. The genes will be from whoever donated the egg. This is usually the mother in practice, but since you need to do In-Vitro Fertilization anyways, there's no fundamental reason it couldn't be someone who is genetically unrelated to either the mom or womb-donor. Note that genetics are not 100% in control, and the conditions of the pregnancy affect the outcome of the pregnancy. We don't know the full effects of this, and we certainly don't know which aspects of it are from the womb specifically vs other biological aspects of the mother (e.g. blood chemistry). Health of the mother certainly has correlations with birth weight and developmental progress, but the extent & mechanisms are still pretty opaque.
- car 12y ago
  Slight correction; the genome is 50% maternal (egg), 50% paternal (sperm).
  - pyre 12y ago
    Fertilized egg = unfertilized egg + sperm :)
    - car 12y ago
      Well, that read differently before.
  - possibilistic 12y ago
    Don't forget mtDNA. That's maternal. Edit: usually. As for nuclear DNA, keep in mind all of the weird crossover failures that are rather common in a large population. These typically result in gene dosing problems and can lead to fetus inviability. Then consider the epigenome, selected immune recognition, and microbiome. These can be/are environmental. 50/50 is the textbook story we teach before undergrad. It's easier to learn and still conveys the central idea of the model.

wyager 12y ago

People can be so insanely desperate to have children exactly in some arbitrary and specific way. I mean, this woman went through a very dangerous and expensive transplant surgery that then required the use of immunosuppressant drugs to prevent organ rejection, when she could have used a surrogate or, gasp, adopted. I hope they had to pay for this surgery with their own cash. There is absolutely no medical necessity behind it. Edit: This comment seems to be eliciting some disapproval. I'm curious why; please let me know what you're thinking.

chrisseaton 12y ago
Having children of their own is life goal number 1 for many people. Asking them to be rational about it is disregarding just how primal this drive is.
- derefr 12y ago
  I would phrase that as "having children of their own is goal number one for [all adaptively-fit lifeforms that undergo sexual selection pressure]." The genes of all plants and animals alive today came from the subset of their species that wished to procreate. Or, to put it another way, among gene sequences that attain fixation through sexual selection pressure, any sequence that impels procreation as a terminal goal is going to be fixated more quickly than any other.
kurokikaze 12y ago
It's a scientific achievement.
- dublinben 12y ago
  A completely unnecessary one. This is just progress for the sake of progress.
  - csallen 12y ago
    Seemingly unnecessary progress might inadvertently lead to important discoveries and useful knowledge.

bayesianhorse 12y ago

The amazing part here is that the immune system is very much involved in the early parts of the pregnancy. Successful "implantation" of an embryo in a transplanted womb with an immune-suppressed host is no mean feat...

Amarok 12y ago
I don't understand why the successful implantation of the embryo is amazing. Many women take immunossupressants while pregnant, and many undergo IVF to give birth, some of which to allogeneic embryos (egg donations). This last one doesn't seem to affect significantly implantation, with the main concern being a higher risk of pregnancy hypertension[1]. I expect conceiving with an allogeneic uterus would be similar, since in both the genetic differences between embryo and uterus are comparable. Succeeding in combining the two is just a matter of probability, which I don't think is that low. Especially if you consider that the uterus had to come from a compatible donor, so the number of HLA mismatches will be lower. 1. http://www.ncbi.nlm.nih.gov/pubmed/20543201 http://www.ncbi.nlm.nih.gov/pubmed/20543201

mrfusion 12y ago

Would she have the womb removed when she's done having children? Seems like that would be worth doing to get off immunosuppressants? And follow up, could the womb then be transplanted in someone else??

gus_massa 12y ago
Last sentence in the article: > The drugs used to prevent the womb being rejected would > be damaging in the long term - so the couple will either > try again or have the womb removed.

whiteshadow 12y ago

The only thing that made me weary here was having a baby on immunosuppressants, and the danger that could present for the fetus. Anyone knows if this can affect the baby on the long term (associated with premature birth)?

3rd3 12y ago
http://www.news-medical.net/news/20131111/Women-taking-immunosuppressive-medications-during-pregnancy-do-not-put-their-babies-at-risk.aspx http://www.news-medical.net/news/20131111/Women-taking-immun...
Amarok 12y ago
During pregnancy the mother was on a triple immunosuppressant regimen: azathioprine, tacrolimus, and prednisolone (corticosteroid). The first is a Pregnancy Class D drug (some reports of human birth defects), and the two are class C (birth defects only in animal studies) A study on azathioprine use in early pregnancy found an increased risk of congenital malformations which wasn't statistically significant (from 4.7% to 6.2%) , and an association with preterm birth and low-weight[1]. But a later meta-analysis concluded only the increased risk of preterm birth was significant for this class of drugs[2] It's mentioned in the article that the mother developed pre-eclampsia (simply put, hypertension during pregnancy, which can lead to eclampsia, with seizures and coma). This should also be a concern for the other women in the study[3]: Firstly, immunosuppressants might increase pre-eclampsia, since the risk is about double in women with a kidney transplant (22%). Also, the age of the donated uterus should be considered: the risk increases seven-fold for pregnancies after 50, though it hasn't been shown the problem is in the uterus itself. Finally, the risk is higher for IVF conception. Given this accumulation of risk, I'm curious how the other pregnancies carry on.To understand what's at risk, being born preterm is associated with increased morbidity and mortality, as well as lower achievement in general. Some papers point towards epigenetic changes (DNA methylation) as the etiology. 1. http://www.ncbi.nlm.nih.gov/pubmed/19343728 http://www.ncbi.nlm.nih.gov/pubmed/19343728 2. http://www.ncbi.nlm.nih.gov/pubmed/22434610 http://www.ncbi.nlm.nih.gov/pubmed/22434610 3. http://press.thelancet.com/wombtransplant.pdf http://press.thelancet.com/wombtransplant.pdf (original paper)

usbreply 12y ago

Why is it called a "womb" transplant rather than a uterus transplant ? Womb is such a weird word to use.

blahedo 12y ago
In the US the word "womb" has a vaguely archaic or religious feel, but it seems to be much more current in UK English (and the link here is to the BBC). I've seen "womb" used regularly on UK sites. US-based news feeds (that I've seen) have indeed generally used the term "uterus transplant" about this story.
- threedaymonk 12y ago
  I can confirm that 'womb' is a perfectly normal word here in the UK. It's no stranger than 'fortnight' or 'autumn'.