Woman with Transplanted Uterus Gives Birth, the First in the U.S
nytimes.com
nytimes.com
> A new frontier, uterus transplants are seen as a source of hope for women who cannot give birth because they were born without a uterus or had to have it removed because of cancer, other illness or complications from childbirth. Researchers estimate that in the United States, 50,000 women might be candidates.
> The transplants are meant to be temporary, left in place just long enough for a woman to have one or two children, and then removed so she can stop taking the immune-suppressing drugs needed to prevent organ rejection.
> The transplants are now experimental, with much of the cost covered by research funds. But they are expensive, and if they become part of medical practice, will probably cost hundreds of thousands of dollars. It is not clear that insurers will pay, and Dr. Testa acknowledged that many women who want the surgery will not be able to afford it.
While the science is amazing, why go this route rather than having a surrogate mother? I've heard the price of a surrogate is $30-50K.
I think a big factor in the cases discussed in the article is that these women were told they would never ever have their own children. Unlike women who are "infertile" (which is usually just a measure of probability, and not a binary diagnosis), women who do not have a uterus obviously understand that there isn't a probability factor for getting pregnant. But then tell a woman with such a diagnosis that there is an experimental procedure that will allow her to fully experience what she had always been told was not possible. It is more for her than just wanting a baby at that point-- the procedure offers her everything she was told she could not have in terms of giving birth to a child.
I don't doubt some level of that drive exists. What feels questionable is the sanity (?) of going to such extreme lengths to pursue it? As if there is a complete unawareness of the bigger picture.
That's one hell of an understatement. It's only the primary driving force of all successful complex lifeforms. Living things that give preference to offspring other than their own die with zero remaining trace of their existence.
Or even just adoption. Adoption is far cheaper as well.
There are plenty of reasons why people want their own biological children... but this seems like it carries a ton more risk with it. With complications from the transplant and heck even just childbirth.
Basically, it's not as simple as just handing off an embryo to another person and 9 months later acting like nothing happened. There are huge ramifications to a decision like this that don't come with being the birth mother.
https://en.wikipedia.org/wiki/Surrogacy_laws_by_country
Adoption on the other hand can be a risky path, leading to a different kind of problems, and some are very hard for parents. Everybody wants their sons being healthy and able to have a normal life but this is not always guaranteed with adoption. Some countries use shady practices and lie to the parents to obtain an emotional (not logical) choice. The cheaper the worst. Systematic racketeering is the minor of them. "Forgetting" about some important condition or omiting relevant medical information is much worse.
While impressive it feels too much like a First World Problem. Aren't there any real problems this team could have solved?
Talk to any couple who has had difficulty conceiving, and the humanity of this "first world problem" gets brought into perspective.
Diversity is helpful here
I don’t think this is an issue of the “American“ perspective or something like that.
You "bear" a child because you have love to give and to share. It's not about you, but about giving selflessly. I'm not judging what this is, or why. But this is not that. This is about the parents. The irony is disturbing.
The problem isn't Africa. The problem is billions of people living a middle-class lifestyle - even with growth rates at or slightly below replacement.
In fact, today is the best time in history to have children (or in your phrasing, today is the least selfish time in human history to have a child). Humanity is radically more capable of supporting another baby now than at any other time. It isn't even remotely a close contest.
Questions of resources? No it's not. We're drowning in food, take a look at the massive boom in Russian wheat production as one example. Global food potential is far beyond where we're at now, likely by a magnitude. We don't know what to do with it all. And that's before we take it up another level and move to drastically more productive food output methods, including indoor farming, AI + robotics, growing meat, better information management & knowledge globally, etc; and that's while we're still acting very inefficient with our existing food (throwing vast amounts of it away). Merely developing Africa's food potential alone will feed billions more people.
Maybe you're thinking energy? Have you seen the massive boom in solar and wind? That's going to get a lot more massive yet. We're intentionally under-developing nuclear, because right now it doesn't look like we're going to need it. Renewables are making up the majority of all new energy production globally, that tilt is going to get more extreme by the year. If the world had to do it, we could collectively throw trillions of dollars at nuclear immediately, and boost global energy output substantially within a few decades.
To date, humanity is batting a thousand at not going extinct due to challenges. Climate change will be no different.
Geothermal, wind, solar, heat, tide, etc. currently amount to a staggering 1.5% of the total primary energy supply of the world. Coil is at 28%, oil is at 31%, natural gas at 22% (and climbing), nuclear at 5%, etc. CO2 emissions continue climbing year after year, and we should have started going down more than twenty years ago.
Our agricultural system is completely dependent on fossil fuels (oil). Because of that it is mostly unsustainable, and also because it tends to destroy fertile lands (topsoil loss is kind of a big issue).
You are kind of right that the current system can support a lot of people. Unfortunately, almost none of it is sustainable. So making more people is really not a good idea at the moment, because the situation will change drastically over the next 80 years.
https://www.scientificamerican.com/article/u-s-reports-a-maj...
Pretty sure most people who want to be parents dont really think about those issues when having kids. It might be important for you but its not for those new parents.
Short-sighted people with more money than awareness doesn't feel like a great way to describe a future parent(s).
> Short-sighted people with more money
Turns out people with money (aka developed countries) the birth rate is falling (or already has fallen) below replacement.
Population is not the problem, population with an American lifestyle is a problem.
The people thinking what you're thinking must be very young or have some strange sociopathy.
Who said this was the most important problem anyway?
Are you, personally, working on solving a particularly important problem?
Most people in the world aren't solving problems anyway, other than getting money from other people's wallets into their own.
Not at all. If I'm supposing anything is that the word priorities is a word most people don't know but should.
* IUI
* IVF
* IVF with egg donor
* IVF with donated embryo
* Surrogacy
* Adoption (direct, not foster)
Are you really surprised that some men who want to be fathers would choose to have the procedure rather than using their own previously stored sperm?
Because rule 34... someone will get off on it.
Surrogate mothers have to have artificial insemination/IVF. So would the hypothetical mother in this case. These eggs don't all stick to the uterus, so the procedure normally involves sticking 3-4 fertilized eggs inside the embryo.
So if you want one kid, you need to plan to have up to 4. That's a concern.
Then there's the chance of having a chimera, where the baby uptakes the surrogate's DNA. This can cause complications (I know with a transplant this is still the case). There's also the whole "mother not carrying the baby" thing.
This isn't as crazy as it sounds.
Ignoring that (and "not as crazy as it seems" is a pretty straw argument), I'd say that the risks to mother and child of such an extreme surgery and long term use of anti-rejection drugs during child bearing raises it's own ethical issues. Adoption seems to be completely inconsidered.
That you want to argue that many people's insemination choices are driven primarily by logic seems odd to me. I think they get off on their idea of what sex, pregnancy, and childbirth are supposed to be like based on what they hear from their friends, family, and media, along with how they want to be perceived. Only a tiny portion of that is related to rational decisions to provide societal or even individual good to their child.
Logic was applied because you need to think about actually having up to 4 kids at once. That's still entirely necessary.
The "whole not carrying a baby" thing attempted to cover the idea of carrying your own flesh. I just didn't go into detail on that because I thought it was obvious. So no, I'm not arguing about logic.
Finally, "not as crazy as it seems" was a conclusion to the three of my points - not a strawman.
Pretend there's enough sperm you don't need IVF, or something. I'm pretty sure the thought experiment is about something that only affects the man, not the woman or child.
- Guy who has done IVF before
Using it for non life-threatening issues would be putting a lot of stress and risk on myself and my body for little reason.
That sounds rhetorical, but I'll bite anyway.
Some women really long for the experience of childbirth. This may not be entirely psychological. Giving birth has significant impact on a woman's physiology. In addition to changing the shape of the hips and often other details like that, it leaves a woman a chimera for many years. Because her blood and the blood of the baby mix, she carries cells from the baby for many years afterwards.
I have a genetic disorder. I have two biological sons. I was not diagnosed until they were about 12 and 14 years old, so I didn't (consciously) know about my condition at the time that I was making reproductive choices (though I did know I was always "sickly").
My first pregnancy significantly impacted how I eat. I removed a number of things from my diet to cope with my difficult pregnancy and many were never added back into my diet. I have reason to believe this did my health a lot of good. For example, it cured the chronic, sever vaginal yeast infections I had for more than two years prior that pregnancy. I never again had chronic, severe yeast infections.
I have read up a bit on pregnancy-induced chimerism and talked a bit with people online about it and talked a fair amount with my sons. I have come to think that some women long for a baby because it can have a profound impact on a woman's body in ways we don't fully understand and perhaps sometimes that longing is rooted in some subconscious awareness that going through the process of carrying a child to term may alter their body in ways that are potentially for the best.
This would be really hard to prove. We have no means to see what the biological outcome would be for the same woman with and without the pregnancy experience. But I am in remarkably good health for someone with my genetic disorder and I credit my two pregnancies with some portion of that fact.
Artificial wombs are coming. I was under the impression that women considered pregnancy as a burden which carries risks, is painful, causes all sorts of negative hormonal / physiological effects, etc.
I think that artificial wombs will initially be challenged by feminist and conservative groups, but will end up being accepted, first with wealthy Western women, but eventually by everyone else.
I have never considered that women might choose to carry a child, if they weren't required due to technological and scientific advances.
It does that, and is also something many women desire. Some thigns are both really hard and painful, and also very rewarding.
I really doubt you are going to get any challenges from feminists, or at least not very many. Feminism is all about empowering women to be able to do what they want, which includes having a baby using an artificial womb. Conservative groups might be against it, but it will depend on which group. Not all conservative groups are against IVF, which is similar in the sense that it allows a woman who would otherwise not be able to have a child have a child.
The types of feminists that you'll see negative responses from, are those that use feminism as a platform for controlling others. For example, the kinds of feminists (some people would call them fake feminists) that get upset when a woman chooses to shave her armpits, or likes to wear lipstick or heels, etc. etc. Those types always look for opportunities - no matter how absurd - to proclaim something is the latest attempt to enslave women to their biology, and so on and so forth.
It is one of the reasons I spend so much time on Hacker News. Most men are less aggravating for me to deal with.
It is also part of why I do not self identify as a feminist.
My wife who is also a homemaker and stay-at home mom. She has heard remarks from family, acquaintances and even random parents playing with kids at the park how she was throwing her university degree down the drain and how somehow she doesn't "need to stay home" and can do whatever she wants. They don't seem to understand that what she wants to do currently is to raise kids.
Any feminism that cannot honor, respect and support the importance of full time parenting is an ideology I want no part of. To my mind, the only good feminism is one that insists that full time parenting should be an equally legitimate choice for either parent, not just the mother.
I love this quote.
Women who work outside the home get rude comments, women who stay at home get rude comments and you can't even avoid it by opting out of childbearing entirely, those women get rude comments too.
I fail to understand what that has to do with feminism or much anything else.
BTW, staying at home is the more socially acceptable choice.[1]
[1] http://www.pewsocialtrends.org/2014/04/08/after-decades-of-d...
In this day and age? Does that still happen? Asking because honestly that’s so far from my personal experience.
Which is to say, I have the highest respect for SAHM moms because it's a damned difficult job.
I'm hoping that we'll be able to work towards a world have a world where stay-at home dads, stay-at home mums, surrogate pregnancies, same-sex parents, dual parental leave, etc, are all valid choices for bringing up children.
Your experience of self proclaimed feminists and full time motherhood is very different to mine, and it's not just a generation gap because my mother was a full time parent and a feminist (still feminist, but spends less time parenting these days) and my sister is both as well.
I am also pretty skeptical of the interpersonal understanding and self awareness of women who explain that they just never get on with other women because of the issues those other women have, and men are just so much nicer - it's usually as much about their issues as anyone else's.
Feminism is all about empowering women to make choices that are right for them, especially with regards to reproduction and childrearing.
If your wife wasn't a stay at home mom she'd get rude comments about working outside the home - it's called the "Mommy Wars"- ever single childrearing choice gets criticized by someone.
I get a massive amount of criticism and nasty comments, from everyone including strangers, for my reproductive choices as well, even though they are firmly "progressive" - I'm a married woman whose voluntarily opted out of childbearing. I also get nasty comments about not taking my husband's name.
It's become fashionable, in the Trump era, to use feminism and liberalism for some sort of scapegoat, or reason for bad things, no matter how absurd. I was at a BBQ and one kid hit another kid and, very seriously, the mom blamed feminism. Yep, feminism caused a minor dispute between siblings.
Plus it’s always in continuous change. Example: currently in the U.K. there’s a hot debate between (some) feminists and trans women [1] but who knows in the future, it would be 100% feminist to accept all self-identifying females as valid females.
Slightly off topic: Feminisim is a bit of a messy subject (imo), I wonder if one can have a clearer picture if it’s expressed in logical terms :o
[1] https://www.theguardian.com/society/2017/nov/26/transgender-...
I can see feminists, evangelicals, and quite a alot of people opposing humans grown in labs.
Carrying a child is often a very emotional experience, and it makes sense that reactions to those emotions would vary pretty wildly between different people.
Feminism is about empowering women to make their own reproductive choices. Giving them MORE choices is a positive not a negative for feminism.
Sure it's risky and is painful and it makes me scared sometimes, but the thought of some artificial womb producing my baby gives me the shudders.
Would it even be "my" baby, if I didn't carry it? Similarly, I don't think I could have the same kind of love for an adopted child as for my biological. I'm sure you can love it just as much, but differently.
This is not true. If the baby had AB blood and the mother had A, then the baby's blood cells would be attacked by the mother's.
Imo: that goes to show that mother and baby share feelings during the childbearing process. If negative feelings are pushed down to the baby. Then it would make sense that positive feelings are too.
The question of longing for a baby is mostly a first world problem. In most parts of the world, they still have more traditional issues, like shot gun weddings for out-of-wedlock pregnancies.
It is sort of like saying "we crave oxygen." You only are aware of that in its absence. Otherwise, you breathe because that's what you do, not because you sit around writing odes to the wonderfulness of oxygen, oh, how I long for thee.
This is part of why people are weirded out. The default state is that women are trying like hell to not get pregnant most of the time. Then you have some weird edge case where they can't just get pregnant, you discover this matters enough to them to be willing to go to rather drastic lengths to achieve it and it flies in the face of our expectations.
Startup idea: Uterent™
(1) is that the correct terminology?
Surely the simplest solution to the reproductive question during space colonization is to send along a doctor or midwife with the couples headed out from earth?
Humans are really good at making this happen.
From this perspective, there may be some merit to the parent poster's argument that human "factories" may be less risky for everyone involved, since it might be easier to control the conditions.
Which is very, very different than sending pregnant humans into space.
>>Long term more serious issues are space radiation effects.
Not just that. Muscular degeneration is a real problem, especially (in this case) for humans who have to carry a child inside them.
That'd be a weird upbringing, huh?
It really wouldn't because women would lose the societal benefits of being child bearers. So at best, it would be a wash.
> This provides the ability for people to have a child without the woman having to gestate the fetus for 9 months? None of the terrible side effects of pregnancy, none of the pain. Sounds pretty idealistic to me.
But most women actually want the experience of being pregnant. It's why this woman chose to transplant a uterus and become pregnant. She could have just hired a surrogate for far less time, effort and money.
But the issue of artificial wombs does offer a interesting question. How would it change humans as a species. Would it make men or women or both obsolete? Evolutionary pressure has made women child bearers and men providers. How would artificial wombs change that? Not to mention, the effects on physiology. Would women eventually lose uteri or will it become a useless vestigial organ over time?
I'm really curious if this is true.
https://www.newscientist.com/article/2128851-artificial-womb...
there are existing procedures to help facilitate implantation and regulate hormones that have high success rate (most common is ivf).
however, vaginal canal can also be useful to expel discharge and in case of pregnancy, placental fluid/sac -- but in a theoretical case of implanted uterus only, I wonder if "including" a vaginal canal would be more symbolic than medically necessary?
Basically turning a man functionally into a woman.
If 30 years out just 1 in 100,000 men are doing this at a given time, it'd be over 100,000 male births annually on the planet.
Personally, I think this will, in modern historical terms, be the most significant catalyst in equalizing the genders. But I don't expect feminist groups to embrace it with open arms.
You'll have men that were born as men, who want to be men / identify as men. I'd expect that to be a smaller share of the male birth number. Then you'll have men that were born as men, who want to be women / identify as women. That will likely represent the far larger share of the male birth number.
Obviously a very interesting idea but for men (or people who were born men) the correct hormone issue is HUGE.
You’d have to give the correct amount of hormones at the correct time with those amounts changing every day (and possibly during the day). It’s an MASSIVE challenge and we may not even know what those correct dosages are right now. I mean has anyone ever done a record of the hormone levels for woman’s pregnancy for even two tests per day during the entire term?
And that’s assuming it static. If the correct hormone levels react to the way the baby is developing in someway (and I assume they must) then the challenge gets even greater.
The doctors on the podcast or in the article (I don’t remember where) seems to imply that what was done for this woman was basically trivial in comparison to making it possible for a man.
I think an elite few trans women might get it, but I don't expect men would want to.
The "hundreds of thousands of dollars" cost is a bit concerning to me. I'm also guessing it will difficult to bring the cost down since it requires a donor uterus.
In a reasonable universe, things like this would be discussed openly in terms of public-vs-private health care coverage, limits of cost, and liability for "uncaused" stuff (genetic bad luck, etc) vs "caused" stuff (e.g. alcoholic or obeseity-caused cirrhosis) so that we weren't simply writing blank checks with future people's money. Especially with the potential to grow organs - now your rate limiter on the costs is potentially gone! But in the US we can't even decide that people deserve health care access at all, so discussing the limits of it will have to wait for later, I suppose.
Plus, pregnancy while taking a lot of immunosuppresant drugs doesn't sound like a really good idea.
Just to show that single payer system can be good for medical innovation, not just universal healthcare.
> The cost of a uterus transplantation is estimated to be around SEK 100,000 per patient. [...] > Will this cost the patient anything? > No. The first initial experiments with uterus transplantation will be covered entirely by research funding.
Apparently some of the research also came from a Professor in the US:
> The team learned this technique at the University of Connecticut and received help at the beginning from Professor John McCracken, who is a pioneer in reproductive medical research. It took about a year before the autotransplantation method on sheep worked well.
Single-payer systems also have to constrain costs, so its not clear that they would actually cover a procedure like this, or if they did there might be a really limited supply. (I suppose the supply would be inherently limited anyway by how many available uteri there are)
Single-payer systems are actually rarely actually single-payer. For example apparently private insurance is becoming more popular in Sweden:
> The number of people purchasing supplementary private insurance is rapidly increasing, from 2.3 per cent of the population in 2004 (Swedish Insurance Federation 2004) to approximately 4.6 per cent in 2008 (Trygg-Hansa 2008). The voluntary health insurance mainly gives quick access to a specialist and allows for jumping the waiting queue for elective surgery (Glenngård et al. 2005).
http://www.euro.who.int/__data/assets/pdf_file/0011/98417/E9...
I wouldn't think they would, but the existence of a single-payer system didn't prevent research on this.
> Single-payer systems are actually rarely actually single-payer.
What you mean in this case is purely single-payer. Paying for things that are outside of normal health care, like fancy private rooms or plastic surgery don't seem like they would have a negative effect. Getting quick access to a specialist seems problematic, though, but maybe the quick access to a specialist means ability to quickly consult with a foreign specialist; there's not a lot of detail there.