Uterine transplant. Just because something CAN be done, SHOULD it?

The New York Downtown Hospital is planning to carry out the first ever successful uterus transplant. The procedure had been attempted six years ago in Saudi Arabia, but failed. Women who do not have a uterus, such as those who underwent a hysterectomy, would possibly have the chance to conceive. The transplant might also help women who have a damaged or defective uterus.

The medical team is currently screening women who want to have children but are unable to.

Team leader, Giuseppe Del Priore M.D., M.P.H., said that the desire to have a child is a tremendous driving force for many women. He believes he and his team may be able to help many women fulfill "this very basic desire".

Even though such a transplant is not planned for the very near future, Del Priore told The Washington Post that a transplant may be attempted towards the end of this year.

Several experts have voiced concern about carrying out such a procedure before further animal tests are done. Others wonder whether the risks may be greater than the benefits for both the woman and the fetus.

A team of physicians in New York City has announced that they intend to conduct the first uterus transplant in the United States. For women born without a uterus, or who have had their uterus removed due to illness, this procedure offers the hope that they will be able to bear children.

(clip) There are three major issues.

First, little research has been done on animals. No animal has given birth to a healthy offspring or even given birth at all post a uterus transplant. If, instead of a surgical innovation, the doctors involved were talking about a new drug treatment to give to infertile women, no one would let them try without showing that it was safe and had some efficacy in animals.

Second, the uterus to be transplanted will have to come from a deceased woman. The New York doctors say they will use someone who has signed a donor card and whose family is OK with the donation. But is this really enough? Few American women ever thought that their uterus might be donated if they signed a donor card. The uterus is not seen by many women in the same light as a kidney or a liver. The transplant team would be on firmer moral ground if they used a donated uterus from a woman who explicitly consented to donate that organ prior to her death and who made it very clear that she and her family renounced any and all claims to a relationship with any child that might result.

Lastly, it is very likely the first uterus transplant will fail. The surgical team says that this is not a problem since they can take the uterus out if things go wrong. But what if that uterus contains a fetus? What if the mother says she is willing to die to give birth to that fetus? What if the father or the mother say they want the uterus removed even if there is a fetus present if things are not going as planned? The doctors have not said as much as they need to about what their "exit" strategy will be if, sadly, the surgery does not go as planned...(more@ link)