New York Times Examines Reaction To Potential First U.S. Uterus Transplant

Main Category: Transplants / Organ Donations
Also Included In: Women's Health / Gynecology;  Pregnancy / Obstetrics
Article Date: 01 Feb 2007 - 18:00 PDT

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Reports earlier this month that a team from New York Downtown Hospital has begun to screen women who are unable to have their own children for the first uterus transplant in the U.S. were criticized by many fertility physicians, medical ethicists and patient advocates, but many women have called the hospital to volunteer to become donors or recipients, the New York Times reports (Rabin, New York Times, 1/30). Giuseppe Del Priore and colleagues at the hospital might perform the transplant using organs from deceased donors and would wait three months after the surgery to ensure the uterus is functioning in the recipient and is stabilized with antirejection drugs. The team would then perform in vitro fertilization using the patient's previously frozen embryos to attempt pregnancy. If pregnancy is achieved, the fetus would be delivered through a caesarean section to reduce risks to the woman and fetus. Doctors would remove the transplanted uterus after the birth -- or after two years if pregnancy attempts are not successful -- to minimize the woman's risks from antirejection drugs. The ethics board of the hospital earlier this month approved the plans for the procedure but will reconsider the approval after a patient is chosen from among 40 to 50 women being screened for it. A similar procedure was performed in Saudi Arabia in 2000 and reported in 2002. Uterine transplants have been successful in mice, rats, rabbits and pigs, although births have resulted only in rodents (Kaiser Daily Women's Health Policy Report, 1/17). "This is very complex, and one woman dying from this is going to be really one too many," Tommaso Falcone, ob-gyn chair at the Cleveland Clinic and a reproductive endocrinologist who has done research on ovarian transplantation, said, adding, "If we were going to cure cancer and save humanity, I'd say take the risks and take it to humans as quickly as possible. But we're looking at patients with essentially a nonlethal condition." Pamela Madsen, executive director of the American Fertility Association, said, "For many women, experiencing pregnancy is a central part of being a woman, and they will go to extremes to have that experience," adding, "But just because we want it, does that mean it is worth the risks?" Del Priore said a uterine transplant would be a "last option," adding, "The entire family unit needs to understand the magnitude of the decision and the experimental nature of the procedure" (New York Times, 1/30).

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