First uterus transplant

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Pregnancy with a transplanted uterus?

Swedish doctors have successfully transplanted a uterus into two women so that they can become pregnant. The intervention is extremely controversial in the professional world, since on the one hand no statements can be made regarding the chances of success for a pregnancy and in the case of an actual pregnancy there is a risk that the transplanted organ could impair the embryonic development.

The doctors at the Sahlgrenska University Clinic in Gothenburg transplanted the two wombs from their mothers to enable them to become pregnant. According to the chairman of the German Society for Reproductive Medicine, Christian Thaler, an ethically extremely borderline intervention. Although the Swedish doctors rate the smooth operation of the operation as entirely successful, they also do not want to speak of a comprehensive success until the two women have actually become pregnant.

Did uterine transplantation enable artificial insemination? Medical options are subject to constant change, opening up previously unimagined options. This includes the transplantation of the uterus. Both patients would have been denied the desire to have children without the intervention. One patient was born without a uterus, the other had to be removed due to cancer. The transplant was the last option for them to have children of their own. However, it will not be possible to say in a year if this attempt will be successful. Because the women with a pregnancy should wait so long to minimize the risk of complications, explained the treating doctors around Mats Braennstroem from the Sahlgrenska University Clinic. After the one-year waiting period, the doctors plan the first attempt at artificial insemination. The patients should use their own, previously frozen egg cells.

Up to two pregnancies with a transplanted uterus So far, the Swedish experts have not been able to state which chances of success for an artificial insemination in women with a transplanted uterus. The head of the surgical team, Mats Braennstroem, explained that even with artificial insemination, under normal circumstances, the chances of success are only 25 to 30 percent. Accordingly, higher chances of success are also not to be expected for the two women with a transplanted uterus, especially since the patients are already between 30 and 40 years old. According to the doctors, the transplanted uteri should be removed after two pregnancies at the latest. Because as long as the transplanted organs are in the patient's body, the women have to take medications that suppress their immune systems and prevent rejection of the organs. Despite the medication, the likelihood of rejection is around 20 percent, the doctors explained. According to the Sahlgrenska University Clinic, the two operations performed over the weekend were the first of their kind and were based on a decade of research into the possibilities of such an intervention. Previously, comparable transplants had previously only been carried out on mice.

Uterine transplantation ethically borderline In the opinion of the chairman of the German Society for Reproductive Medicine, Christian Thaler, the current procedure was an "experiment with two patients", the outcome of which is uncertain. His fundamental concern was that "the uterus must undergo a variety of changes during pregnancy that are of the utmost importance for the well-being of the child" and that there are considerable doubts as to whether and to what extent this works with a transplant Thaler opposite the news magazine "ZEIT Online". If successful fertilization actually takes place, it can no longer be reversed and thus becomes an "experiment with two patients - mother and baby." Although he had a basic understanding of the desire for women and their willingness to do nothing, he did current uterine transplants are "ethically absolutely borderline."

Further uterine transplants planned How many women could benefit from such an operation was illustrated by the Swedish doctors based on the number of cases involving patients without a uterus. In Sweden, about two to three thousand women remain childless because they have no womb. A transplant could create the basic prerequisites for a successful pregnancy, but it is by no means guaranteed that it would be successful afterwards. Due to ethical concerns, the Swedish Ethics Council initially blocked the current interventions, but approved the operations in May, on condition that a specially established committee monitors the transplants and their consequences. After the surgery on the weekend went without complications, corresponding operations are now planned for eight other women. (fp)

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