The scientific research has revolutionized our routine life. It has altered the entire world with delightful inventions and discoveries. No corner of our life is untouched of scientific mysteries. The uterus transplantation is one of these mysteries. For the first time in the USA, a woman gave birth to a baby who was born without a uterus. This scientific landmark was the outcome of wonderful efforts of Dr. Liza Johannesson and Dr. Giuliano Testaand their handful team at Baylor University Medical Center in Dallas, USA. The identity of the couple and baby boy’s date of birth are protected on the request of couple.
The newly born baby boy is named as “the baby number Nine”. Eight other babies have been born in Sahlgrenska University Hospital, Gothenburg, Sweden who are working on uterus transplantation since 2014. No doubt, this significant landmark of uterus transplantation is a hope for a woman who cannot give birth to baby. According to a survey, researchers believe that this amazing uterus transplantation will be a hope for 50,000 women only in USA who have no uterus in their body naturally or are removed from the body because of cancer, infections, diseases or complications during pregnancies.
In this transplantation procedure, the uterus is placed in the body of woman for short period of time; just long enough for a birth of one or two babies. Later it is removed from the body to discontinue the intake of immune- suppressing drugs which is obligatory for the expecting mother to prevent the organ rejection system of the body. Each recipient woman of uterus transplant can have up to two babies.
Dr. Liza Johannesson, the member of Uterus transplantation research team and ex-researcher of Gothenburg Hospital Sweden, expressed that it was very exciting and special birth for her. She said this procedure can be expanded and she uncovered that at Baylor there are eight more women, in a clinical trial phase, who had this uterus transplants including one woman, who’s donor is deceased one, is trying to conceive.
Dr. Testa, principal investigator of Uterus transplantation research team, said: “I think man cannot understand this feeling fully, only the mother can do this. Their desire moved them towards us with a hope to see a baby in their hands, when she was told – you will never become a mother”.
In the present case, it has been leaked that the donor of uterus was a registered nurse in the Dallas named Taylor Siler of age 36, who have successful children. She donated her uterus for the humanity. The donor went under surgery of more than five hours for removing uterus and later, the surgery took another five hours to transplant her uterus into the body of recipient.
The uterus transplantation is an expensive procedure, may be hundreds of thousands of dollars. But, currently, it is in an experimental stage in Baylor, USA because of this the treatment cost is covered by research funds. The woman with first baby birth in last November, received uterus in September 2016 and was the fourth candidate for receiving uterus transplantation at Baylor.
According to the researchers, the whole procedure is complex and full of complications and risks for both the donors and recipients. The donor of uterus has to go for more than five -hours surgery for the removal of her uterus. On the other hand, recipients have to face risks associated with organ rejection reactions of the body and have to intake multiple drugs for prevention. These types of pregnancies are at high risk and babies are delivered by cesarean sections. The only option of cesarean section is to avoid the stress on the transplanted uterus in the body of recipient. The gestation periods of recipient women are ended at 32-36 weeks instead of 40.
The complications in the conceiving process have led to this costly procedure of uterus transplantation. Generally, ovaries have no connection with uterus in woman naturally. Therefore, it is impossible for an egg to enter which is the most common complications. This deficiency is coped by hormones which stimulate the ovaries to release multiple eggs which are harvested, fertilized and frozen before the start of transplantation. After the post –surgical recovery of candidate women, when start menstruating, one by one, that eggs are implanted in the Uterus until she become pregnant.
According to principal investigator of research team in Baylor clinical trials, Dr. Testa, the USA candidate women are young and healthy, so the researchers have modified the procedure of the transplantation. They have reduced the time of stay after transplant; they started procedure of conceiving trials soon after candidate woman began menstruating, while the Sweden doctors were practicing one year gap after uterus transplantation.
The high and undisclosed cost of this procedure was founded by the Baylor Foundation. The candidate women were relocated to Dallas for the clinical trial of Uterus transplantation and paid for in-vitro fertilization or IVF which is round $ 10,000.
A rough estimate says it’s up to $500,000. Currently, the health insurance companies categorized this uterus transplantation as an elective and not cover the cost of procedure. There are about 16 uterus transplants working worldwide including the Cleveland, who transplanted a woman with uterus from deceased donor but failed due to complications during pregnancy. In September 2017, Penn Medicine, Philadelphia has announced their offers for uterus transplantation.
In this procedure, the uterus donor can be dead or alive. The donor can be relative or unknown to the recipient. But research believes that for reducing the risk of failure, the donor like mother or sister are safe. In the recent birth through uterus transplant, the donor was alive and unknown to recipient. The best age of women for uterus donation procedure is 20-35 years age and should be healthy according to the criteria of Baylor clinical trials research project.
Is uterus transplantation a controversial treatment?
The gynecologists and researchers believe that this significant milestone of uterus transplantation will be able to treat thousands of infertile women who have abnormalities in uterus or have undergone the procedure of hysterectomies after a cancer.
In the Baylor clinical trials, all the candidate women enrolled were suffering with complete uterine infertility which means that they were born with no uterus. This condition happens in 1 out of 500 women a survey in USA has estimated that presently about 13,500 women are born without a uterus. These women are left with no option of carrying a baby.
Therefore, the birth of “baby number Nine” is great news not only for the infertile women but also for the modern science. But on the other side, many researchers, ethicists, doctors and health economists believe that many aspects of uterine transplantation are still not addressed which can bring this research back to the preliminary phase of investigation.
A big question arises, whether a desire of a woman for holding a baby is worthier than the risks and cost of this transplantation procedure? This question is a part of ethical and economic controversies.
Dr. Vivian Ho, director of center for Health and Bio-sciences Houston, says: “It’s not a matter of life-saving but it’s a matter of life creating. I believe that many infertile women will go for it. So, there must be few competitors to drop the cost of this treatment to make this novel procedure affordable and accessible”.
Additionally, Dr. Ho said that the hundreds and thousands dollar are only going to benefit a small number of people in the community on the name of uterus transplantation procedure despite of scrutinization of health insurance companies.