Temporary womb transplants?

Wow – not sure what to think about this:

Nine women in Sweden have successfully received transplanted wombs donated from relatives and will soon try to become pregnant, the doctor in charge of the pioneering project has revealed.

The women were born without a uterus or had it removed because of cervical cancer. Most are in their 30s and are part of the first major experiment to test whether it’s possible to transplant wombs into women so they can give birth to their own children.

The intended procedure, as it stands now, is not ethical by Catholic standards:

The transplant operations did not connect the women’s uteruses to their fallopian tubes, so they are unable to get pregnant naturally. But all who received a womb have their own ovaries and can make eggs. Before the operation, they had some removed to create embryos through in-vitro fertilization. The embryos were then frozen and doctors plan to transfer them into the new wombs, allowing the women to carry their own biological children.

But what if doctors eventually learn how to connect a transplanted uterus to fallopian tubes, to permit for natural conception?  Could the procedure then be ethical?  It’s not surrogacy.

At first I thought, “Well, a uterus is just an organ, and other organs can be transplanted ethically.”  But it’s not really just another organ, because its purpose is to support another human being; whereas if you undergo a risky heart transplant, it’s only your own life you have to consider.  So far, no one with a transplanted womb has brought a baby to term. Is it ethical to get pregnant when you have reason to believe the baby may not survive? If so, is that different from a woman with the womb she was born with, knowingly getting pregnant even if she’s had several miscarriages before?

Also, who could ethically donate a womb, according to Catholic bioethics?  I’m pretty sure it would not be ethical for a married woman of childbearing age to donate her womb, even if she considered herself “done” having children.  What about someone who made a vow of celibacy? A purely medical question:  would a post-menopausal woman’s womb even be useful to a young woman with younger eggs who was trying to conceive?

Does it make a difference that these are intended to be temporary transplants?  The idea is that women try to have as many as two children, and then the uterus is removed so they can stop taking anti-rejection drugs, which have bad side effects.

I don’t want to automatically shy away from science. Just because something sounds creepy doesn’t mean it’s wrong.  But this is an especially complicated situation.  What do you think?

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  • Rachel

    It seems to me that if there was a population that could donate their uterus ethically (maybe patients that have died, like with other organs), and if the procedure actually resulted in a fully functioning reproductive system, and if conception could be achieved in the normal way…that would probably be ethical by Catholic standards, right? Maybe even if there was the maximum of two pregnancies, thought I’m not sure. It is ethical now for a woman to have a hysterectomy for medical reasons, this could fall into that category.

    It seems strange, but to me all organ transplants seem strange in a way! My thinking usually is that if a procedure is done to fix what’s broken and to support the normal healthy functioning of the body, it’s ok. I wonder why they didn’t hook everything up, for lack of a better phrase. I wonder if that is even possible with our current technology and understanding.

    • Nan

      There’s some controversy about organ transplants though because organs are harvested when the person is still in an “alive” state. Sometimes there’s pressure to declare the person brain dead so the organs can be used. So no, I wouldn’t say that organ donation is non-controversial.

  • Katie Rose

    This makes my heart flutter with hope; I no longer have a uterus, due to a life-saving hysterectomy when Josephine was born, and I wonder if it might eventually be possible to obtain uterus in ethical ways, such as from a woman who has died. And, what if the entire reproductive system was transplanted, uterus and fallopian tubes? Though, that raises an interesting thought, namely, that my new ovaries would release eggs that were not genetically my own; any children conceived from those eggs would have the DNA of the uterus donor, rather than mine. Hmm…

  • Leeandra Nolting

    What would be the effect of anti-rejection drugs on the babies?

  • Lisa Cook

    This is an interesting question. On the one hand, treatments which work to restore natural fertility when there is none are typically acceptable. Fertility, after all, is a state of health and when infertility is present, we are trying to heal the source of it. But does this heal…especially if it is temporary? And your question about the risk to babies conceived under such circumstances is absolutely valid. I think it will be interesting to see how ethicists come down on this if/when a procedure is created that connects the tubes and allows for babies to be conceived within the marital act.

    Here’s the other thing…the uterus is an unnecessary organ from the perspective that you can live a relatively normal (non-medically-assisted) life without it. You can’t live without a heart or lung. So, from that sense, it’s not just another organ that can be ethically transplanted, necessarily. Other organs are transplanted to preserve life the life of the transplant recipient. Not so in this case. And to what lengths are we willing to go to have a baby who shares our DNA and have the opportunity to gestate that baby ourselves?

    I’m not trying to downplay the suffering of sincere Catholic couples who desire children. (Personal experience with that!) I’m thinking, though, that there comes a point when we have to make a distinction between what is healing infertility and what is unnecessary and unjust risk and use of resources. What, exactly, is God calling us to do with this cross of infertility? Where is He leading us? Is it prudent to spend this kind of money and take this kind of risk for the chance of a biological child? Are we letting the “promise” of this possibility blind us to the path that God is calling us to follow because we refuse to let infertility be a part of our path?

    • Sheila Connolly

      A woman with a non-functional uterus isn’t actually infertile, though. She is just incapable of carrying children to term. It’s in incredible burden to a woman to get pregnant again and again, knowing it’s a matter of weeks before she has to grieve yet another child. (And don’t say “use NFP,” in real life I don’t know anyone who uses it so perfectly that they never have any oopses.) That’s much worse, IMO, than simply not being able to have a biological child. A uterus transplant would in fact be lifesaving for the babies involved.

  • Sarah

    I don’t think that the risk makes it wrong if there is good reason to believe that it could work. Creating a life is, generally speaking, a good thing, and it is well worth the risk. Also, miscarried babies get to go to heaven without the bother of living in this stinky world first, so it is not a total loss. I might feel differently if this were not so.

    You could skirt the donor issue by using organs from deceased donors. I think post-menopausal women would be iffy: think of the biblical examples of old women having babies. Women whose ovaries had been removed/were never there would probably be fair game, though. Unless the church considered the matter and decided otherwise, I think the donor would have to be outside of even the most extraordinary means of conception.

    I don’t think it makes a difference that it is temporary. The drugs to sustain the transplant are an extraordinary measure and have serious health implications (including increased risk or cancer). The loss of fertility is a secondary effect of preserving the woman’s health.

    What a potentially lovely thing this is! I think the biggest risks are the temptation to fall back on IVF and the reenforcement of the idea of children as a commodity, though, and I think they will be difficult to avoid.

  • Lydia

    I would think that if the fallopian tubes were connected, and the ovaries were the woman’s it would be ok. The only thing would be that I think it would be really risky for the baby because pregnancy is very stressful on the uterus (even though it is made for that) and since it relies on blood supply etc. if anything happened the baby could die.

  • Anna

    “Just because something sounds creepy doesn’t mean it’s wrong.”
    True, though Peter Kreeft has written about that: if your reasonably well-formed conscience has a knee-jerk reaction to something, then that’s often going to turn out to be correct. Not always, since a lot of factors play in to each person’s “ick” reactions, but often there’s a reason we shy away from things that do turn out to be immoral. Not everyone has to be Germain Grisez to make good moral decisions.

    As matters currently stand, these transplants aren’t ethical since IVF is the only way to conceive with a donor womb and because the hoped-for benefit doesn’t outweigh the risk. There is a risk to the woman having the surgery (and to any living donors) as well as risk to the baby; the baby is an unwitting subject of a medical experiment in these cases. Also, the risk to the baby isn’t an inherent one such as the risk of miscarriage with any pregnancy; it’s an induced risk from the experimental actions of others.

  • LisaTwaronite

    Fascinating.
    I would be a poor candidate as a donor, because of my age and after 3 c-sections, but I can certainly imagine donating my own womb under some circumstances. I wonder, does one’s uterus deteriorate with age, as the quality of one’s eggs do, or is the uterus of a healthy women in her late 40′s/early 50′s still supple enough to carry a baby? If the latter, then can post-menopausal women donate?

    Major surgery does present risks, so deciding on donation would require a lot of careful consideration. But a woman like me, who is not open to babies, would certainly see a plus in the final surgical removal of her unwanted fertility, while at the same time, she might be able to help a woman who does want a baby. Those aspects, at least, seem like win-win to me.

  • rhtaylor

    I wonder how many children would have to be sacrificed or put in harm’s way to perfect this procedure? How many lives lost would be acceptable? The unborn are supposed to be treated with dignity and respect. Is placing a human being in an experimental womb and subjecting them to anti-rejection drugs during the most critical part of their development treating them with dignity and respect? If something goes wrong there will be life long consequences for the child. It would be nice to have uterus transplants for every woman who needed one, but the unborn would have to be test subjects to make that a reality. In truth, there are lots of medical advancements we could have if we treated human subjects unethically. I think the same applies here.

  • anna lisa

    Interesting…A little bit Frankensteinish at this point and clearly unethical because of the IVF. I agree with many of the comments here. Making children a commodity is wrong. The fecundity that we are called to can be realized in so many ways. One could arguably say that a nun is free to be the most fertile of all. If gestating a baby in the womb was the only way to become a mother than Mary would be the mother of only one.
    .
    I can definitely say that my last three pregnancies were long shots Considering the last two, I had very little hope that they would result in a live birth in this world. How could this be even remotely unethical? Before birth control came on the scene generations and generations of women in their late forties and early fifties must have conceived and lost plenty of babies, but these conceptions happened in a good faith way. (My husband has a dashing cousin who was conceived when his mother was 53…)
    .
    The ethical question that gives me a rash to even think about is this: What if a crazy nutjob decided to break into an IVF clinic and fertilized as many eggs as he could get his hands on, or what about some crazed mother who hired a horrible doctor to fertilize *hundreds* of her eggs in the name of creating immortal souls that will live forever? –And then there are the women with IUDs who might conceive twenty or thirty kids in her lifespan.
    The person who is created wouldn’t otherwise have existed…
    Thomas Aquinas said that one human soul is worth more than the entire physical universe.
    Clearly fertility is not the most important function that a human being can exercise

    • LisaTwaronite

      Just want to say that it’s highly unlikely a woman with an IUD would conceive 20-30 kids, particularly if she has a copper one (such as a ParaGard), because they work by mainly by disrupting sperm mobility so conception doesn’t occur. Yes, they could also possibly prevent an embryo from attaching if conception does occur, but that’s not the main way they work.

      • anna lisa

        Well Lisa, you know how I feel about this. Even one who dies is enough.collateral damage.
        The whole mentality of immobilizing and exterminating sperm is a big turn off for me too–so unsexy.
        The other day I had a rash on my chest that I was complaining about. Guess what my husband suggested that I put on it! I said “You think??” He looked at me with this mixture of pride and fervency and said something like:
        “It’s the elixir of Life!”
        Haha, I agreed with him and thanked him for all of his gifts.
        I’ll let you know if it works when I remember to take his advice.

        • LisaTwaronite

          Someone once said to me, if you knew that your actions would cause a two-year old to wander onto a busy freeway, where she would very likely be maimed or killed, would you still take those actions? Of course I wouldn’t! They were making the point that my contraception was EXACTLY the same — it was an action that could possibly cause the death of a baby in EXACTLY the same way. They couldn’t understand why this didn’t bother me in the least — and I couldn’t understand why this DID bother them so much. Both of us logically understood the other’s position, but we were not (and will never be) on the same page.
          And the absence of sperm is a BIG turn-on for me — but to each her own!
          Enjoy….

          • anna lisa

            Well, I suppose all that bounty came as a bit of a surprise to me at one point in life. The same went for breastfeeding. I was a little miffed and thought it could have been designed better. Once I stopped fighting what I initially considered to be unseemly, I started to find some peace, and then ultimately just beauty, and a hearty affirmation…
            As for embryos and toddlers, I like what the Hippocratic oath says …”I promise to do no harm”…at least on the conscious level. I could be pregnant right now, and I just poured myself a glass of red wine. I’m going to Laguna Beach tonight, and there’s still so much to pack. I suppose the wine is better than a ball of nerves in the gut. haha, and I’m escaping my duties I guess, by writing this.

  • Sheila Connolly

    I want the bioethicists to get on this and figure it out. The Church forbids me from being a surrogate for a dear friend of mine, I haven’t the emotional strength to give her one of my biological children (who would?), but I’d gladly give my uterus so she could stop having miscarriage after miscarriage and have a child at last. If I can love someone enough to give them a kidney, why can’t I love someone enough to give my uterus?


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