The Cade Foundation hosted a Multidisciplinary Grand Rounds at the University of Maryland School of Medicine recently discussing the Ethical, Medical, and Emotional risks of uterine transplants. It's very interesting to hear from various medical professionals and the first US transplant recipient, a fellow MRKH Warrior. Unfortunately that transplant failed but its still a pioneering event.
The recording and slides from the panel can be accessed HERE. There are several topics, scroll down for the uterine transplant discussion.
When the first baby, Vincent, was born in 2014 I was so overcome with excitement and awe in science. What would this mean for future MRKH Warriors? Since then there have been several more children born from the Sweden trials. Other countries have held trials as well, but with no success. The prospect of future women being able to carry their own children when they otherwise wouldn't have the opportunity is still very exciting.
In this presentation the uterus transplant is described as "the most difficult transplant." With over 10 hours of surgery for the donor (only successful surgeries have been living donors), and over 6 hours for the recipient. Its more than a radical hysterectomy including large vascular structures. The risks to the donor are the same as with a hysterectomy but also include the risks of vascular issues including death. "The donor carries all of the risks and none of the benefits except perhaps altruism."
The risks to the recipient are organ rejection, possible transfer of cancer cells or infections, etc. The pregnancy is highly monitored and is a mandatory C-Section. Unfortunately the first US recipient had to have hers removed after a transferred yeast infection turned to sepsis.
The risks to the unborn child are severe prematurity, the first child was born at 31 weeks, also being exposed to immunosuppressant drugs during the entire pregnancy, and other unknown factors since it is so new.
Ethical concerns include the physician's code of honor, first do no harm. Since this is a "life enhancing" transplant and not a "life saving" transplant, this is often argued. In addition some say there are ethical "consent" issues meaning that the unborn child can not give consent to possible health concerns that may arise from being born from a transplanted uterus. This one does not hold for me as this could be said for IVF as well.
Emotionally we need to remember "this is not a cure" this is a treatment, infertility is a life long diagnoses. Receiving this transplant does not erase those feelings. Therefore emotional concerns include trying to determine if individuals are predisposed to mental health concerns before the transplant and advising against the procedure. Also providing support during and after the procedure. The emotional benefit of being able to carry a pregnancy is something that needs to be weighed against the risks. As being able to experience pregnancy is often a life long dream and can out weigh most of the risks according to the recipients.
For me this transplant is not an option. I have abnormal vascular in the pelvic area that would exempt me. Even if that wasn't the case I know I wouldn't persue it. There are far to many risks for me. Our surrogacy journey was beautiful and without stress (as much as possible). I couldn't imagine such a high risk pregnancy...and something i learned in the presentation... you wouldn't feel any motion (beyond pressure) during the pregnancy, or contractions during labor because the procedure doesn't connect the muscles or nerves to you... only the vascular arteries.
It is such an amazing scientific achievement and I can't wait to see what the future holds. I have the utmost respect for the women willing to take on these risks for future generations! I can't wait to see how this procedure can improve over the years and become a real possibility for many women.
Bram's Birth Story
Ways to Save Money
Things not to say to IPs
Tips for newly diagnosed
Mothers with MRKH
Our Gender Reveal
2000- Chrissy dx w/ MRKH
2002- Chrissy & Lee meet
2007- Chrissy & Lee Marry
2009- Chrissy 'hysterectomy'
2013- Awarded Cade Grant
7/3/14- IVF egg retrieval (5)
1/18/15- Embryo Transfer (1)
9/29/15 - Bram born!