First U.S. Baby Born After a Uterus Transplant

Last September, a woman at Baylor University Hospital received a uterus transplant. Yesterday, this woman gave birth to her own baby. This marked the first birth via uterine transplant in the United States leaving women born without uteruses or who have undergone a hysterectomy due to cancer or other diseases cheering! Finally, their dreams of carrying and birthing their own child can come true.

This is the first replication of a trial in Sweden where the uterine transplants resulted in 8 live births. It was not without complication though, as the first three transplants carried out at Baylor were failures. The worst case of the three was a women who, within two weeks of transplant, developed an infection that caused life-threatening hemorrhage and required emergency surgery to remove the uterus. Tentatively, the trial was resumed. This woman was the fourth to receive a transplant and 8 of 10 planned trial transplants have occurred. One of the other women is currently pregnant.

Shockingly, the uterine donation can be from a live donor, as was the case with this first successful birth. Taylor Siler decided to donate her uterus after seeing a segment on Baylor's uterine transplant program. She and her husband had already decided they were not going to have any more children (they have 2) and she wanted to offer someone else a shot at motherhood. Siler went through a five hour procedure to have her uterus removed and required 12 weeks for recovery. Siler still has not met the woman who received her uterus, however, the women exchanged letters on transplant day and the day the recipient's pregnancy was announced. Baylor states that they have more than 70 women who have expressed interest in donating their uterus for this study.

While this is a phenomenal achievement, let us discuss the ethics of uterine transplant. The autonomy of both the donor and the recipient were upheld. The donor wanted to help another woman become a mother and the recipient desperately wanted a chance to have her own baby. The principle of beneficence was upheld as the recipient received the best possible outcome, a child.

However, when we become physicians we are asked to take an oath to 'do no harm'. This principle of nonmaleficence is at odds with the case of uterine transplants. We must discuss the real possibility that harm was done to both the donor and the recipient as they were healthy individuals that underwent risky, invasive surgery with a long recovery. Additionally, the recipient had to begin taking anti-rejection medications that her otherwise healthy self would not need. While those who donate and receive other organs must undergo a similar process, these recipients face the same risks of surgery and anti-rejection drugs for a transplant they they, unlike someone with heart or liver failure, do not need to save their lives. The beneficence may not outweigh the maleficence in this case. In regards to justice, we must think about the prohibitive costs of this operation ($500,000 in addition to the cost of the IVF that the recipient must receive) and the fact that by giving each woman who wants to be a mother a uterus, we are potentially depriving a child in need of adoption a family. Finally, after a mother delivers, the uterus is removed and discarded as it is no longer necessary. Is it justifiable to treat an organ from a living donor as a used-then-discarded commodity? This sci-fi-sounding newly feasible option for women without uteruses is exciting but let us not forget to ask, even if we can do it, ought we?

Grady, D. (2017, December 02). Woman With Transplanted Uterus Gives Birth, the First in the U.S. Retrieved December 02, 2017, from https://www.nytimes.com/2017/12/02/health/uterus-transplant-baby.html

Sifferlin, A. (2017, December 1). First Baby in U.S. Born Via Uterus Transplant at Baylor. Retrieved December 02, 2017, from http://time.com/5044565/exclusive-first-u-s-baby-born-after-a-uterus-transplant/