Sometimes we need to think out of the box in order to solve issues that are emotionally and morally charged. The abortion issue hits a nerve, strikes so deep it motivates violence in those invested in moral definitions and the right to life issue. When does life begin? When do we start and stop caring about life? Where do we draw the lines?
What if a mother will die if she continues her pregnancy? Do you sacrifice the life of one that is born for the unborn? When does the soul join the fetus? Does life begin at conception or birth?
There are many well-written articles and excellent videos that cover this topic. I’ll do what I can to find them and attach them to this article. I’m here to think outside the box and present solutions that may help ease the pain and calm down nerves, lessen rhetoric and violence and find common ground to heal, mend and come to peace with a topic that’s as old as mankind itself.
What if an option can be added to the abortion choice menu where a mother can opt to have her fetus removed and frozen for adoption where it would be transferred into a different womb to carry it to term?
I have to do more research on this part of the issue and I’m not sure what’s out there because abortions are so controversial it may not be promoted on the web. But there are times when a woman cannot carry the fetus to term. The child may be in danger of spontaneously aborting. The mother may not be healthy. The mother may, for example, have terminal cancer and is not going to live long enough to deliver her child.
Do we have the technology to 1) transfer fetuses to a) another woman’s womb or b) an artificial womb?
BABY BORN VIA
A Cleveland Clinic research trial was the first in the United States to offer uterus transplant to women suffering from uterine factor infertility (UFI). These women cannot carry a pregnancy. They were born without a uterus or have lost their uterus. Since Cleveland Clinic began the clinical trial, the team has completed eight uterus transplants; six transplants were technically successful, with four livebirths thus far. Currently, two women are awaiting embryo transfers, while other candidates are listed for transplant.
Cleveland Clinic’s clinical trial milestones:
- Became the first in North America to deliver a baby from a deceased-donor uterine transplant in 2019.
- Performed their first embryo transfer in a uterus recipient, resulting in pregnancy in 2018.
- Performed the nation’s first uterus transplant on Feb. 24, 2016, which was removed on March 9, 2016 due to a candida infection
A uterus transplant is a replacement of the uterus in women who have absolute uterine factor infertility (AUFI). Women with AUFI—a term used to describe any reason why a woman is unable to get pregnant—can have congenital conditions and malformations related to the uterus or conditions which develop over time such as adhesions and fibroids. This type of infertility can also be the result of an altogether absent uterus.https://441f64263b1c8c4a8769ba03144d1983.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html
A woman who receives a transplanted uterus often receives the uterus with the intention of conceiving a child. There are certain instances, such as being born without a uterus, where a woman will receive a transplanted uterus for the purposes of balance in reproductive health.
There has been controversy surrounding uterus transplants for some time due to the outcome of the first clinical trial. The first uterus transplant was initially successful, but the uterus was removed shortly after transplant due to tissue death.1 Despite the failure of the initial trial, there have been successful uterus transplants completed, some of which yielded full-term pregnancies.
Reasons for Uterus Transplant
One of the main reasons a woman would undergo a uterus transplant is for the purpose of AUFI, which affects 1–5% of women who are of child-bearing age.2 This can include congenital conditions such as having an absent uterus, duplication of uterine structures, lack of fully formed structures, a single uterus divided into two parts, or two uteri sharing a single cervix.
Women living with certain developmental conditions, like Mayer-Rokitansky-Kuster-Hauser syndrome, may have been born without a uterus or with an underdeveloped uterus—another one of the main reasons to receive a uterus transplant.2
Other reasons for AUFI are acquired conditions that often result from chronic reproductive diagnoses such as endometriosis or polycystic ovary syndrome (PCOS). These diagnoses may cause issues including uterine adhesions, ovarian and/or uterine cysts, or uterine fibroids. The presence of each of these within the uterus can impact a woman’s ability to conceive a child.
The best candidate for a uterus transplant is a woman who is of child-bearing age, wishes to continue having children, and has AUFI.3 The woman receiving a uterus transplant should also be in otherwise good health in order to support the immune system and the body’s ability to accept a transplanted uterus.
A uterus transplant is certainly not a first-line treatment for reproductive conditions such as endometriosis. Conservative management is explored in the form of pain medications and lifestyle changes to assist with managing reproductive diagnoses. Surgery may be indicated to assist in removing fibroids or adhesions and improve pain levels and balance hormones.
A uterus transplant may be recommended in cases where all else fails; however, the procedure remains relatively rare and many women do not have access to hospitals that offer the transplant.
Who Is Not a Good Candidate?
Women who are simply looking to manage their chronic reproductive issues are not good candidates for uterus transplants. This transplant is more appropriate for women who wish to conceive and carry their own child, understanding the heavy risk associated with this procedure.
Donor Recipient Selection Process
Due to the scarcity of deceased donors, live donors have become necessary to meet the increasing demand for donor uteri. A donor uterus is first screened for systemic illness, infertility, thickness, polyps, fibroids, working blood vessels and arteries, adhesions, and infections.2
The donor, whether alive or deceased, will ideally be premenopausal with proven fertility and no previous uterine surgeries which may impact the transplant process. As with all transplants, important factors to consider when selecting a donor include blood type, size of organ needed, time on the waiting list, and how well the donor and recipient’s immune systems match. The severity of the recipient’s condition is typically a factor in the donor selection process for essential organs, but that does not apply in the case of the uterus as it is considered non-essential.
Around 50 people worldwide had received transplanted uteri as of 2019, which has led to 16 successful live births.4 That said, some of the women who received transplanted uteri needed to have the organ surgically removed due to bodily rejection and tissue death.
Before receiving a uterus transplant, it’s important that a woman seeks care from a facility that follows an Institutional Review Board-approved research protocol. This will place appropriate emphasis on their safety during the procedure.
The waiting process can be long and difficult. However, it’s a good idea to consistently consult your healthcare provider regarding whether you are a good fit for a uterus transplant and whether there are other safer and more immediate alternatives.
Types of Donors
A uterus transplant can come from either a living or deceased donor. The risk of infection and transplant rejection is much higher when a recipient receives the uterus of a deceased donor. This is thought to be due to the anatomical and vascular changes which occur in the body after death.5 The ideal candidate is someone who has a similar blood type as the recipient and someone who is in relatively good health, especially reproductive health.
Before surgery, it’s necessary to perform exploratory procedures on both the donor and the recipient to determine pelvic anatomy and the state of the current vasculature.
The recipient is given fertility drugs to assist in harvesting her eggs. These eggs are then fertilized and the embryos are frozen for the purpose of preservation.6 This is typically a necessary step, as one of the driving reasons for uterus transplant is to allow the recipient to carry a child who is biologically her own.
The womb and cervix are removed from the donor and implanted into the recipient. Once the uterus is in the recipient, surgeons work diligently to connect muscles, cartilage, tendons, arteries, veins, and other blood vessels in order to allow the uterus to function. The transplant takes several hours and a large team. This is due to the likelihood of a live donor who also needs to be operated on, monitored, and rehabilitated after the surgery.
Potential risks during the transplant include massive blood loss requiring a transfusion as a life-saving effort, infection, organ rejection, or poor reactions to immunosuppressive medications or anesthesia.6
It’s important the recipient and donor both remain in the intensive care unit for several days immediately following the transplant. This will allow for pain management along with medical monitoring of how the recipient responds to the immunosuppressive medications. The donor should also be observed for a time to prevent infection and manage pain levels.
Physical therapy will likely be indicated to increase strength in both the donor and the recipient, as any major surgical procedure can cause generalized weakness from deconditioning.
It’s important to note uterus transplants are not intended to be permanent options in response to infertility or uterine conditions. The risk of taking immunosuppressive drugs long-term, especially during and before pregnancy, is harmful and not advised. The transplanted uterus is intended to be temporary while attempting pregnancy, and a hysterectomy will be indicated in order to ensure the optimal health of the recipient.7
Due to the occurrence of this transplant in different countries and the variable long-term results of the transplant, there are no definite numbers regarding the survival rate for women who undergo uterus transplants. Much of the literature discourages women from receiving uterus transplants due to the high risk involved in treating a non-life-threatening condition (infertility).
Support and Coping
While studies show that there’s a higher prevalence of psychiatric disorders among transplant candidates and recipients,8 psychological responses to a uterus transplant vary based on the outcome. It’s a normal response for a woman to have a negative reaction and potentially enter a short-term depression in response to a failed uterus transplant and/or a subsequently failed pregnancy. Women experiencing depressive symptoms which exceed several months should be evaluated by a healthcare provider for psychiatric recommendations.
A regular stress management routine should be developed to assist with typical feelings following a transplant. This may include support groups, online discussion boards, social gatherings with friends and family, leisure activities of choice, and relaxation activities such as spending time in nature and meditation.
Exercise should be added to a daily schedule after any major surgery or transplant to decrease the risk of infection and improve healthy circulation.9 Your transplant team will often include a physical therapist who can recommend an appropriate regimen as you heal.
Good nutrition is essential for healing, as well as supporting fertility and successful pregnancy. Your transplant team will often include a dietitian or you can ask for a referral to one.Was this page helpful?
MEDICAL BREAKTHROUGH! Doctors Complete The FIRST EVER Uterus Transplant INTO A MAN . . . So Now Men . . . Can GET PREGNANT!!
Doctors claim to have for the first time in HUMAN HISTORY, transplanted a uterus into a male. The implications of this procedure are GROUNDBREAKING.
First off, now transgenders may be able to get pregnant. And second . . . well we’re not sure what else doctors are planning on doing with this.
Here’s how the website STUFF.co.nz is reporting it:
That’s right, men and transgender women could theoretically receive a uterus, carry a baby to term, and give birth in the next decade thanks to recent medical advancements in reproductive transplant surgery.
“My guess is five, 10 years away, maybe sooner,” Dr. Karine Chung, director of the fertility preservation program at the University of Southern California’s Keck School of Medicine, told Yahoo Health.
While the surgery is “still considered highly experimental” according to Cleveland Clinic doctor Tommaso Falcone, a Swedish research team from the University of Gothenberg has performed nine uterus transplants to date, achieving five pregnancies and four live births.
“The exciting work from the investigators in Sweden demonstrated that uterine transplantation can result in the successful delivery of healthy infants,” says Cleveland Clinic lead investigator Andreas Tzakis.
How a Transgender Woman Could Get Pregnant
The uncharted territory of uterus transplants is sparking patients’ interest, but surgeons and endocrinologists remain wary
- By Dina Fine Maron on June 15, 2016
When Mats Brännström first dreamed of performing uterus transplants, he envisioned helping women who were born without the organ or had to have hysterectomies. He wanted to give them a chance at birthing their own children, especially in countries like his native Sweden where surrogacy is illegal.
He auditioned the procedure in female rodents. Then he moved on to sheep and baboons. Two years ago, in a medical first, he managed to help a human womb–transplant patient deliver her own baby boy. In other patients, four more babies followed.
But his monumental feats have had an unintended effect: igniting hopes among some transwomen (those whose birth certificates read “male” but who identify as female) that they might one day carry their own children.
Cecile Unger, a specialist in female pelvic medicine at Cleveland Clinic, says several of the roughly 40 male-to-female transgender patients she saw in the past year have asked her about uterine transplants. One patient, she says, asked if she should wait to have her sex reassignment surgery until she could have a uterine transplant at the same time. (Unger’s advice was no.) Marci Bowers, a gynecological surgeon in northern California at Mills–Peninsula Medical Center, says that a handful of her male-to-female patients—“fewer than 5 percent”— ask about transplants. Boston Medical Center endocrinologist Joshua Safer says he, too, has fielded such requests among a small number of his transgender patients. With each patient, the subsequent conversations were an exercise in tamping down expectations.
To date there are no hard answers about whether such a fantastical-sounding procedure could enable a transwoman to carry a child. The operation has not been explored in animal trials, let alone in humans. Yet with six planned uterine transplant clinical trials among natal female patients across the U.S. and Europe reproductive researchers are hoping to become more comfortable with the surgery in the coming years. A string of successes could set a precedent that—along with patient interest—may crack open the door for other applications, including helping transwomen. “A lot of this work [in women] is intended to go down that road but no one is talking about that,” says Mark Sauer, a professor of obstetrics and gynecology at Columbia University.
Such a future is hard to imagine, at least in the near term. The surgery is still very experimental, even among natal women. Just over a dozen uterus transplants have been performed so far—with mixed results. One day after the first U.S. attempt, for example, the 26-year-old Cleveland Clinic patient had to have the transplanted organ removed due to complications. And only the Brännström group’s procedures have led to babies. More efforts are expected in the United States: Cleveland Clinic, Baylor University Medical Center, Brigham and Women’s Hospital, and the University of Nebraska Medical Center are all registered to perform small pilot trials with female patients who are hoping to carry their own children.
A RISKY PROSPECT
The trouble is that uterine transplants are extremely complex and resource-intensive, requiring dozens of health personnel and careful coordination. First a uterus and its accompanying veins and arteries must be removed from a donor, either a living volunteer or a cadaver. Then the organ must be quickly implanted and must function correctly—ultimately producing menstruation in its recipient. If the patient does not have further complications, a year later a doctor may then implant an embryo created via in vitro fertilization. The resulting baby would have to be born through cesarean section—as a safety precaution to limit stress on the transplanted organ, and because the patient cannot feel labor contractions (nerves are not transplanted with the uterus). Following the transplant and throughout the pregnancy the patient has to take powerful antirejection drugs that come with the risk of problematic side effects.
The dynamic process of pregnancy also requires much more than simply having a womb to host a fetus, so the hurdles would be even greater for a transwoman. To support a fetus through pregnancy a transgender recipient would also need the right hormonal milieu and the vasculature to feed the uterus, along with a vagina. For individuals who are willing to take these extreme steps, reproductive specialists say such a breakthrough could be theoretically possible—just not easy.
Here is how it could work: First, a patient would likely need castration surgery and high doses of exogenous hormones because high levels of male sex hormones, called androgens, could threaten pregnancy. (Although hormone treatments can be powerful, patients would likely need to be castrated because the therapy might not be enough to maintain the pregnancy among patients with testes.) The patient would also need surgery to create a “neovagina” that would be connected to the transplant uterus, to shed menses and give doctors access to the uterus for follow-up care.
A small number of surgeons already have experience creating artificial vaginas and connecting them to uterine transplants. Most of Brännström’s transplant patients have been women with a condition called Rokitansky syndrome, and as a result they lack the upper part of the vagina and had to have a neovagina surgically made—typically by extending the lower vagina. Separately, surgeons that specialize in working with transwomen also often create neovaginas after castration, using skin from the penis and the scrotum.
Even if the hormonal and anatomical challenges are overcome, for someone who was born producing sperm instead of eggs there would be one more hurdle: Before castration that person’s sperm must be collected and combined with a donor’s or partner’s egg to make an embryo via in vitro fertilization, and that embryo would have to be frozen until the transplant patient is ready. If the embryo is successfully implanted, the transwoman would then naturally produce the placenta required to sustain the pregnancy and begin to lactate in preparation for breast-feeding, Cleveland Clinic’s Unger says.
Experts disagree about what would be the biggest barrier to pulling off these theoretical transplants and pregnancies. Giuliano Testa, a transplant surgeon at Baylor University Medical Center who will soon be directing uterine transplant surgeries among natal women, says the hormones would likely prove the biggest obstacle. “It would really be a feat of unknown proportions,” Testa says. “I would never do this.” But he concedes the transplants are not out of the question. “At the end of the day it is two arteries and two veins that are connected with fine surgical techniques.”
Unger—who is not involved in Cleveland Clinic’s uterine transplant team trial—worries about a consistent and ample blood flow to the fetus. Bowers, who is transgender herself, says she is concerned about dangers to the fetus from a potentially unstable biological environment and unforeseen risks for the mother-to-be. “I respect reproduction and I don’t think we will ever see this in my lifetime in a transgender woman,” she says. “That’s what I tell my patients.”
Costs and ethics also pose significant barriers. Many transgender patients have already been saving for years to pay for male-to-female genital surgery— which can cost around $24,000 without insurance coverage—so a uterine transplant could be out of financial reach, Unger says. And some doctors working on the frontlines with transgender patients have expressed concerns about the ethics involved in the risks. Sauer, the gynecologist from Columbia, says that with options including surrogacy and adoption available in many locations, an experimental surgery to help patients give birth—not save their lives—seems like a huge risk. Safer, medical director for the Center of Transgender Medicine and Surgery at Boston Medical Center, agrees. “If you are going to die without a transplant, of course you take [antirejection] drugs. But this is not the case here,” he says. “This is not life and death.”
The American Society for Reproductive Medicine’s Ethics Committee is already discussing how uterine transplants could be prioritized, says Sauer, who is a member of that panel. Yet there is no discussion yet about how transgender candidates would be included in the mix. Additionally, it is unclear how demand for a uterus would be weighed by a hospital or an organization like the United Network for Organ Sharing.
Yet interest in uterine transplants is growing: Brännström, the Swedish surgeon who led the prior transplant work among women, says his inbox is now inundated with messages from less-traditional patients. “I get e-mails from all over the world on this, sometimes from gay males with one partner that would like to carry a child,” he says. Brännström does not plan to perform such procedures himself—instead he wants to focus on women who were born without a uterus or lost it due to cancer or another illness. The next natural step for those interested in assisting transgender or male patients, however, would likely be tackling this procedure among women with a rare condition called androgen insensitivity syndrome, he says. A person with AIS appears largely female, but has no uterus and is genetically male.
Amid these complex discussions there is one bright spot, the relative ease of finding the organs. Already one group has proved rich in willing donors: people who are transitioning from female to male and have also decided to have their uteruses removed. Unger says among her female-to-male patients, “one in three” have asked if they could donate the organs. Because there is no protocol set up to deal with these offers (Cleveland Clinic’s trial uses cadaver uteruses), they are currently turned down. Such potential donors may seem ideal because they are not pursuing a hysterectomy due to disease. But a major catch is the medical risk they face: A standard hysterectomy takes between a half-hour and an hour, but preparing a uterus and its associated blood vessels for transplant would keep such patients under the knife for as long as 10 or 11 hours. Clearly, the ethics of such donations would have to be studied extensively, Unger says. Like uterine transplants for transgender patients, this is all uncharted territory.
New Technology Could Let Women Terminate Pregnancy Without Killing the Baby
BY TYLER O’NEIL JUL 29, 2017 11:24 AM ET
A technological breakthrough could enable a baby to develop in an artificial womb, allowing a mother to avoid abortion while saving the baby’s life. This would undercut the legal justification for abortion in Roe v. Wade, creating a fascinating legal dilemma. A bioethicist at Harvard University warned that it would undercut a woman’s “right to an abortion.”
“It could wind up being that you only have the right to an abortion up until you can put [a fetus] in the artificial womb,” I. Glenn Cohen, a bioethicist at Harvard Law School, told Gizmodo. “It’s terrifying.”
Cohen published a report Friday discussing the legal ramifications of a major breakthrough scientists had in April. A research team led by Alan Flake from the Children’s Hospital of Philadelphia successfully incubated eight premature baby lambs in an external womb resembling a high-tech ziplock bag. By April, the oldest lamb was nearly a year old and still seemed to be developing naturally.
It may take between five years and a decade before such technology can be used on premature human infants, but the results suggested that it could indeed keep premature babies alive before birth. If the technology becomes reliable and cheap enough, it could become a kind of substitute for abortion.
Gizmodo’s Kristen Brown explained that this technology could save the lives of the 30,000 or so babies each year born earlier than 26 weeks into pregnancy. But it could also complicate “and even jeopardize” the Supreme Court’s 1973 ruling in Roe v. Wade that women have a right to an abortion before their baby reaches the point of viability.
“The Supreme Court has pegged the constitutional treatment of abortion to the viability of a fetus,” Cohen explained. “This has the potential to really disrupt things, first by asking the question of whether a fetus could be considered ‘viable’ at the time of abortion if you could place it in an artificial womb.”
In other words, if a woman decided to get an abortion to avoid carrying the child to term, she wouldn’t have to kill the fetus — the fetus could be removed and placed in an artificial womb to develop fully. This would save a life, and it would redefine the legal setting behind abortion.
Viability has already changed in the past few decades. A normal human pregnancy lasts about 40 weeks. In 1973, when the Supreme Court ruled abortion legal, the Court defined viability as a fetus’s ability to live outside of the womb. At the time, the Court said viability typically began at some point during the third trimester, which begins at 24 weeks.
In 1992, the Court reaffirmed viability as key to restricting a state’s power to regulate abortion. Today, viability ranges between 22 and 24 weeks by state, but no state can enforce a ban on abortion at any stage of development if a woman’s health is at risk.
Cohen suggested that the artificial womb technology could save the lives of fetuses as early as 18 weeks. This would push viability back, changing the way women go about the process of abortion — or fetus transfer, keeping the child alive.
In his article, Cohen presented three possible legal interpretations. The state may “prohibit abortion outright only after viability but that it may require transfer to an artificial womb instead of abortion for women between eighteen weeks and viability.”
Another possibility is that the artificial womb changes the legal understanding of viability. “That is, while an eighteen-week-old fetus would not be viable under the traditional definition of viability, we may understand it as viable once transfer to an artificial womb was possible; therefore the state could prohibit both the transfer to an artificial womb and the abortion at eighteen weeks.” This would be the cruelest interpretation and therefore is least likely to come to pass.
Finally, Cohen presented another alternative, that states that would have prevented abortion outright after viability would be forced to allow women to transfer the fetus to the artificial womb as an alternative.
In his article, Cohen seemed to fear that pro-life activists and legislators, in their zeal to destroy the lives of women, would abuse this possibility of keeping babies alive in order to ruin women’s lives. Contrary to the irrational fear of pro-life activists as secret misogynists, there is no evidence to suggest pro-life legislators would use the new technology merely to outlaw abortion, without allowing another possibility.
Most likely, pro-life legislators would champion the artificial wombs as a possibility. Pro-life non-profits should raise money to help women who would get abortions transfer their babies into artificial wombs. A new legal apparatus should be created by which mothers and fathers surrender their paternal rights and allow full adoption for babies born in artificial wombs.
While pro-abortion activists may fear that this new technology could remove a “woman’s right to choose,” it could arguably be the perfect solution to the complex moral problem of abortion.
As Cohen noted, both legally and ethically, “the abortion right has been most vigorously defended as a right not to be a gestational parent, not as a right not to be a legal or genetic parent.” The problem is, a woman does not want to be saddled with a life-altering pregnancy. Abortion allows her to avoid this, but so would the artificial womb.
“The right enjoyed by women is a right to stop gestating, not a right to end the existence of the fetus,” Cohen explained. “The artificial womb would allow women to exercise the first right without the second.”
Because of this legal situation, the artificial womb solves both the demands of pro-choice activists (for women to “control their own bodies”) and those of pro-life activists (for the fetus to survive).
Cohen is right to point out, however, that “defending the right to abortion when transfer is possible would change the moral terrain.” The argument of “‘my body, my choice’ would instead become a right to terminate the life of the fetus. A defense along these lines could still be possible on the philosophical level, but seems a much harder sell legally and politically.”
Naturally, the artificial wombs would present legal problems around maternal and paternal rights. Cohen cited the 1976 Supreme Court case Missouri v. Danforth in which the Court “rejected one state’s paternal veto on the provision of abortion on the ground that when a father and mother disagree on whether abortion should go forward, only one can prevail, and ‘as it is the woman who physically bears the child and who is the more directly and immediately affected by the pregnancy, as between the two, the balance weighs in her favor.’”
The transfer to the artificial womb would invalidate this argument, which is why the technology would require new legal structures regarding parental rights. As an alternative to abortion, a mother (and father) should be able to sacrifice her (and his) parental rights entirely, enabling easy adoption in such cases.
This new technology may undercut abortion, but it need not damage women’s rights. It may provide the impossible third way long sought by the pro-life and pro-choice movements. If a woman can be free of the challenges of pregnancy without killing the baby, this could permanently solve the issue.
Naturally, the case will require a great deal of debate and the technology has not yet been developed. But this alternative should be welcomed, not resisted.
Watch a heartening video about this new breakthrough, from the Children’s Hospital of Philadelphia.https://www.youtube.com/embed/z7OsEGT9d3o?feature=oembed