First Uterus Transplant in US: Be Careful What You Wish For

Today, the Cleveland Clinic announced that they performed the first uterus transplant in the United States. According to the New York Times, the operation, took nine hours, and used a uterus from a deceased organ donor. Here is more information from that article.

  • The recipient, 26, is not being identified to protect her privacy
  • The patient will have to wait one year before trying to become pregnant, letting her heal and giving doctors time to adjust anti-rejection medications
  • The transplant is only Temporary: The uterus will be removed after the recipient has had one or two babies
  • The ethics committee at Cleveland Clinic has given it permission to perform the procedure 10 times, as an experiment. Then, it will evaluate whether it will offer this as a "standard procedure"

I first wrote about the possibility of the uterus transplants almost 10 years ago on the old Doctor Anonymous blog, and it was by far one of the most popular posts on the DA blog.  I still have many of the same questions 10 years later. I'll quote from that blog piece below, and I also invite you to read the comments from back then, which I think still apply today.

  • Medical Questions: Anti-rejection transplant drugs are powerful stuff. Yes, we have some data which states that the pregnancy rate for transplant patients are "not much worse than for the general population. Can this data be correlated to uterine transplant patients? How much do anti-rejection drugs cross the placenta barrier? What would be the effects to the fetus/baby? What about the 3D Printing of a uterus? Can/should this be done?
  • Moral Questions: You have to know that this will be another platform for the abortion debate to take place (especially so in this US Presidential election cycle). Presuming the transplant goes ok, what if the pregnancy goes awry? What if the life of the mother is at risk and/or the life of the fetus/baby is at risk? Both sides of this debate will definitely make their points of view known.
  • Legal Questions: The malpractice attorneys are preying, er, praying that this procedure becomes a "standard procedure" as outlined above. The liability here is huge. The potential for medical problems are everywhere starting wtih the transplant itself, then the pregnancy, then the potential complications of anti-rejection drugs.
  • Not to mention the Financial Questions: Who is going to pay for all of this? I know I'm going to get hate mail saying, "Hey Jerk, isn't life priceless to you?" There are some estimates that one fertility treatment alone can cost $25,000 dollars. But, then there's the first surgery of the transplant. At least two fertility treatments, removal of the uterus (according to the Cleveland Clinic protocol above), the anti-rejection medication, and a lot more. I forsee more feedback for me, "You don't know what it's like to be told that from a medical standpoint, you can NEVER have the possibility of the pregnancy and childbirth experience."

As I said 10 years ago, I'll say again. I'm pessimistic that the uterus transplant will become a "standard procedure" for a number of reasons. Just because it looks like it can be technically done, I don't think they should be done. I think there are still too many unanswered questions to proceed further...