Thursday, 1 October 2015

Womb transplants get ethical approval in UK



Regulators have now given the go-ahead for Womb transplants. The UK Womb Transplant Research group has been granted ethical permission to begin an expanded series of 10 womb transplant operations.

As many as 50,000 women of childbearing age in the UK have no viable womb, a surprisingly high number, and affecting 1 in 5000 women, and 1 in 500 women of child bearing age who suffer from womb factor infertility.

In the UK adoption and surrogacy are the only options and the vast majority of children born to UK parents suffering this condition are born abroad. Surrogacy is only possible and legal in a few special cases in the UK. So how many women would be likely to benefit from womb transplantation in the UK?

Womb Transplant UK, the charity behind the research in the UK, say they currently have 104 potential patients who meet their criteria for a transplant.

Research in the UK on the potential for womb transplants has been undertaken for the past two decades. Each womb transplant will be labour intensive, requiring a team team of 12 for each operation; 5 for the retrieval of the donated womb and 7 for the transplantation. The donated womb would be the gift of a woman who has died. So how successful could it be?

There is a great deal of uncertainty about the risks and potential success.  This is why those involved will be moving forward cautiously.

The World’s first womb transplant was carried out in the Middle East some 10 years ago. The transplanted womb was viable but had to be removed after three months. Several years ago a successful transplant was carried out in Turkey and the recipient became pregnant but miscarried after a few weeks.

However, a Swedish team have undertaken nine womb transplants, with seven being successful (78% success rate). They officially reported the first live born child following uterine transplantation in September 2014. It has since been reported that a further three have delivered healthy babies whilst another has become pregnant resulting in a pregnancy rate of at least 71%. 

There is specific ethical concern because the transplant is not 'life saving'.  Some have referred to it as a 'luxury'. Whatever the argument, it is certainly life enhancing and life creating if successful. Furthermore, womb transplantation may become the only option for women who are unable to conceive for reasons such as cancers or infertility or in cultures where surrogacy is an unacceptable option for couples owing to religious or ethical reasons.

There are concerns about  the effects on the developing baby of immunosuppressive drugs required during the pregnancy to prevent rejection of the uterine transplant. However, there is  now extensive information regarding the effects of these drugs. Since 1954, over 15,000 successful births have occurred in women with other transplanted organs, and the evidence supports the safety of various immunosuppressive drugs.

Further information can be obtained from Womb Transplant UK.



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