Womb Transplants Still Infertile

By Jay Delancy, 11.29.06

A medical researcher’s 2003 sensational claims that womb transplanted babies could be possible within three years spurred hopes worldwide for infertile couples. But the claim remains infertile, since no transplant surgeries have occurred.

The highly publicized claim from Professor Mats Brannstrom, a leading Swedish medical researcher, came after his 70 percent birthrate success in mice that were born out of a transplanted uterus.

In an update to this story, Duke University medical researchers expressed doubts as they explained the difficulties of such a procedure.

According to Professor Duane Davis, Director of Duke’s transplantation center,
there are still big questions that need to be answered before such procedure is possible.

“The fact that something was accomplished in a murine or mouse model does not guarantee that it would be reproducible in a human or some other large mammal,” Davis said.

According to Davis, one of the main reasons that medical researchers use mice is to reduce the complexity.

“If all the things we have achieved in mouse models were successfully duplicated in humans, we would have already cured all aspects of transplantation,” Davis said.

“Transplantation is fairly acceptable for life-threatening problems like heart and lungs, and even in kidneys, we have remedies like dialysis but there are still some good reasons to go forward with it,” Davis said.

But transplants with no survival benefit have typically raised more cost-benefit questions among the profession, according to Davis. The danger from the entire surgical procedure and the risk of rejection make many doctors wince at the prospect of transplanting things like a hand, a face or even a uterus.

Donor matching is a way that transplant specialists can often reduce the risk of rejection. And the safest bet for a successful womb donation would be between identical-twin sisters, Davis said.

But, while the possibility of organ rejection makes the procedure risky, the elective nature of the surgery raises other questions that deter doctors from moving forward.

While not wanting to dash the hopes of couples seeking solutions, a Duke fertility specialist agrees. Surgeon Professor David Walmer, remembers the Swedish case report but didn’t know of any ongoing research in this area.

“In circles that I run in, risk-benefit ratio questions suggest that this is not worth doing,” Walmer said.

Both surgeons said that medical professionals do not consider the uterus to be a vital organ. As a result, the danger of the medicines raises a bigger concern.

“The benefit of a new uterus doesn’t outweigh the risk of immuno-suppressant drugs,” Walmer said. “Because the uterus is not a vital organ, we advocate alternatives.”

Their most common alternative is surrogacy. In this procedure, the mother’s fertilized egg can be implanted in another woman’s womb. But while relatively simple from a medical perspective, the legal issues make it more complicated.

“A North Carolina woman giving birth to a surrogate baby becomes the mother,” Walmer said. “And then she has to adopt the baby out to the couple [who actually made the baby].

Many states do not have laws addressing surrogacy but this situation is improving. He advised prospective surrogate parents to seek legal advice in their resident state.