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Doctors two years away from successful womb transplants

11 September 2006
Appeared in BioNews 375

Doctors at Hammersmith Hospital, London, aim to carry out the first successful womb transplant within two years, reported the Evening Standard. Doctors say that the womb would be taken from a dead donor and will only remain in the recipient for two or three years, or until a baby is born. Richard Smith, a surgeon at Hammersmith Hospital, working with teams in Budapest and New York, announced that animal trials have been successful; 'We have had stunningly good results in the laboratory with good blood supply to the organ', he said. The team now wishes to move on to clinical trials in humans.

This procedure may bring hope to women whose own wombs have been rendered useless by disease or surgery, or who were born without one, for whom IVF  is not an option, and for women who have come to the end of the line of IVF with no success. There are currently 15,000 women in Britain who have no uterus, of which about 200 have turned to surrogacy.

The procedure would provide an alternative to surrogacy, where problems include difficulties in finding someone to carry the baby and fears that the surrogate mother will refuse to hand over the child once born. There are also risks for the surrogate mother herself. In 2004, Natasha Caltabiano died after given birth for another couple. However, womb transplantation may carry associated risks as well. The mother would have to give birth by Caesarean and would have to undergo a course of immunosuppressant drugs. For this reason the transplanted womb would only be in for two or three years and would be removed once a child is born. Mr Smith highlighted that women have already given birth to healthy children after kidney transplants, which required them to take immunosuppressant courses to prevent rejection. Women who undergo a womb transplant would also be offered psychological counselling.

Mr Smith said that the hospital, which is currently funded by charitable donations, would need £250,000 a year in funding to perform the transplants. It is estimated that each transplant would cost about £50,000.

Womb transplantation has provoked a mixed response from the authorities and the public. Infertility organisations have welcomed the news but have warned women not to raise their hopes until the procedure has undergone successful human trials. Professor Lord Robert Winston, however, warned that 'this is not a road we should be going down. It is a dangerous procedure which could cost a woman her life'. Dr Patrick O'Brien, spokesman for the Royal College of Obstetricians and Gynaecologists, called the procedure 'fascinating' and said that women would chose to undergo the transplant but added that it was a 'separate question, for the Human Embryology Authority and the public to consider'. Public discussion boards have revealed concerns over 'Frankenstein' procedures and some have preferred the alternative of adoption. Whilst issues of safety may be overcome by Mr Smith and his team, the ethical objection to such a procedure may remain. The first human womb transplant was announced in 2002 by a team in Saudi Arabia but the transplanted womb failed after 90 days because of the development of a blood clot. Mr Smith has said animal trials have shown no blood supply problems so far.

SOURCES & REFERENCES
First womb transplants
The Evening Standard |  4 September 2006
We'll transplant a womb in two years
The Mirror |  5 September 2006
Womb transplants could restore fertility
The Scotsman |  5 September 2006
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