First U.S. Uterus Transplant Planned

By Rob Stein
Washington Post Staff Writer
Monday, January 15, 2007

First came kidney, liver and heart transplants. Then a few doctors started transplanting hands. French surgeons even did a face.

Now, doctors are planning the first womb transplant in the United States.

A team based in Manhattan has begun screening women left barren by cancer, injuries or other problems who want a chance to bear their own children.

"The desire to have a child is a tremendous driving force for many women," said Giuseppe Del Priore of the New York Downtown Hospital, who is leading the team. "We think we could help many women fulfill this very basic desire."

But the planned operation, which Del Priore and his colleagues could attempt later this year, is stirring objections among some transplant experts, fertility specialists and medical ethicists. They question whether the procedure has been tested sufficiently on animals and whether the benefit of being able to carry a pregnancy outweighs the risks for the woman and fetus.

"This raises a set of very difficult medical and ethical questions," said Thomas H. Murray, who heads the Hastings Center, a bioethics think tank in Garrison, N.Y. "I think it's very questionable. This would be very hard to justify."

The operation marks a confluence of two medical specialties -- transplant surgery and reproductive medicine -- that frequently spark controversy.

"It is the convergence of two fields that are already embedded in large ethical disputes," said Lori B. Andrews, a bioethicist at the Chicago-Kent College of Law. "This represents the worst of both worlds."

Several experts said the plans highlight the unique status that childbearing holds in the United States and elsewhere, and the lengths to which some women will go to experience it, even with the availability of such options as adoption and surrogacy.

"I'm not convinced that science and medicine and society as a whole should be putting so much emphasis on having this particular nine-month experience," said Adrienne Asch, who studies family life at Yeshiva University. "Why is that the sine qua non of being a parent? The real work of parenting is in the time after a child is born and is in someone's home."

But Del Priore and others defend the effort, saying the procedure will be attempted only after careful vetting by independent experts.

They note that thousands of women cannot bear children because they were born with a malfunctioning uterus or their wombs were damaged by cancer, accidents, pregnancy complications or other problems. Women who want the operation are being screened exhaustively to make sure they fully understand the risks and have seriously considered alternatives.

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