Motherhood

Medical science has proven itself capable of lengthening human life, through interventions that enable people to outlive the effects of once-deadly conditions but which are now able to be kept in control through protocols including surgery and the use of medications whose function is to prolong life and increase its quality in the process. Medical researchers are always being challenged by the need to discover new and workable solutions to the tragedy of human bodily dysfunction.

And although it is never legal or considered to be ethical, moral or humane to use human guinea pigs, this is exactly what occurs when a new surgical procedure or a new drug is being experimented with to enable an assessment of its usefulness, once initial animal trials have been dispensed with. Doctors in Turkey transplanted a womb from a cadaver into a 22-year-old Turkish woman born without a womb, in 2011. After a year and a half living with her transplant, Derya Sert, 22, received fertility treatment and an embryo was implanted.

Initial tests showed that the young woman was pregnant. The news was sensational, it meant that women born without a womb, or who suffered a disability as a result of disease or accident, might hold out hope of a transplant that would enable them to become pregnant, carry a foetus and have a child of their own. This kind of extreme medical action might not appeal to all women, but certainly it does to many who cannot think of life fulfilment without experiencing carrying a pregnancy to birth.

Pioneering: Derya Sert, 22, from Anamur in Southern Turkey, was born without a womb

Unfortunately Derya Sert's pregnancy was terminated soon afterward. The embryo from one of her own eggs simply did not take. At eight weeks of pregnancy the fetal heartbeat had stopped. The young woman hopes to repeat the process, to have it result in a successful conclusion. She will receive new fertilization treatment for that very purpose. And the world watches with curiosity and anticipation.

And now, in Sweden doctors are preparing to fertilize a womb that they had transplanted in 2012 from a mother to a daughter. Two of these surgical transplants had taken place in Sweden. And the longest surviving transplant is of a year's duration, according to Dr. Mats Brannstrom, chair of the department of obstetrics and gynecology, University of Gothenburg. The transferal of embryos is set to begin within weeks, to complete the experiment.

Each woman who had the transplant procedure has over ten embryos in deep freeze, created with the use of each woman's own eggs and her partner's sperm. Some women were born without a womb or with a malformed uterus, while others lost their wombs to cancer. Donor wombs have been received from sisters, from aunts, friends, and mothers. The seeming impossibility of a woman carrying the womb that carried her, to produce her own child appears on the cusp of reality.

The goal "of course, is to get a healthy baby", Dr. Brannnstrom says. "We don't know if that is achievable yet, and we don't know the risks yet"; whether the procedure could result in risks to a developing foetus. Animal experimentation with rats resulted in perfect, normal offspring. Human transplantation is far more complex; a delicate 10 - 12 hour operation to retrieve wombs and blood vessels on the sides of the uterus is involved.

The transplanted women must take powerful immune-suppressant drugs to ensure their bodies don't reject the donor wombs. Those drugs are linked to a higher risk of miscarriage, premature birth, and uterine growth restriction. As immune-suppressants they also curtail normal immune response critical to normal health outcomes. If the trials are successful after one or two successful pregnancies, the donor wombs would be surgically removed rather than have the women remain on anti-rejection drugs.

Over a decade ago in Saudi Arabia, the first uterus transplant with a live donor was performed. Three months later it had to be removed as a result of massive tissue death. The 2011 Turkish uterus transplant using a womb from a dead donor represented the first successful such transplant. The procedure can be seen as an extreme response to a fervent desire; the complexities and complications involved are not for the faint of heart.