
First womb-transplant baby born - forrest_t
http://www.bbc.com/news/health-29485996
======
wyager
People can be so insanely desperate to have children _exactly_ in some
arbitrary and specific way.

I mean, this woman went through a very dangerous and expensive transplant
surgery that then required the use of immunosuppressant drugs to prevent organ
rejection, when she could have used a surrogate or, _gasp_ , adopted.

I hope they had to pay for this surgery with their own cash. There is
absolutely no medical necessity behind it.

Edit: This comment seems to be eliciting some disapproval. I'm curious why;
please let me know what you're thinking.

~~~
gfodor
You're saying that the specific manner of giving birth to a child you carry in
a womb in your own body over 9 months that is of your own genetic makeup is
"arbitrary," despite the fact that this is the exclusive mechanism of human
procreation up until recent history.

~~~
wyager
Yes. If you're asserting that "giving birth to a child you carry in a womb in
your own body over 9 months" is somehow inherently preferable or special
compared to any other form of child rearing, your argument that "this is the
exclusive mechanism of human procreation up until recent history" is an
argumentum ad antiquitatem and/or argumentum ad naturam fallacy.

~~~
TeMPOraL
A meta observation: naming someone's logical fallacies seems to be positively
correlated with being wrong and/or arrogant, and generally tends to derail
discussions quickly.

The failure mode Eliezer used to write about[0] seems to be true - in many,
learning about logical fallacies tends to induce dysrationalia. Instead
thinking about what other side says, one can just pattern-match anything they
disagree with to a fallacy and cry foul.

[0] -
[http://wiki.lesswrong.com/wiki/Dangerous_knowledge](http://wiki.lesswrong.com/wiki/Dangerous_knowledge)

~~~
wyager
>naming someone's logical fallacies seems to be positively correlated with
being wrong and/or arrogant

Way to slam me without really addressing anything I said. You managed to say I
was wrong and attack my character in one fell swoop!

>one can just pattern-match anything they disagree with to a fallacy and cry
foul.

Is there anything wrong with this? People should probably try not to argue
anything that is obviously a fallacy.

~~~
TeMPOraL
> _Way to slam me without really addressing anything I said. You managed to
> say I was wrong and attack my character in one fell swoop!_

I was trying to make a meta-point; I used your comment as an anchor. After re-
reading my post I realize it might come off condescending and personal, I
sincerely apologize. I stand by my meta-point though, i.e. most of the
comments I see that enumerate logical fallacies are written as a way to
implicitly attack the other commenter (I admit that my previous comment did
exactly this to you), and are also often wrong.

As for addressing what you said: my belief is that the _argumentum ad naturam_
here is justified given how the "natural" child bearing and birth processes
are strongly tied to body chemistry, as well as being important in our culture
since forever. It's not inherently special in an ontological way, but we are
hard-wired to prefer it.

> _Is there anything wrong with this? People should probably try not to argue
> anything that is obviously a fallacy._

Yes, because a/ just because something is a logical fallacy, doesn't mean it's
wrong (see: _fallacy fallacy_ , aka. _argumentum ad logicam_ ) and b/ you can
pattern-match anything to some fallacy if you try hard enough, which people
often do (one common failure mode is forgetting that all fallacies are defined
with additional conditions that must be met; if those conditions are not
satisfied, then the very same sentence becomes a perfectly valid argument).

~~~
wyager
> It's not inherently special in an ontological way, but we are hard-wired to
> prefer it.

I agree with you. However, being hard-wired for something doesn't make it
right. One might argue humans are hard-wired for war, rape, etc.

>Yes, because a/ just because something is a logical fallacy, doesn't mean
it's wrong (see: fallacy fallacy, aka. argumentum ad logicam)

An argument being a fallacy _does_ mean it's wrong. However, it doesn't mean
the conclusion is wrong. The fallacy fallacy is as follows:

A proves B → B (this is true)

¬(A proves B) → ¬B (this is the fallacy)

All the fallacy fallacy says is that "Just because an argument is fallacious
doesn't mean that its conclusion is wrong".

It may well be true that "natural" births are better for some reason. I was
simply saying that gfodor's explanation for why this might be the case is
wrong.

------
bayesianhorse
The amazing part here is that the immune system is very much involved in the
early parts of the pregnancy. Successful "implantation" of an embryo in a
transplanted womb with an immune-suppressed host is no mean feat...

~~~
Amarok
I don't understand why the successful implantation of the embryo is amazing.

Many women take immunossupressants while pregnant, and many undergo IVF to
give birth, some of which to allogeneic embryos (egg donations). This last one
doesn't seem to affect significantly implantation, with the main concern being
a higher risk of pregnancy hypertension[1]. I expect conceiving with an
allogeneic uterus would be similar, since in both the genetic differences
between embryo and uterus are comparable.

Succeeding in combining the two is just a matter of probability, which I don't
think is that low. Especially if you consider that the uterus had to come from
a compatible donor, so the number of HLA mismatches will be lower.

1\.
[http://www.ncbi.nlm.nih.gov/pubmed/20543201](http://www.ncbi.nlm.nih.gov/pubmed/20543201)

------
fcoury
May be a dumb question but in this case which genes will the baby inherit: the
mom's or the womb donor's?

~~~
lmkg
Genes of the baby are 100% determined by the fertilized egg. The genes will be
from whoever donated the egg. This is usually the mother in practice, but
since you need to do In-Vitro Fertilization anyways, there's no fundamental
reason it couldn't be someone who is genetically unrelated to either the mom
or womb-donor.

Note that genetics are not 100% in control, and the conditions of the
pregnancy affect the outcome of the pregnancy. We don't know the full effects
of this, and we certainly don't know which aspects of it are from the womb
specifically vs other biological aspects of the mother (e.g. blood chemistry).
Health of the mother certainly has correlations with birth weight and
developmental progress, but the extent & mechanisms are still pretty opaque.

~~~
car
Slight correction; the genome is 50% maternal (egg), 50% paternal (sperm).

~~~
pyre
_Fertilized_ egg = unfertilized egg + sperm :)

~~~
car
Well, that read differently before.

------
whiteshadow
The only thing that made me weary here was having a baby on
immunosuppressants, and the danger that could present for the fetus. Anyone
knows if this can affect the baby on the long term (associated with premature
birth)?

~~~
Amarok
During pregnancy the mother was on a triple immunosuppressant regimen:
azathioprine, tacrolimus, and prednisolone (corticosteroid). The first is a
Pregnancy Class D drug (some reports of human birth defects), and the two are
class C (birth defects only in animal studies)

A study on azathioprine use in early pregnancy found an increased risk of
congenital malformations which wasn't statistically significant (from 4.7% to
6.2%) , and an association with preterm birth and low-weight[1]. But a later
meta-analysis concluded only the increased risk of preterm birth was
significant for this class of drugs[2]

It's mentioned in the article that the mother developed pre-eclampsia (simply
put, hypertension during pregnancy, which can lead to eclampsia, with seizures
and coma). This should also be a concern for the other women in the study[3]:
Firstly, immunosuppressants might increase pre-eclampsia, since the risk is
about double in women with a kidney transplant (22%). Also, the age of the
donated uterus should be considered: the risk increases seven-fold for
pregnancies after 50, though it hasn't been shown the problem is in the uterus
itself. Finally, the risk is higher for IVF conception.

Given this accumulation of risk, I'm curious how the other pregnancies carry
on.To understand what's at risk, being born preterm is associated with
increased morbidity and mortality, as well as lower achievement in general.
Some papers point towards epigenetic changes (DNA methylation) as the
etiology.

1\.
[http://www.ncbi.nlm.nih.gov/pubmed/19343728](http://www.ncbi.nlm.nih.gov/pubmed/19343728)

2\.
[http://www.ncbi.nlm.nih.gov/pubmed/22434610](http://www.ncbi.nlm.nih.gov/pubmed/22434610)

3\.
[http://press.thelancet.com/wombtransplant.pdf](http://press.thelancet.com/wombtransplant.pdf)
(original paper)

------
mrfusion
Would she have the womb removed when she's done having children? Seems like
that would be worth doing to get off immunosuppressants?

And follow up, could the womb then be transplanted in someone else??

~~~
gus_massa
Last sentence in the article:

> The drugs used to prevent the womb being rejected would > be damaging in the
> long term - so the couple will either > try again or have the womb removed.

------
usbreply
Why is it called a "womb" transplant rather than a uterus transplant ?

Womb is such a weird word to use.

~~~
blahedo
In the US the word "womb" has a vaguely archaic or religious feel, but it
seems to be much more current in UK English (and the link here is to the BBC).
I've seen "womb" used regularly on UK sites. US-based news feeds (that I've
seen) have indeed generally used the term "uterus transplant" about this
story.

~~~
threedaymonk
I can confirm that 'womb' is a perfectly normal word here in the UK. It's no
stranger than 'fortnight' or 'autumn'.

------
pygy_
Next up: m2w trans pregnancies, then just male pregnancies.

Stem cells-derived gametes (of both types, regardless of the sex of the donor)
are also around the corner.

Exciting times :-)

~~~
cherry_su
Thomas Beatie (a m2w trans) got pregnant in 2007.

>>> Beatie chose to become pregnant because his wife Nancy was infertile,
doing so with cryogenic donated sperm.

[https://en.wikipedia.org/wiki/Thomas_Beatie](https://en.wikipedia.org/wiki/Thomas_Beatie)

~~~
stormbrew
That's the other way around. Thomas Beatie was assigned female at birth. The
GP is talking about someone assigned male at birth, I'm pretty sure. That's
what 'm2w' or 'mtf' generally means.

~~~
meowface
Yeah, the inverse would be an amazing feat of science and medicine.

~~~
bjornsing
I agree, truly amazing.

