
First baby born after deceased womb transplant - daegloe
https://www.bbc.com/news/health-46438396
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woliveirajr
> The uterus was removed in the same surgical procedure as the livebirth and
> immunosuppressive therapy was suspended. (from the lancet article)

So not only the woman got an uterus, it was used specifically to get pregnant
and was removed afterwards, so that the mother now doesn't need to get
immunosuppressive drugs.

It's amazing because, in the end, it wasn't the common approach to take
material from the father, mother, implant in somebody's else body... it was
somebody's else uterus, but this time it was implanted inside the mother.

Amazing how much progress is done combining surgeries and drugs, until a new
medical protocol is developed.

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rodolphoarruda
Brazil, the most violent country in the world (60k violent deaths per year) is
also capable of promoting life. I'm feeling a bit prouder of my country today.

~~~
PhasmaFelis
Really not sure why this was downvoted. It seems like a reasonable sentiment.

~~~
pc86
As an American, Americans have a habit of taking anything around pregnancy
that mentions the word "life" to mean a pro-life/anti-choice stance, even if
the context is from regions of the world without such a distinction. The
response varies by audience, but the response on HN to anything approaching
pro-life/anti-choice is usually downvotes.

~~~
solveit
HN also seems to lean against patriotism (and for good reason in general,
although this comment seems completely harmless), so that could also have
played a part.

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Doxin
HN also seems to lean against patriotism _for non-americans_. There is plenty
of patriotism to go around on HN, but don't try saying anything positive about
countries other than the USA or it might just get interpreted as you saying
the USA is bad.

~~~
beaconstudios
Are we on the same website? For a US-centric site, I've always experienced HN
as being pretty anti-US in keeping with the seemingly average Democrat
attitude of thinking the US has been a detriment to the rest of the world for
a long time.

And that's coming from a Brit. I have no horse in the Democrat-vs-Republican
fight.

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hirundo
Could a womb be implanted into a male and be functional? Plan on a C-section
to skip the birth-capable vagina transplant, which might not be even possible
now. I wonder if the necessary hormone manipulations would be practical.

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yholio
All this waste of medical resources to deliver essentially a feeling to the
mother, while there are plenty of adoptable and miserable children all over
the world. At least in this case, they used the mother's own DNA.

~~~
ygjb
"waste of medical resources" \- over and above the outcome of the procedure,
each preceding failure likely yielded new information about female anatomy,
interactions between host and donor immune responses and the impact of those
immune responses, and a plethora of other useful information about human
reproduction. Yes, adopting would be easier, but procedures like this can
yield valuable insight into women's health and the reproductive process, which
is still fraught with risk in much of the world.

~~~
yholio
The suggestion was that the same procedure be applied for male biology. And of
course, the waste should be examined on the long run, where every transwoman
should have the right to a similar procedure if the money and donor are
available and they so desire.

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random878
Brief overview of the article if anyone is interested. Very interesting case.

 _Background_

Uterus transplantation from live donors became a reality to treat infertility
following a successful Swedish 2014 series, inspiring uterus transplantation
centres and programmes worldwide. However, no case of livebirth via deceased
donor uterus has, to our knowledge, been successfully achieved, raising doubts
about its feasibility and viability, including whether the womb remains viable
after prolonged ischaemia.

 _Methods_

In September, 2016, a 32-year-old woman with congenital uterine absence
(Mayer-Rokitansky-Küster-Hauser [MRKH] syndrome) underwent uterine
transplantation in Hospital das Clínicas, University of São Paulo, Brazil,
from a donor who died of subarachnoid haemorrhage. The donor was 45 years old
and had three previous vaginal deliveries. The recipient had one in-vitro
fertilisation cycle 4 months before transplant, which yielded eight
cryopreserved blastocysts.

 _Findings_

The recipient showed satisfactory postoperative recovery and was discharged
after 8 days' observation in hospital. Immunosuppression was induced with
prednisolone and thymoglobulin and continued via tacrolimus and mycophenalate
mofetil (MMF), until 5 months post-transplantation, at which time azathioprine
replaced MMF. First menstruation occurred 37 days post-transplantation, and
regularly (every 26–32 days) thereafter. Pregnancy occurred after the first
single embryo transfer 7 months post-transplantation. No blood flow velocity
waveform abnormalities were detected by Doppler ultrasound of uterine
arteries, fetal umbilical, or middle cerebral arteries, nor any fetal growth
impairments during pregnancy. No rejection episodes occurred after
transplantation or during gestation. Caesarean delivery occurred on Dec 15,
2017, near gestational week 36. The female baby weighed 2550 g at birth,
appropriate for gestational age, with Apgar scores of 9 at 1 min, 10 at 5 min,
and 10 at 10 min, and along with the mother remains healthy and developing
normally 7 months post partum. The uterus was removed in the same surgical
procedure as the livebirth and immunosuppressive therapy was suspended.

 _Interpretation_

We describe, to our knowledge, the first case worldwide of livebirth following
uterine transplantation from a deceased donor in a patient with MRKH syndrome.
The results establish proof-of-concept for treating uterine infertility by
transplantation from a deceased donor, opening a path to healthy pregnancy for
all women with uterine factor infertility, without need of living donors or
live donor surgery.

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adrianN
I'm not sure why this is preferable to a surrogate mother. It seems like it's
much less risky to implant a fetus into a surrogate mother than to implant it
into a transplanted womb that is removed after the pregnancy.

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Operyl
It’s one of those feelings, personally. Sure, surrogate mothers and adoptions
are preferable, but it’s just not the same as giving birth _myself_. It’s all
in my head, I guess.

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presidentender
Would it be practical to keep the womb alive via a heart/lung machine and
blood transfusions? Just remove human beings from the process altogether?

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XorNot
Really this is the question I'm interested in. Hopefully some animal models
can be attempted in the near future.

Given that we're getting better at growing body parts from stem cells, you
could easily imagine in the nearish future being able to gestate an embryo in
a womb grown from an individuals own stem cells and enough attached organs to
provide the full environment.

~~~
tspike
This is a bit horrifying to me. Babies are quite familiar with their mothers'
voices by the time they are born, among other influences; would we also
attempt to artificially simulate that sort of pre-birth bonding?

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tropo
Here, I'll crank it up a notch: instead of animal models, how about just
gestating humans in animals? There is your artificial womb. It just requires a
bit of anti-rejection drugs, or a bit of GMO effort for tissue similarity.

Whales have the right body temperature. There is enough room to do dozens of
babies at once.

Cows are close enough. A cow can probably handle a half dozen babies.

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chithanh
Fortunately or unfortunately, neither cows nor whales are close enough.

[https://en.wikipedia.org/wiki/Interspecific_pregnancy#Causes...](https://en.wikipedia.org/wiki/Interspecific_pregnancy#Causes_of_failure)

~~~
tropo
They are close enough after "a bit of anti-rejection drugs, or a bit of GMO
effort".

We can suppress the immune response, one way or another. If the animal is
unable to clear the placenta after the birth, we lose the animal, but we still
get a baby.

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adetrest
I... Don't get the point. How many orphans are there who will never be
adopted? Why go to such length if you really want a kid? I find this a bit
perverse personally. While the medical and scientific achievement is amazing,
I don't know if it's a net positive overall.

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tathougies
> How many orphans are there who will never be adopted?

In most developed countries, very, very few.

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buboard
How far are we from artificial wombs? afaik they can support the growth of
lamb fetuses.

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mr_overalls
This kind of procedure could be a breakthrough for transgender women who want
to bear their own children.

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accnumnplus1
I think if I was that kid I might feel a bit creepy.

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pc86
Why?

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accnumnplus1
Maybe too much Lovecraft, horror channel, or Slayer, but there's an element of
"born of dead womb". Certainly nice for the transplant recipient and partner,
but I think I'd feel a bit weird having groen in a transplanted womb, even
with downvotes telling me I'm not allowed to have an opinion.

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mLuby
Shouldn't you feel the same way if your mother had a heart, kidney, or liver
transplant? You'd be directly hooked up to it as a fetus and it's as "dead" as
the womb in this case.

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andrewflnr
No, because feelings don't work by strictly following nutrient flows.

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sandworm101
Cool, and on an individual human level I'm happy for the parents. But at the
larger societal level I find such procedures very disturbing. I don't mean to
sound like a eugenicist, everyone has the right to have kids imho, but the
resources spent to create this one kid were immense. There are far easier ways
for these parents to have genetic children, a surrogacy being top of the list.

The possibility of men carrying children is scientifically interesting, but
again the human race is not struggling for kids. We are a growing population.
I'd rather the resources spent on these procedures go towards vaccinations or
the basic medical treatments that so many people lack on this planet.

~~~
pc86
We have enough scientists to work on multiple things concurrently. There is
_always_ something "more worthy" of research/funding/time/facility
allocation/manpower than whatever it is you're working on at the moment.

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sandworm101
Research is one thing, it advances human knowledge. My issue is with the
procedure that comes from the research. I would not support this becoming a
therapy, something to be used not to advance knowledge but to cure disease.
I'm all for the experiment. I get worried when people talk about this as
another answer to infertility, or those who suggest it as a means for men to
carry babies.

Similarly, I have no issue with some of the so-called "vampire" experiments,
blood transfusions between young and old (ie moving blood both ways). Much can
be learned through this (liver functions, immune cells etc). But I would very
much against such a thing becoming a standard therapy beyond the lab.

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pc86
This would be a surprisingly backward and anti-science viewpoint for the
general public, let alone HN.

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trubbedstrullen
At extraordinary expense, including the entire machine to provide the doctors,
facilities, etc. This and tech like it only allow the elite to further
separate themselves from anybody else.

