
Woman with Transplanted Uterus Gives Birth, the First in the U.S - iamthirsty
https://www.nytimes.com/2017/12/02/health/uterus-transplant-baby.html
======
koolba
From the article (not all contiguous but related):

> A new frontier, uterus transplants are seen as a source of hope for women
> who cannot give birth because they were born without a uterus or had to have
> it removed because of cancer, other illness or complications from
> childbirth. Researchers estimate that in the United States, 50,000 women
> might be candidates.

> The transplants are meant to be temporary, left in place just long enough
> for a woman to have one or two children, and then removed so she can stop
> taking the immune-suppressing drugs needed to prevent organ rejection.

> The transplants are now experimental, with much of the cost covered by
> research funds. But they are expensive, and if they become part of medical
> practice, will probably cost hundreds of thousands of dollars. It is not
> clear that insurers will pay, and Dr. Testa acknowledged that many women who
> want the surgery will not be able to afford it.

While the science is amazing, why go this route rather than having a surrogate
mother? I've heard the price of a surrogate is $30-50K.

~~~
DoreenMichele
_While the science is amazing, why go this route rather than having a
surrogate mother? I 've heard the price of a surrogate is $30-50K._

That sounds rhetorical, but I'll bite anyway.

Some women really long for the experience of childbirth. This may not be
entirely psychological. Giving birth has significant impact on a woman's
physiology. In addition to changing the shape of the hips and often other
details like that, it leaves a woman a _chimera_ for many years. Because her
blood and the blood of the baby mix, she carries cells from the baby for many
years afterwards.

I have a genetic disorder. I have two biological sons. I was not diagnosed
until they were about 12 and 14 years old, so I didn't (consciously) know
about my condition at the time that I was making reproductive choices (though
I did know I was always "sickly").

My first pregnancy significantly impacted how I eat. I removed a number of
things from my diet to cope with my difficult pregnancy and many were never
added back into my diet. I have reason to believe this did my health a lot of
good. For example, it cured the chronic, sever vaginal yeast infections I had
for more than two years prior that pregnancy. I never again had chronic,
severe yeast infections.

I have read up a bit on pregnancy-induced chimerism and talked a bit with
people online about it and talked a fair amount with my sons. I have come to
think that some women long for a baby because it can have a profound impact on
a woman's body in ways we don't fully understand and perhaps sometimes that
longing is rooted in some subconscious awareness that going through the
process of carrying a child to term may alter their body in ways that are
potentially for the best.

This would be really hard to prove. We have no means to see what the
biological outcome would be for the same woman with and without the pregnancy
experience. But I am in remarkably good health for someone with my genetic
disorder and I credit my two pregnancies with some portion of that fact.

~~~
hiram112
That is quite interesting to hear from a woman.

Artificial wombs are coming. I was under the impression that women considered
pregnancy as a burden which carries risks, is painful, causes all sorts of
negative hormonal / physiological effects, etc.

I think that artificial wombs will initially be challenged by feminist and
conservative groups, but will end up being accepted, first with wealthy
Western women, but eventually by everyone else.

I have never considered that women might choose to carry a child, if they
weren't required due to technological and scientific advances.

~~~
cortesoft
> I was under the impression that women considered pregnancy as a burden which
> carries risks, is painful, causes all sorts of negative hormonal /
> physiological effects, etc.

It does that, and is also something many women desire. Some thigns are both
really hard and painful, and also very rewarding.

I really doubt you are going to get any challenges from feminists, or at least
not very many. Feminism is all about empowering women to be able to do what
they want, which includes having a baby using an artificial womb. Conservative
groups might be against it, but it will depend on which group. Not all
conservative groups are against IVF, which is similar in the sense that it
allows a woman who would otherwise not be able to have a child have a child.

~~~
adventured
> Feminism is all about empowering women to be able to do what they want,
> which includes having a baby using an artificial womb.

The types of feminists that you'll see negative responses from, are those that
use feminism as a platform for controlling others. For example, the kinds of
feminists (some people would call them fake feminists) that get upset when a
woman chooses to shave her armpits, or likes to wear lipstick or heels, etc.
etc. Those types always look for opportunities - no matter how absurd - to
proclaim something is the latest attempt to enslave women to their biology,
and so on and so forth.

~~~
DoreenMichele
I am a former homemaker and full-time mom. Most self proclaimed feminists I
have interacted with have been virulently hostile, disrespectful and
contemptuous of me. They seem to not see full-time motherhood as a legitimate
choice at all. It sometimes feels to me like they _wish_ a man would take care
of them, but they don't know how to make that work, so hating on me is de
rigueur.

It is one of the reasons I spend so much time on Hacker News. Most men are
less aggravating for me to deal with.

It is also part of why I do not self identify as a _feminist._

~~~
rdtsc
> I am a former homemaker and full-time mom.

My wife who is also a homemaker and stay-at home mom. She has heard remarks
from family, acquaintances and even random parents playing with kids at the
park how she was throwing her university degree down the drain and how somehow
she doesn't "need to stay home" and can do whatever she wants. They don't seem
to understand that what she wants to do currently is to raise kids.

~~~
astura
There's impolite people everywhere. If your wife worked outside the home she'd
get impolite comments from family, acquaintances, and random strangers about
working outside the home instead of being home with the kids.

Women who work outside the home get rude comments, women who stay at home get
rude comments and you can't even avoid it by opting out of childbearing
entirely, those women get rude comments too.

I fail to understand what that has to do with feminism or much anything else.

BTW, staying at home is the more socially acceptable choice.[1]

[1] [http://www.pewsocialtrends.org/2014/04/08/after-decades-
of-d...](http://www.pewsocialtrends.org/2014/04/08/after-decades-of-decline-a-
rise-in-stay-at-home-mothers/)

~~~
ryanmarsh
_If your wife worked outside the home she 'd get impolite comments from
family, acquaintances, and random strangers about working outside the home
instead of being home with the kids._

In this day and age? Does that still happen? Asking because honestly that’s so
far from my personal experience.

~~~
snegu
Ha! Yes, of course. I get this all the time. Shocked reactions from people
when I tell them our baby is in daycare. Sometimes it's more subtle and framed
as "oh, it's too bad you can't afford to stay home with him," as if it
couldn't possibly have been my choice.

Which is to say, I have the highest respect for SAHM moms because it's a
damned difficult job.

------
bitL
How far are we from completely artificial uterus with no need for human body?
If we plan to colonize other planets, we need literal "baby factories". How
far are we from this technology? (regardless of dystopian vibe)

~~~
yjftsjthsd-h
Why would we need non-human baby factories?

~~~
chairmanwow
Could you imagine something that equalizes the playing field more between men
and women? This provides the ability for people to have a child without the
woman having to gestate the fetus for 9 months? None of the terrible side
effects of pregnancy, none of the pain. Sounds pretty idealistic to me.

~~~
eighthnate
> Could you imagine something that equalizes the playing field more between
> men and women?

It really wouldn't because women would lose the societal benefits of being
child bearers. So at best, it would be a wash.

> This provides the ability for people to have a child without the woman
> having to gestate the fetus for 9 months? None of the terrible side effects
> of pregnancy, none of the pain. Sounds pretty idealistic to me.

But most women actually want the experience of being pregnant. It's why this
woman chose to transplant a uterus and become pregnant. She could have just
hired a surrogate for far less time, effort and money.

But the issue of artificial wombs does offer a interesting question. How would
it change humans as a species. Would it make men or women or both obsolete?
Evolutionary pressure has made women child bearers and men providers. How
would artificial wombs change that? Not to mention, the effects on physiology.
Would women eventually lose uteri or will it become a useless vestigial organ
over time?

~~~
fibbery
> most women actually want the experience of being pregnant.

I'm really curious if this is true.

------
GarvielLoken
I first read " Woman with Transparent Uterus Gives Birth, the First in the U.S
"

------
robocat
Any reason a man couldn't get one, with correct hormones?

~~~
actuallyalys
He would also need a vaginal canal so he could menstrate. That's possible with
surgery, but it'd be a deal breaker for most men.

~~~
keyboardhitter
menstruation would only be a component if the transplanted organs included
functional ovaries and fallopian tubes. women who have full ovariectomy do not
mensturate afterwards, as a slightly related example.

there are existing procedures to help facilitate implantation and regulate
hormones that have high success rate (most common is ivf).

however, vaginal canal can also be useful to expel discharge and in case of
pregnancy, placental fluid/sac -- but in a theoretical case of implanted
uterus only, I wonder if "including" a vaginal canal would be more symbolic
than medically necessary?

~~~
robocat
So it would seem that the ovaries would also need to be transplanted, and
probably the testes removed (or otherwise eunichised).

Basically turning a man functionally into a woman.

------
creep
I find it interesting that the Baylor team chose a shorter timeframe from
surgery to implantation with success. According to the article, the initial
thought was that a longer wait time gave a chance for the women to heal, but
the Baylor team thought the immune-system-suppressants (used to ensure the
body does not reject a foreign organ) too harmful to continue for long
periods.

~~~
jessriedel
Do we know if they removed the uterus during the same surgery as the
c-section, or was it done later?

~~~
creep
From the article we know that each uterus recipient can have up to two births
before the uterus is removed. But specifically when it is removed after that
possible second birth I'm not sure. Looked around a bit and couldn't find
anything. I'm assuming that would make the most sense, but I'm not a surgeon.

------
LeoJiWoo
Pretty fascinating science.

The "hundreds of thousands of dollars" cost is a bit concerning to me. I'm
also guessing it will difficult to bring the cost down since it requires a
donor uterus.

~~~
majormajor
Transplants are expensive (not just the procedure, all the after-care for the
rest of the life), and leading-edge medical treatment will continue to be
expensive, even if we can get the cost of transplantation itself down (my
hunch is that most of the hundreds of thousands is in the cost of the
surgeons, the cost of the medical facility, and all the intense recovery from
extremely invasive surgery stuff).

In a reasonable universe, things like this would be discussed openly in terms
of public-vs-private health care coverage, limits of cost, and liability for
"uncaused" stuff (genetic bad luck, etc) vs "caused" stuff (e.g. alcoholic or
obeseity-caused cirrhosis) so that we weren't simply writing blank checks with
future people's money. Especially with the potential to grow organs - now your
rate limiter on the costs is potentially gone! But in the US we can't even
decide that people deserve health care access at all, so discussing the limits
of it will have to wait for later, I suppose.

------
partycoder
Pregnancy already has many associated risks. This may increase the odds
substantially.

Plus, pregnancy while taking a lot of immunosuppresant drugs doesn't sound
like a really good idea.

------
donohoe
To be fair, what did you think she was going to do with it? This shouldn’t be
a surprise!

------
quickConclusion
>Since 2014, eight other babies have been born to women who had uterus
transplants, all in Sweden

Just to show that single payer system can be good for medical innovation, not
just universal healthcare.

~~~
cdoxsey
It looks like the swedish transplants were funded by research at a university,
not insurance:
[http://sahlgrenska.gu.se/english/research/uterus/questions](http://sahlgrenska.gu.se/english/research/uterus/questions)
(though perhaps that's a distinction without a difference?)

> The cost of a uterus transplantation is estimated to be around SEK 100,000
> per patient. [...] > Will this cost the patient anything? > No. The first
> initial experiments with uterus transplantation will be covered entirely by
> research funding.

Apparently some of the research also came from a Professor in the US:

> The team learned this technique at the University of Connecticut and
> received help at the beginning from Professor John McCracken, who is a
> pioneer in reproductive medical research. It took about a year before the
> autotransplantation method on sheep worked well.

Single-payer systems also have to constrain costs, so its not clear that they
would actually cover a procedure like this, or if they did there might be a
really limited supply. (I suppose the supply would be inherently limited
anyway by how many available uteri there are)

Single-payer systems are actually rarely actually single-payer. For example
apparently private insurance is becoming more popular in Sweden:

> The number of people purchasing supplementary private insurance is rapidly
> increasing, from 2.3 per cent of the population in 2004 (Swedish Insurance
> Federation 2004) to approximately 4.6 per cent in 2008 (Trygg-Hansa 2008).
> The voluntary health insurance mainly gives quick access to a specialist and
> allows for jumping the waiting queue for elective surgery (Glenngård et al.
> 2005).

[http://www.euro.who.int/__data/assets/pdf_file/0011/98417/E9...](http://www.euro.who.int/__data/assets/pdf_file/0011/98417/E93429.pdf)

~~~
pessimizer
> Single-payer systems also have to constrain costs, so its not clear that
> they would actually cover a procedure like this,

I wouldn't think they would, but the existence of a single-payer system didn't
prevent research on this.

> Single-payer systems are actually rarely actually single-payer.

What you mean in this case is _purely_ single-payer. Paying for things that
are outside of normal health care, like fancy private rooms or plastic surgery
don't seem like they would have a negative effect. Getting quick access to a
specialist seems problematic, though, but maybe the quick access to a
specialist means ability to quickly consult with a foreign specialist; there's
not a lot of detail there.

