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Woman with Transplanted Uterus Gives Birth, the First in the U.S (nytimes.com)
243 points by iamthirsty on Dec 2, 2017 | hide | past | favorite | 183 comments



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.


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.


It's not only about the woman and her body. It's also about the child and the relationship between woman and child. Our lives don't start when we leave the womb. Our first experiences are inside of it, when we are immensely close with the mother - hell, we are inside of her body. So... It's also about sharing this first experiences and about bonding with the child. Something that is not possible with a surrogate mother. Or rather, something that happens to the surrogate mother instead. I don't think that 'handing the baby over' can ever be easy for that reason.


Theres a good episode of Law and Order that deals with that issue. The plot is a surrogate mother keeping the child because she became attached to it.


The mental state of the mother while she's pregnant has a significant effect on the baby. For example if the mother has a lot of stress the baby will have symptoms of that stress years later.

Imo: that goes to show that mother and baby share feelings during the childbearing process. If negative feelings are pushed down to the baby. Then it would make sense that positive feelings are too.


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.


> 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.


> 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.


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.


> 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.


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...


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.


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.


Yes, absolutely, it happens a ton. The Duggars even turn it into "wholesome family TV."


There is some statistic showing that every dollar invested in our small children saves multiple dollars down the line for things like the prison system.

Any feminism that cannot honor, respect and support the importance of full time parenting is an ideology I want no part of. To my mind, the only good feminism is one that insists that full time parenting should be an equally legitimate choice for either parent, not just the mother.


"To my mind, the only good feminism is one that insists that full-time parenting should be an equally legitimate choice for either parent, not just the mother."

I love this quote.


[flagged]


Children are a resource that creates our future. It would be super nice if society stopped acting like investing in our children is a waste of resources while wondering why the world is going to hell.


Investing in children isn't a waste but getting a graduate degree to do it is.


I homeschooled my 2xe sons. I served as Director of Community Life for the TAG Project for a time. This was support for my ability to homeschool my kids in a situation where no school, public or private, was qualified to adequately accommodate them at both ends of the spectrum at the same time, which was what they needed. My oldest has two conditions which can each lead to a neurotic relationship to food severe enough to require in patient intervention. He has a healthy relationship to food because of my approach to handling his issues.

There are an awful lot of things that can go wrong in a child's life that can potentially lead to a need for enormous resources at state expense from medical to mental health to behavioral, which can go very differently if there is a sufficiently knowledgeable full time parent to handle it before it goes so very wrong.

You are in error. More education is not wasted on raising kids. Your opinion sounds incredibly ignorant to me.


It also sounds ignorant and ill-considered to me.

What baffles me is the amount of people in the US, usually in parochial cultural settings, who lack significant formal education or pedagogical background and are nevertheless deemed fit to home-school their kids. How is this legally possible? Now can a high school drop-out single mom (absent some extraordinary characteristics) possibly provide a well-rounded and adequate curriculum in a variety of general education subjects, ranging from math to literature, to world history, to biology?

If anything, the problem is that there aren’t nearly enough PhDs teaching kids.


>How is this legally possible?

Freedom.

Absent abuse, in the US we allow a very large degree of freedom in ways people are allowed to raise their children, no matter how unconventional and ill advised.

You're legally allowed to mess your kids up in many ways, such as by not teaching them life skills, encouraging teen marriage and pregnancy, teaching them bad manners, withholding critical information from them, giving them misinformation, disallowing them to be around unapproved peers, having tons of kids, raising them to be hateful (Westboro Baptist Church, KKK,...) etc, etc, etc.

BTW, I actually know of a high school dropout single mom who homeschools her kids. Of course, since she's unemployed^H^H^H^H^H^H^H^H^H^H a stay at home mom so shes entirely dependant on her own mom for every single thing, there's no father in the picture. She's a 35 year old child. Her kids are going to be so screwed up and entirely ill prepared for adult life, but it's legal, her "homeschool" is registered with the state.

For better or worse in the US individual liberty is valued over almost everything else.


Ugh. Yeah, that's the kind of pathology I had in mind at the heart of my comment.

All this "freedom" has much to recommend it, one can hardly deny, but it has it limits.


The online high schools these days are varied and pretty good. If you have a child with special needs or just doesn’t fit into the box the public education system is designed around then homeschooling is the best option. You don’t need a PhD to teach grammar to an 8 year old. There’s also a wealth of incredible videos and teaching materials to help too.

If anything I think parents are best suited to teach their own children until high school given the parents have a reasonable IQ.


Yes, but a certain level of literacy, cultural development and education is still required on the part of the parent in order to make effective use of all those resources. One still has to make sensible judgments about how to appropriate them and to supplement them with intelligent pedagogy.

Doubtless, some parents who home-school their parents have an adequate foundation for this. However, some of the greatest proponents of home-schooling I've met most definitely do not, and it boggles my mind.


This is true. I’ve seen it. I’m not sure this is such a bad thing. I know this sounds crazy but I kinda want to see how this plays out. Maybe some education diversity will have positive impacts we can’t forsee


Mayhaps. But based on the trends I've seen to predominate in the world of "education diversity", I wouldn't bet on it...


For reasons better addressed in PG's timeless "Nerds" article (http://paulgraham.com/nerds.html) better than in most other places, I don't think many children, least of all intelligent children, really "fit" into the box of public school.

But that's part of the point, as I see it. Lots of modern institutions are a bit unnatural and require some contortion for humans to squeeze themselves into. Public school is valuable in teaching that, or at least it was to me and many other people I know, as we reflect upon it years later.


We have the worlds okayest public education system. I’m glad I have the freedom in my state to offer my children something better at home, because the system utterly failed me (or I failed to adapt to it).


Well, yes, a high school drop-out single mom may be able to do a fine job of homeschooling. Or may not. And that will depend on a lot of factors beyond their formal education.

I am not comfortable with the suggestion here that a parent needs advanced education to successfully homeschool. There are support systems for homeschoolers. I was involved with that at one time.

If you homeschool gifted kids, even if you have a lot of formal education, you can find yourself really challenged. You can find yourself dealing with a child who knows more about a subject than you do, even though you have had college classes in the subject.

One way to handle that is to become a resource person for the child. Instead of instructing them, you participate on email lists and what not, learn what books and other materials have a good reputation and make sure the child has access to such materials. There is no reason a high school drop-out cannot take a similar approach.

A bigger problem in my mind is that when women go to college and have difficulty with a subject, they are often actively steered towards early childhood education. One outcome of this fact is that a high percentage of elementary school teachers are not only bad at math, they are math phobic. They pass this math phobia on to impressionable young children and may not be really qualified to teach math.

My oldest son likely has dyscalculia. By the time I pulled him out of school, he feared and loathed math. When he asked questions in school, his teachers often read him the explanation in the book. He read well above grade level. If the book explanation were going to help, he didn't need the teacher for that. It never helped him.

Fortunately, I had more college level math by the time I graduated high school than most people with non STEM bachelor's degrees have. I also have a background tutoring it and I can find novel ways to explain it. I was eventually able to get my son over his fear of math and give him a solid grounding in the subject.

When men struggle with subjects like math in college, they are not encouraged to give up and "go do something easier, like teach small kids." My ex is not good at math. I tutored him when he took college math classes. No one suggested he give up. They expected him to man up and do what it took to meet the standard to complete his goals.

This is very much a gendered difference in student outcomes and it has all kinds of negative consequences for not only both genders -- because men don't get support for making other choices if they genuinely can't do something -- but for the entire fabric of society.


Thank you for your feedback; it was quite interesting.

One thought:

I am not comfortable with the suggestion here that a parent needs advanced education to successfully homeschool.

I did not mean to make that suggestion, either. I deliberately chose the language of my comment to leave open the possibility of pedagogical experience or aptitude without the corresponding formal education. Perhaps it is my mistake that this did not come across as emphatically as I had meant it.

However, I still harbour a great deal of scepticism about the capacity of many parents I've seen take up home-schooling, simply on the basis that they don't seem particularly knowledgeable, curious, or educated themselves — whether formally or informally.


Well, unfortunately, I think that is sometimes due in part to people in authoritative positions having no respect for their "lessers," whether that is children, women, people of color, poor people, underlings at work or some other category. So a lot of things that get framed as "instruction" or "education" is really about enforcing an unhealthy pecking order that is actively harmful to whomever is framed as "lesser."

There are no easy solutions for that situation. But I think it starts with having a high degree of respect for individuals and their right to choose, even under circumstances where it is challenging to feel real respect for them. Or, perhaps, especially at such times.


For what it's worth, I'm a university drop-out so I have no personal dog in any credentialing fight. :-)

But despite what I'd like to believe is a generously well-rounded upbringing in a university family, I have serious doubts about my ability to home-school my son to anywhere near the same effect as an average public school—and that's bearing in mind the variation in quality among them. I wouldn't dare try.

Then there's the sheer effort and energy involved in juggling multiple subjects. My knowledge on certain subjects doubtless exceeds that of most public school teachers, but certainly not all the core subjects! And knowledge alone doesn't translate into effective teaching ability or experience with presenting information in effective and compelling ways to kids.


:-)

One parent went and surveyed what their child did all day in school. They concluded that most of the school day was spent changing classes, queing up, calling roll, etc. They estimated that only one to two hours a day was spent actually learning.

California laws allow for tutors as a valid education option. They specify 3 hours a day, not 8. One-on-one teaching is much more intense, relevant and information dense than a one-to-many teaching situation. Most teaching in school relies heavily on the kids reading the material provided. A homeschool parent can similarly provide good materials.

Learning comes more naturally than teaching. ;)

Anyway, it isn't intended to try to convince you to homeschool. It is only intended to say that lots of parents have felt the same way and then found it was more do-able than they expected.

I tried to enroll my son in college when he was 13 to get him out of my hair. His knowledge of some subjects has long been over my head. That did not work out and I had to woman up and figure out how to keep being a resource for him. So I am no stranger to feeling like "This is something I am not qualified for." But a parent with a sincere interest in supporting their child's education can be an excellent resource, even when they can offer no further instruction.


So, ideally children should be taught about life and how the world works, helped with homework, and/or home-schooled by people with little to no formal postsecondary education?

Seriously?


It's obviously hard to be feminist if you think women are worse than men.

Your experience of self proclaimed feminists and full time motherhood is very different to mine, and it's not just a generation gap because my mother was a full time parent and a feminist (still feminist, but spends less time parenting these days) and my sister is both as well.

I am also pretty skeptical of the interpersonal understanding and self awareness of women who explain that they just never get on with other women because of the issues those other women have, and men are just so much nicer - it's usually as much about their issues as anyone else's.


There are many shades of feminism. Some women believe that modest clothing such as headscarves are empowering, shifting the focus on character rather than physical appearance, while other feminists will strongly disagree. For me it’s easier to accept that feminism is just an umbrella term for women’s right to do anything as she pleases just as easily as men can.

Plus it’s always in continuous change. Example: currently in the U.K. there’s a hot debate between (some) feminists and trans women [1] but who knows in the future, it would be 100% feminist to accept all self-identifying females as valid females.

Slightly off topic: Feminisim is a bit of a messy subject (imo), I wonder if one can have a clearer picture if it’s expressed in logical terms :o

[1] https://www.theguardian.com/society/2017/nov/26/transgender-...


My wife has said the same. In addition feminists have been hostile to me over the fact that my wife is a SAHM as if she’s my prisoner in some sort of Handmaid’s Tale conservative dystopian fantasy.


Once again, people being rude has nothing to do with feminism and why do you assume people making rude comments are "feminists" rather than just "assholes?"

Feminism is all about empowering women to make choices that are right for them, especially with regards to reproduction and childrearing.

If your wife wasn't a stay at home mom she'd get rude comments about working outside the home - it's called the "Mommy Wars"- ever single childrearing choice gets criticized by someone.

I get a massive amount of criticism and nasty comments, from everyone including strangers, for my reproductive choices as well, even though they are firmly "progressive" - I'm a married woman whose voluntarily opted out of childbearing. I also get nasty comments about not taking my husband's name.

It's become fashionable, in the Trump era, to use feminism and liberalism for some sort of scapegoat, or reason for bad things, no matter how absurd. I was at a BBQ and one kid hit another kid and, very seriously, the mom blamed feminism. Yep, feminism caused a minor dispute between siblings.


I wish it didn't have to be one or the other. I guess it's human nature to tend towards thinking that choices have to be binary - I've often been guilty of it myself. Whenever somebody makes a choice that is different to our own we fear that it might dilute the possibility of us making our own choices, and so we become hostile. But it's important we work against this tendency.

I'm hoping that we'll be able to work towards a world have a world where stay-at home dads, stay-at home mums, surrogate pregnancies, same-sex parents, dual parental leave, etc, are all valid choices for bringing up children.


Some women hate it. Some feel a sense of wonder (my mother was like that, when carrying my younger brother). Some face it with resignation (that was more like my wife). My wife's biggest issues involved her blood pressure and fear about actually giving birth. One friend I have no doubt would still have carried her child naturally, even given another option. Another friend, I'm not sure about.

Carrying a child is often a very emotional experience, and it makes sense that reactions to those emotions would vary pretty wildly between different people.


Are you talking about artificial wombs that are independent of humans?

I can see feminists, evangelicals, and quite a alot of people opposing humans grown in labs.


You might be surprised to learn that there is a whole segment of the population who view bringing new lives into the world as a sacred undertaking. Some women of this persuasion consider growing a new person inside of themselves to be the highest calling. Also, pregnancy and childbirth can be incredibly fulfilling experiences, for both parents. After all, modern life doesn’t have many rights of passage on the same level.


Why exactly do you believe feminism would be against artificial wombs? (which, btw, is not even what we are talking about - these are transplanted natural wombs not artificial).

Feminism is about empowering women to make their own reproductive choices. Giving them MORE choices is a positive not a negative for feminism.


I'm a woman, and I absolutely agree with the OP. There is nothing in the world like the mother-child bond!

Sure it's risky and is painful and it makes me scared sometimes, but the thought of some artificial womb producing my baby gives me the shudders.

Would it even be "my" baby, if I didn't carry it? Similarly, I don't think I could have the same kind of love for an adopted child as for my biological. I'm sure you can love it just as much, but differently.


This reminds me of a peculiar condition my mother was suffering from. She had to consume this particular tablet everyday to keep her cough and cold at bay. When she began carrying my sister, she was told by the Gynac that she had to stop consuming the tablet as it would harm the baby. She stopped the tablet and after 3-4 days of trouble, her cough and cold problem simply disappeared. Ever since, she never had to consume the tablet again.


> Because her blood and the blood of the baby mix, she carries cells from the baby for many years afterwards.

This is not true. If the baby had AB blood and the mother had A, then the baby's blood cells would be attacked by the mother's.



I don't know about cells of the baby remaining in the body of the mother, but in the link you posted it says that HDN is caused (a) in the baby (b) by IgG antibodies (not cells).



Do you feel it’s fair to say that women generally long for childbirth because that’s what selection pressures in the environment left us with?


I mostly think nature designed sex to feel good as a way of tricking people into getting pregnant. Most pregnancies are not planned. Two people were just trying to have a good time. You have to actively work at not getting pregnant if you want a sex life, but don't want children.

The question of longing for a baby is mostly a first world problem. In most parts of the world, they still have more traditional issues, like shot gun weddings for out-of-wedlock pregnancies.

It is sort of like saying "we crave oxygen." You only are aware of that in its absence. Otherwise, you breathe because that's what you do, not because you sit around writing odes to the wonderfulness of oxygen, oh, how I long for thee.

This is part of why people are weirded out. The default state is that women are trying like hell to not get pregnant most of the time. Then you have some weird edge case where they can't just get pregnant, you discover this matters enough to them to be willing to go to rather drastic lengths to achieve it and it flies in the face of our expectations.


Even if this question was interesting (it is not) there is no reason to think the experience of motherhood would give someone particular insight into the answer.


Wow, that sounds intense/neat. Thanks for sharing.


> While the science is amazing, why go this route rather than having a surrogate mother?

Or even just adoption. Adoption is far cheaper as well.

There are plenty of reasons why people want their own biological children... but this seems like it carries a ton more risk with it. With complications from the transplant and heck even just childbirth.


Surrogacy is illegal in some places and countries.

https://en.wikipedia.org/wiki/Surrogacy_laws_by_country

Adoption on the other hand can be a risky path, leading to a different kind of problems, and some are very hard for parents. Everybody wants their sons being healthy and able to have a normal life but this is not always guaranteed with adoption. Some countries use shady practices and lie to the parents to obtain an emotional (not logical) choice. The cheaper the worst. Systematic racketeering is the minor of them. "Forgetting" about some important condition or omiting relevant medical information is much worse.


Yes that's what I was trying to get at. The increased cost comes with significantly increased risk yet the same end result (a biological child).


It's not the same end result. There are huge psychological issues that can come up with being the genetic mother to your child but having someone else carry them for you. Then you also have to figure out how (if?) the surrogate is involved in the child's life at all, how you explain to the child that someone else birthed them, etc. If you ever find yourself favoring one child over another, you'll always wonder if it's because it's not "your" baby.

Basically, it's not as simple as just handing off an embryo to another person and 9 months later acting like nothing happened. There are huge ramifications to a decision like this that don't come with being the birth mother.


I’m always struck that people overestimate how difficult it is to explain things to children. I think people often project their own discomfort about talking about something onto the child that is hearing about whatever it is.


Adoptions in the US cost ~$40k, a lot more then the 10-15k for pregnancy.


If you are trying to import a baby, yes. The price can be considerably lower, if not free, for foster to adopt, especially for older children.


Domestic adoption costs a lot too. Source: I adopted a baby from Virginia and it cost over $50,000. It is a very broken system.


Countries such as France, Germany, Italy, Spain, Portugal and Bulgaria prohibit all forms of surrogacy. So, this gives women in those countries the option of having a child legally.


Many, many women wish to carry their own children. Some want to do that this badly.


"Want" as in they are biologically wired to want to do so; hormones/evolution/etc.


It may or may not be simply biological "wiring". Many women are fine with surrogates, and most surrogates are fine with carrying another woman's child without significant emotional attachment. Women who use surrogates want the child, the experience doesn't matter as much as a successful birth by any method.

I think a big factor in the cases discussed in the article is that these women were told they would never ever have their own children. Unlike women who are "infertile" (which is usually just a measure of probability, and not a binary diagnosis), women who do not have a uterus obviously understand that there isn't a probability factor for getting pregnant. But then tell a woman with such a diagnosis that there is an experimental procedure that will allow her to fully experience what she had always been told was not possible. It is more for her than just wanting a baby at that point-- the procedure offers her everything she was told she could not have in terms of giving birth to a child.


Literally all of your thoughts and feelings are biologically wired.


By the same token, you can just lay off having sex, since you are just wired biologically to want it ;-)


So many wants are biologically wired...


Sure, but I don't think any insurance should ever pay for this.


This is an amazing story of progress, technology, and hope. Do you need to make it about what it costs to you, or can that discussion maybe wait for another context?


It can't really wait, because I bet someone wants this now, and shouldn't get it from public coffers.


And they will petition the government to tax you enough to make it happen. They are doing soon.


Lucky for them there are no enforced prerequisites (i.e., test and/or license) for becoming a parent.

I don't doubt some level of that drive exists. What feels questionable is the sanity (?) of going to such extreme lengths to pursue it? As if there is a complete unawareness of the bigger picture.


>I don't doubt some level of that drive exists.

That's one hell of an understatement. It's only the primary driving force of all successful complex lifeforms. Living things that give preference to offspring other than their own die with zero remaining trace of their existence.


Maybe they meant the specific drive to carry a child, which, in my experience, not all women possess, even if they possess other drives that lead to successfully promulgating the next generation.


Drive to go through pregnancy and childbirth, not drive to reproduce.


I'll go out on a limb and say if you aren't a female I don't think you are well positioned to judge a woman's judgement towards wanting her "own" baby versus using a surrogate or adopting. (I'm not a female so I have no point of view here.)


It’s not about sanity. Desire for reproduction is a biological imperative.


Let’s say you lost your testicles due to cancer, but there’s a new procedure that can grow new ones from your stem cells. It’s experimental and will cost $150,000. Before having your cancerous testes removed you stored sperm.

Are you really surprised that some men who want to be fathers would choose to have the procedure rather than using their own previously stored sperm?


Yes I'm surprised. I'd want my testicles back for other reasons maybe, but if I had stored sperm I don't see why to have an expensive operation.


Yes. In fact, much more surprised than in this case - I can at least see why would you want to have your baby grow inside you. Doing experimental surgery just so you can have fresh sperm seems absurd to me.


Shit, I'd just want my balls back so I didn't have to take shots every few weeks.


And they'd be brand new, with none of the reduced output that comes from aging.


That's pretty much the worst example you could have come up with. Carrying a child inside of you, is no stretch of the imagination equivalent to impregnating someone the old fashioned way. No man in their right mind would put up $150,000 in experimental money, when they have their own stored semen. Sure, if none exists maybe, but doing all that just so you can use fresh? That's just silly. It's still your DNA, and you can still have sex.


I'd probably be very wary at that point of going into the hospital any more than I have to, especially for experimental treatments. I'm surprised everyone is so sanguine about things like that; you're enduring invasive surgery, and experimental methods that could easily fail and cause serious side effects. I'd only take it if the situation was dire and there was no other option.

Using it for non life-threatening issues would be putting a lot of stress and risk on myself and my body for little reason.


Well, yes I'm shocked that someone would go to great expense, risk their life, and use scarce research resources in a completely unnatural effort to do something "naturally"... but I shouldn't be.

Because rule 34... someone will get off on it.


It's not about "someone getting off on it". Having a "natural" pregnancy leads to way less issues:

Surrogate mothers have to have artificial insemination/IVF. So would the hypothetical mother in this case. These eggs don't all stick to the uterus, so the procedure normally involves sticking 3-4 fertilized eggs inside the embryo.

So if you want one kid, you need to plan to have up to 4. That's a concern.

Then there's the chance of having a chimera, where the baby uptakes the surrogate's DNA. This can cause complications (I know with a transplant this is still the case). There's also the whole "mother not carrying the baby" thing.

This isn't as crazy as it sounds.


This was about testicles not pregnancy, if you look up post.

Ignoring that (and "not as crazy as it seems" is a pretty straw argument), I'd say that the risks to mother and child of such an extreme surgery and long term use of anti-rejection drugs during child bearing raises it's own ethical issues. Adoption seems to be completely inconsidered.

That you want to argue that many people's insemination choices are driven primarily by logic seems odd to me. I think they get off on their idea of what sex, pregnancy, and childbirth are supposed to be like based on what they hear from their friends, family, and media, along with how they want to be perceived. Only a tiny portion of that is related to rational decisions to provide societal or even individual good to their child.


IVF still applies to testicles. With frozen sperm you need it.

Logic was applied because you need to think about actually having up to 4 kids at once. That's still entirely necessary.

The "whole not carrying a baby" thing attempted to cover the idea of carrying your own flesh. I just didn't go into detail on that because I thought it was obvious. So no, I'm not arguing about logic.

Finally, "not as crazy as it seems" was a conclusion to the three of my points - not a strawman.


> IVF still applies to testicles. With frozen sperm you need it.

Pretend there's enough sperm you don't need IVF, or something. I'm pretty sure the thought experiment is about something that only affects the man, not the woman or child.


Implanting 3-4 3-day embryos is quite rare these days. Most doctors now do 5-day blastocysts, and insert only 1-2 (many insurance companies will only cover 1 at a time). The "4 babies at a time" concern is now very rare.

- Guy who has done IVF before


I think it is incredibly cool that we can essentially move a uterus from one woman to several others.

Startup idea: Uterent™


Can you harvest(1) eggs from a woman without a uterus? I don't see how you would. To get to the ovaries of a woman without a uterus you'd need to cut her open.

(1) is that the correct terminology?


Taken a step further..why not adopt?

While impressive it feels too much like a First World Problem. Aren't there any real problems this team could have solved?


> While impressive it feels too much like a First World Problem. Aren't there any real problems this team could have solved?

Talk to any couple who has had difficulty conceiving, and the humanity of this "first world problem" gets brought into perspective.


Exactly. How can you not understand a person’s desire to have a child of their own flesh and blood? That instinct and desire is such a deep part of our biology. The people asking must be very young or have some strang sociopathy.


I'm not doubting the desire. But in the face of 7 BILLION and counting...climate change...other questions about resources...AND there are other proxy-esque options...It to me feels selfish and shallow.

You "bear" a child because you have love to give and to share. It's not about you, but about giving selflessly. I'm not judging what this is, or why. But this is not that. This is about the parents. The irony is disturbing.


The birth rate of most countries outside Africa is below replacement. There’s plenty of room for more children.


Our current rate of resource usage is not sustainable. Africa may have a high population growth rate, but its carbon footprint is minuscule.

The problem isn't Africa. The problem is billions of people living a middle-class lifestyle - even with growth rates at or slightly below replacement.


Since we're swimming in the realm of opinion: it's not selfish precisely because the issues you raise are all solvable and I choose to believe they will be solved. There has been no time in human history where one could not have raised equally valid issues, and then proclaim nobody should have children because of said issues.

In fact, today is the best time in history to have children (or in your phrasing, today is the least selfish time in human history to have a child). Humanity is radically more capable of supporting another baby now than at any other time. It isn't even remotely a close contest.

Questions of resources? No it's not. We're drowning in food, take a look at the massive boom in Russian wheat production as one example. Global food potential is far beyond where we're at now, likely by a magnitude. We don't know what to do with it all. And that's before we take it up another level and move to drastically more productive food output methods, including indoor farming, AI + robotics, growing meat, better information management & knowledge globally, etc; and that's while we're still acting very inefficient with our existing food (throwing vast amounts of it away). Merely developing Africa's food potential alone will feed billions more people.

Maybe you're thinking energy? Have you seen the massive boom in solar and wind? That's going to get a lot more massive yet. We're intentionally under-developing nuclear, because right now it doesn't look like we're going to need it. Renewables are making up the majority of all new energy production globally, that tilt is going to get more extreme by the year. If the world had to do it, we could collectively throw trillions of dollars at nuclear immediately, and boost global energy output substantially within a few decades.

To date, humanity is batting a thousand at not going extinct due to challenges. Climate change will be no different.


Where the hell do you get your news from? The "massive wind and solar boom" exists only in the media. There's a rule of thumb you can follow here: the importance of a technology / energy source / whatever is inversely proportional to the number of articles about it in the general media (and on HN for that matter).

Geothermal, wind, solar, heat, tide, etc. currently amount to a staggering 1.5% of the total primary energy supply of the world. Coil is at 28%, oil is at 31%, natural gas at 22% (and climbing), nuclear at 5%, etc. CO2 emissions continue climbing year after year, and we should have started going down more than twenty years ago.

Our agricultural system is completely dependent on fossil fuels (oil). Because of that it is mostly unsustainable, and also because it tends to destroy fertile lands (topsoil loss is kind of a big issue).

You are kind of right that the current system can support a lot of people. Unfortunately, almost none of it is sustainable. So making more people is really not a good idea at the moment, because the situation will change drastically over the next 80 years.


The US has hit the milestone of generating 10% of its electricity via wind and solar, a huge increase from the 1% number of less than a decade ago. Sounds like a pretty big deal to me.

https://www.scientificamerican.com/article/u-s-reports-a-maj...


Population will stop growing much sooner than 80 years. You can look up Hans Rosling's talks on the subject.


> But in the face of 7 BILLION and counting...climate change...other questions about resources

Pretty sure most people who want to be parents dont really think about those issues when having kids. It might be important for you but its not for those new parents.


Yes. And thus my original comment about the lack of the need for a license, etc.

Short-sighted people with more money than awareness doesn't feel like a great way to describe a future parent(s).


You accuse others of being short sighted when you first need to look in the mirror.

> Short-sighted people with more money

Turns out people with money (aka developed countries) the birth rate is falling (or already has fallen) below replacement.

Population is not the problem, population with an American lifestyle is a problem.


I think it's pretty clear that you don't actually believe in evolution.


Intelligence and empathy may be inversely correlated.

Diversity is helpful here


Name a society on earth were people would prefer to adopt rather than go to this option if it was available to them.

I don’t think this is an issue of the “American“ perspective or something like that.


I'd bet most of them. People don't adopt because it is extremely difficult for some reason. Adopting probably costs more than an artificial uterus.



So cure (?) a problem for a handful of rich Westerners is The Most Important medical problem in the world right now? Seems to me you're overlooking other, far more significant (in terms of total numbers) suffering.

The people thinking what you're thinking must be very young or have some strange sociopathy.


Are you suggesting that everyone in the world concentrate on one problem at a time?

Who said this was the most important problem anyway?

Are you, personally, working on solving a particularly important problem?

Most people in the world aren't solving problems anyway, other than getting money from other people's wallets into their own.


> Are you suggesting that everyone in the world concentrate on one problem at a time?

Not at all. If I'm supposing anything is that the word priorities is a word most people don't know but should.


Choosing this place to make a line on medical funding or even just societal preferences seems pretty absurd. The economy does not work in absolutes nor with firm regard to societal well being or even marginal valuation. There are so many other worthy critiques to make before getting to the granularity of reproduction.


Humans are allowed to work on more than one problem at a time.


In the US the difficulty (factoring in stress, disappointment, and costs) of various options for infertile partners in ascending order:

  * IUI
  * IVF
  * IVF with egg donor
  * IVF with donated embryo
  * Surrogacy
  * Adoption (direct, not foster)
Unfortunately "Why not adopt" is rarely the simplest option for most people.


What effect do immunosuppressors have on the fetus?


Probably well studied in pregnant moms with cancer or transplants. I would guess not a big impact as far as we know today. First there are cases where the maternal immune system attacks the fetus. Second the placenta generates immunosuppressants to prevent that, third, the fetus itself and the baby at birth does not have any innate immunity. In fact the baby relies on the moms immunity after birth.


Surrogate motherhood is a very traumatising experience.


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)


Earlier this year researchers got the first artificial uterus for sheep working. That one is aiming more at keeping extremely premature babies alive and developing for a few weeks than at actually controlling the full range of embryonic development, but I think that's a matter of time.

https://www.newscientist.com/article/2128851-artificial-womb...


Why would we need non-human baby factories?


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.


Idealistic? Further erosion of our humanity for the sake of productivity and furthering of the capitalist machine sounds about as far away from idealism as you can get.


Sure, but I was questioning tho use in context of space travel specifically


> 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?


> most women actually want the experience of being pregnant.

I'm really curious if this is true.


I dunno about 'need', but I guess you could avoid the whole 'sending people' problem that way. DNA is a lot more durable.

That'd be a weird upbringing, huh?


This whole subthread might find Terraforming Earth by Jack Williamson interesting, since this is essentially part of the book's plot.


I meant without the need of having uterus inside a (living) human being. Literally growing human babies in factories.


You've not supported your conclusion that we "need" a non-human baby factory with any actual argument or facts.

Surely the simplest solution to the reproductive question during space colonization is to send along a doctor or midwife with the couples headed out from earth?

Humans are really good at making this happen.


Spending extended amounts of time in zero gravity has profound effects on the human body, most of them negative. Pregnancy is already very tough, and we know literally nothing about the additional challenges associated with it (and with childbirth) in a zero G environment, or on another planet.

From this perspective, there may be some merit to the parent poster's argument that human "factories" may be less risky for everyone involved, since it might be easier to control the conditions.


We’ve sent pregnant rats into space. We know a lot about zero g rat babies and moms. Long term more serious issues are space radiation effects. Nobody has any idea how to practically solve that issue.


>>We’ve sent pregnant rats into space.

Which is very, very different than sending pregnant humans into space.

>>Long term more serious issues are space radiation effects.

Not just that. Muscular degeneration is a real problem, especially (in this case) for humans who have to carry a child inside them.


Generation starships!


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


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


I’ve heard this discussed before the first of these procedures was successful.

Obviously a very interesting idea but for men (or people who were born men) the correct hormone issue is HUGE.

You’d have to give the correct amount of hormones at the correct time with those amounts changing every day (and possibly during the day). It’s an MASSIVE challenge and we may not even know what those correct dosages are right now. I mean has anyone ever done a record of the hormone levels for woman’s pregnancy for even two tests per day during the entire term?

And that’s assuming it static. If the correct hormone levels react to the way the baby is developing in someway (and I assume they must) then the challenge gets even greater.

The doctors on the podcast or in the article (I don’t remember where) seems to imply that what was done for this woman was basically trivial in comparison to making it possible for a man.


Given where the technology is now, there's no scenario where thousands of men won't be doing this within a few decades. It'll get easier, safer and cheaper over the next 10-15 years of experimentation and development, putting it within reach of a lot more people. The number count won't be very high early on, it'll still be an incredible technological achievement.

If 30 years out just 1 in 100,000 men are doing this at a given time, it'd be over 100,000 male births annually on the planet.


I doubt this procedure will catch on with men, but artificial wombs are coming sooner or later.

Personally, I think this will, in modern historical terms, be the most significant catalyst in equalizing the genders. But I don't expect feminist groups to embrace it with open arms.


I suspect it’s highly likely to catch on with people born as men, now keen to be women.


That's my suspicion as well. We'll hit 10 billion people pretty soon, which is my basis for claiming it's almost guaranteed we'll see male births at that type of numerical rate in several decades (100k per year or more globally). When you're talking about such a vast number of people, it doesn't take much to reach ~100k for any given thing.

You'll have men that were born as men, who want to be men / identify as men. I'd expect that to be a smaller share of the male birth number. Then you'll have men that were born as men, who want to be women / identify as women. That will likely represent the far larger share of the male birth number.


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.


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?


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.


I don't see how a person with a transplanted uterus would need to menstruate. The role of the uterus is to facilitate pregnancy. Just as many women do not menstruate when taking oral contraceptive pills, just so could a transplant recipient not menstruate.


That was probably a misleading way to put it. The patient wouldn't be menstruating regularly, but if implantation fails, they'd have to shed the menses somehow.


Wait, how do you get a man to produce eggs? Aren’t they present in a woman’s body at birth?


A male pelvis is more narrow than a female pelvis.


All the babies delivered so far from a uterus transplant were C-sections (as explained in article).


C-sections are already a thing.


Don't other parts of the body expand during gestation, though?


Yes. We think of our bodies as these static things, but the way a pregnant woman’s body transforms to prepare for birth is nothing short of amazing.


Please no.


Now that's an interesting question


It may be important for the baby's health to nurse with their biological mother.


Men, with the right hormones, are able to lactate and produce milk. (In some rare cases men lactate naturally without hormone injections)


Do you want your penis sliced up and turned inside-out to make a uterus?

I think an elite few trans women might get it, but I don't expect men would want to.


Um, that makes a vagina, not a uterus. There isn't enough material in the penis to do that much :/


…er, right, yes. I wasn’t thinking straight.


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.


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


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.


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.


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.


The price will be brought down through other methods, specifically cloning. It won't make sense at all to rely on donor organs. At our current rate of improvement on cloning / growing organs and tissue, we'll be able to do it in the next decade or two.


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.


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


>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.


It looks like the swedish transplants were funded by research at a university, not insurance: 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...


> 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.


I would rather this innovation not be made with my taxes. The money thrown at this could have done so much elsewhere.


[flagged]


Would you please not take HN threads into national flamewars? The parent comment may not have been substantive but this direction is even worse.


Sorry


[flagged]


Why incite a political discussion? The connection this article has to politics is extrapolated in your mind for one purpose.


You will probably find they're in favour of bringing more of "their kind" into the world.


Don't most people feel the exact same way ?


What's "their kind?"


Your statement contrasts amusingly with the actual context.

This occurred at a conservative-leaning, Baptist university in Texas: Baylor.


Normally this would be a nit-pick, but it's a potentially significant one here since the medical center isn't religiously affiliated: Baylor the hospital system isn't affiliated with the university these days.

It's affiliated with Texas A&M. https://en.wikipedia.org/wiki/Baylor_University_Medical_Cent...


It's a fair point. I wasn't implying it was a religious medical center, rather, that that region very much leans conservative, which is in fact true.

Texas A&M is one of the most conservative state schools:

"Texas A&M leads Princeton Review list of most conservative state schools"

http://www.chron.com/news/education/article/Texas-A-M-leads-...


The uni is actually in Waco, about 150+ miles south of where the hospital is. Not sure how connected they are these days.




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