By The Bakersfield Californian
Ah, the uterus: without it, where would we be? The uterus is a remarkable organ, in that it must endure the radical changes and stresses of pregnancy. A hollow, muscular organ, the uterus is an inverted pear-shape when at rest. Once an egg, or ovum, is fertilized, it seeks to implant itself into the uterus's lining, or endometrium. Then the work begins. The uterus develops special blood vessels to feed the fertilized ovum, or zygote. It shelters and grows along with the zygote in the transformation from embryo, to fetus, to baby. During labor and birth, the uterus contracts powerfully to open the cervix, or neck of the womb, thus to expel the newborn child into the world.
Swedish surgeons have arrived at a new frontier for the uterus: They have successfully completed the first mother-to-daughter uterine transplants. Two women in their 50s agreed to donate their uteruses to their daughters, one of whom lost her uterus to cancer, the other of whom lacked a uterus at birth. The daughters have not yet carried children to term in their transplanted wombs, but the Swedish doctors are confident that the younger women will be able to do so in the future, because the mice, rats, sheep, pigs, and primates into which they have already transplanted uteruses have subsequently had healthy pregnancies and offspring. If all goes well, the daughters will attempt pregnancy in late 2014.
With less fanfare last year, a young woman in Turkey, who was also born without a uterus, received the uterus of a deceased organ donor. With the help of her new uterus, the Turkish woman has since begun to menstruate, so she now knows all the fun she has been missing. Her doctors plan to transplant one of her eggs, fertilized with her husband's sperm, into her new womb. Only with the birth of a child will the woman and her doctors deem the Turkish transplant a success: stay tuned.
My uterus has been a happy and hospitable home to four growing beings. Its mysterious depths have nurtured and delivered four beautiful babies. Although we had a good thing going for many productive years, my uterus is no longer of any use to me. I have been waiting for menopause for at least a decade, but it seems to be taking its time coming. Really, my uterus is nothing more to me these days than a source of sporadic trouble, and so I am looking for a way to be rid of it. My gynecologist, bless her heart, believes that removing a healthy organ for no other reason than its host is tired of its shenanigans is too extreme a measure to take. She has tried various ways to mitigate my uterus's bad behavior, but she has more patience than I do. I say: Get rid of it, already! Since one in 5,000 women are born lacking a uterus, I've decided to make a public offer of my uterus to any American doctor who might like to try a stateside transplant. Take my uterus. Please.
The donation of an older woman's uterus to a younger woman who wants to have a baby is the opposite scenario of many organ donations, in which a younger organ goes to replace the worn-out organ of an older person. Usually, a younger organ is a healthier organ. Ethically, this can be a tough call. When my dad was on dialysis in the final year of his life, he refused my offer of a kidney, on the grounds that he was too old to make the best use of my younger kidney. Upon reflection, I'm pretty sure I would do the same thing. I would not want to compromise the future health of one of my children in any way. I would, however, not hesitate to give my children any vital part. If one of my daughters ever needed a uterus, I would hop up onto the operating table that day. Like Thomas the Train Engine, whose mission is to be Really Useful, being useful is my uterus's raison d'etre . And believe me, I no longer have any use for it.
Controversy hangs over the ethics of using health-care dollars to develop the transplanting of a non-essential organ, or what one American doctor calls "optional transplants." Says the quoted doctor, "Nobody needs a uterus to live, OK?" I imagine his mother feels differently. Would the good doctor call any infertility treatment a waste of money? One person's "option" is another person's mission in life. As in any quality-of-life discussion, there are no easy or universal answers to the miraculous medical possibilities we continue to enact and the dilemmas we then face. I tend to err on the side of enabling motherhood, of creating avenues to new life. My uterus is now officially advertised as free to a good home. Honest: I won't charge a dime.
These are the opinions of Valerie Schultz, not necessarily those of The Californian. Email her at firstname.lastname@example.org.