Medical Sensation: Doctors in Tübingen, one-off birth manage nationwide

For many women, the desire to have a child is huge. In Tübingen, Doctors have gone a long way to make the patients possible: they transplanted a uterus. The procedure is also controversial.

For the first time, physicians in Germany have met women in their desire to have children with the help of a donated uterus. “We actually now have two healthy children after the first two uterus transplants brought into Germany to the world,” said the gynecologist Sara Brucker on Thursday in Tübingen. In March and may of this year, they were born there, cut at the University hospital by caesarean. In October 2016, the tübingen-based physicians had discounted in order to Brucker for the first time in Germany a uterus successfully transplanted.

Both women had come without a vagina and womb to the world – they suffered from the so-called Mayer-Rokitansky-Küster-Hauser syndrome. “It is a rare genital malformation that occurs in approximately one out of 4500 female newborns,” said Brucker. Each year, the nationwide, 60 to 80 girls. You could get a child of their own in Germany, because surrogacy is banned.

“For the first Time in your life you got your period”

After the Creation of a vagina at a young age, the womb (uterus) has been the 25 – and 26-year-old women in Tübingen transplant – donors in both cases were their mothers. The intervention lasted a total of approximately twelve hours. Especially, the extraction-consuming: The to – and outgoing vessels to the uterus are not likely to be injured.

“These vessels are found deep in the pelvis and they must be exposed. This is Millimeter work,“ says the gynecologist. After six weeks, the two women certainty, that the transplanted organs are also functional. “For the first Time in your life you got your period.” About a year later, the women used their own fertilized egg.

18 departments, 40 experts, a birth

In March 2019, the tübingen-based Physicians had the final proof for your successful work: A healthy child was born, the gender and other Details were not betrayed at the request of the mother. 18 departments and more than 40 experts were involved in the entire project.

Paid according to the hospital, the health of the two women. The costs could not be quantified exactly. The number would have to be significantly below EUR 50,000, the Medical Director of the University clinic for transplantation surgery, Alfred Königsrainer. Part of the research project is also to find out how expensive such an Operation is, and how and when the insurance companies cover the cost.

Insurance companies cover the cost?

It would only be logical that this treatment is taken in the future by health insurance, according to the head of the transplant centre, University hospital of Ghent (Belgium), Xavier Rogiers. “Otherwise, this therapeutic possibility would remain only reserved for the Wealthy.”

Rogiérs also urged: “From an ethical point of view, it is important to find a balance between the risks to the living donors – you are likely to be very low-but not Zero – and the opportunities afforded to the recipient to get a child of their own.” Also the pros and cons of the Alternatives, so surrogacy or Adoption, should be weighed.

Difficult ethical questions

Claudia Bozzaro by the Institute for ethics and history of medicine at the Albert-Ludwigs-University of Freiburg described the transplant as non-proportionate means to allow a woman’s pregnancy. “In the case of a Uterus transplant, a healthy donor of an extremely invasive measure will be subjected to – namely, a multi – hour Operation-no health Benefits.” Since it is not so much to save the life of the recipient, the ethical Legitimation for a living donation is questionable.

The head of the Institute for medical ethics in Tübingen replied, Concerned it was “under normal circumstances, be denied, what is not for all women, but for many women, something Central in your life – namely, that you yourself give birth to a child. And you suffer for it.“ He believe that the medicine will stay in your genuine tasks: “the sick, the suffering, to help.”

So far there have been in Tübingen for three successful Uterus transplants. When I have no birth. A fourth failed because of the removed uterus could not be used. That the transplant is feasible and that children can be born, had shown to the Swedish gynaecologist Mats Brännström for the first Time in the world. 2014 a woman with a donated uterus brought up in Gothenburg, a healthy Baby to the world. According to the University hospital of Tübingen, it was there the 15. and 17. Child.