A Womb of One's Own

In-vitro fertilization wasn't the only technique making reproductive news last week. The medical wires were buzzing as well with reports of the first human uterine transplant--an improbable operation that raises more questions than it answers.

The surgery, performed in Saudi Arabia, involved the transfer of a uterus from a 46-year-old donor who had undergone a hysterectomy into a 26-year-old woman whose uterus had been removed because of hemorrhaging. The organ survived for 99 days but failed after kinking or other blood-vessel problems choked off circulation. Many members of the medical community were nonetheless encouraged. Says New York University's Giuseppe Del Priore, who has performed the procedure on animals: "Now that we have the first, the second and third transplant should come soon."

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But problems remain. Transplant surgery is a punishing procedure, and the battery of antirejection drugs a patient must take can cause grueling side effects. If a transplant recipient did become pregnant, the body, already fighting to reject the alien organ, might reject the fetus too. And if the fetus survived, the circulatory problems that caused the Saudi transplant to fail could only get worse during pregnancy, when blood volume increases dramatically.

For all these reasons, uterine transplants are unlikely to become commonplace--even among those who could afford them. They may be a viable option for younger women who have lost a uterus to cervical cancer. They may also catch on in Muslim countries, where Islamic law forbids women to exchange eggs or embryos. But most other infertile couples will probably choose simpler, safer methods.

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