Try surrogacy, not uterus transplant: Docs

As India watches with bated breath if a Pune hospital can make medical history with the nation’s first uterus transplant, doctors weigh the pros and cons

As a Pune Hospital gears up for the first uterus transplant in India tomorrow (May 18), gynaecologists debate the risks involved. Doctors say that while there is no doubt it will be a landmark surgery in India’s medical history, there are inherent risks involved, and therefore surrogacy offers a safer alternative.

Dr Hrishikesh Pai, general secretary, the Federation of Obstetric and Gynaecological Societies of India (FOGSI) and past president of the Indian Society For Assisted Reproduction (ISAR) says, “It is certainly creditable that India will be trying a uterus transplant, but when it comes to practical application, the need is debatable especially in a country when surrogacy is an alternative. In comparison with surrogacy, uterus transplant has three additional surgeries increasing the risk to the recipient and the donor.”

Try surrogacy, not uterus transplant: Docs
Source-American Pregnancy Association

Uterus transplant is a surgical procedure whereby a healthy uterus is transplanted in a woman whose uterus is absent or diseased.

Dr Nandita Palshetkar, president of Indian Association of Gynaecological Endoscopists says, “It is indeed welcome news for medical science in India, but I have mixed feelings due to the risks associated with the transplant.”

Concurring with her, Dr Ashok Anand, Professor and Head of Gynaecology Department, Sir JJ Group of Hospitals said uterine transplant is fine so far as it experimental, but not a lifesaving procedure.  “Uterus is necessary for menstruation and reproduction. If you find it difficult to conceive because of your uterus, there are options like surrogacy. Also the success of this transplant is questionable.”

Gynaecologists have also questioned the affordability of the transplant. “If it works it may be a boon for a lot of women who need the uterus for child bearing. It’s practical if the cost is rational and less than the cost of surrogacy,” said Dr Saurabh Dani, Consultant Obstetrician and Gynaecologist at Ankur Hospital, Kandivali.

Doctors say a uterus transplant can be deemed to be successful only after the patient gives birth. Dr Prakash Trivedi, past president of the Federation of Obstetric and Gynaecological Societies of India said, “It is a good step, but we need to also consider the successful functioning after the transplant. It is a subject of debate globally. We need to see if the patient can indeed give birth with the transplanted uterus. If yes, the procedure will certainly benefit patients, especially patients who have genital tuberculosis, or if there’s been a hysterectomy or the patient does not have a uterus since birth.”

Speaking to My Medical Mantra, Dr Arun Nayak, gynaecologist at Lokmanya Tilak Municipal General (Sion) Hospital said, “This type of surgery has been performed in Europe, but this is something new in India. This will definitely help women who can’t conceive.”

BOX: Risk involved

  • The recipient has to undergo a major surgery
  • The woman who undergoes uterus transplant has to take immunosuppresant drugs to avoid organ rejection. There is no study available  on the effect of these drugs on a developing foetus.
  • The immunosuppresant drugs have side effects and can increase the risk of preterm delivery
  • Post-delivery, the recipient has to undergo another major operation to remove the uterus to stop taking immunosuppresant drugs

uterus transplantGynaecological Endoscopistssurrogacy, genital tuberculosis