Womb implant to bring a lifeline

Is a womb transplant an option for Indian women who have undergone hysterectomy or were born without a uterus? For a group of women awaiting clearance for the procedure in Bengaluru, the remarkable concept could well herald a new chapter in their --and Indian women's -lives.
A path-breaking surgery conducted first at Stockholm and later in the US and China has raised the hopes for many in the country and sent top fertility centres to their ethical committee for clearance to carry out the procedure.

Milann Fertility Centre which has facilities in multiple cities, including Delhi and Bengaluru, is one of them "We have registered 11 women suffering from a rare congenital disorder called MRKH (Mayer Rokitansky Küster Hauser) syndrome for womb trans plants," said Dr Kamini Rao its medical director. "They will be operated upon as soon as we get clearance from the organ transplant authority." Rao said that the first few cases will be handled by doctors from Sweden's University of Gothenburg at Milann's Bengaluru centre. "The Medical Council of India has permitted the Swedish experts to perform the procedure, but a final nod from the organ transplant authority is awaited," she added.

In a womb transplant, surgeons implant the uterus harvested from a living or cadaver donor into a patient who lacks a functional womb. "Most of the transplants conducted thus far have used organs harvested from living donors. Any woman who has completed her childbearing function can be a donor," said Dr Suneeta Mittal, director and head of obstetrics at Gurgaon's Fortis Memorial Research Institute. For the 11 women, the donors are their mothers and sisters, all beyond the age of child-bearing.

However, while a boon for women who may want to bear children, the procedure has ethical dimensions. For one, as Dr AS Soin, transplant surgeon at Medanta Medicity, Gurgaon, points out, unlike most transplants, this is not a life-saving procedure. Adoption, surrogacy and other nontraumatic alternatives exist for those who want children.

More importantly, a transplant exposes both the donor and the recipient to high risks because the process involves the removal of the entire uterine system from the donor rather than just the organ. It also forces the recipient to remain on immunosuppressive drugs for a long period, which can lead to low immunity and other complications. And finally it involves three surgeries for the recipient: transplantation, child birth through Caesarean section and the removal of the donor organ post child birth.