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When should a doctor say “you just can’t have a baby”?

Tory Maguire

by Tory Maguire

19 Sep 02:15pm

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Filed under: Babies, Fertility, Ivf, Parenting, Women

49 comments

Overnight news broke Swedish doctors have made a startling breakthrough in fertility treatment, by transplanting the functioning wombs of two women into their own adult daughters.

The stork's getting so busy she needs a few transplants of her own. Cartoon: Eric Lobbecke

They’ll now give the new uteruses a year to settle in before trying for pregnancies with IVF. It’s an incredible medical development, that will give some infertile women hope they will one day become biological mothers.

The clinical director of women’s health at Westmead Hospital in Sydney Dr Andrew Pesce told ABC radio this morning: “It’s obviously emotionally a much more powerful and strong bond and experience if the woman carries the baby herself. I think it’s not possible to anticipate yet that such women could give birth naturally.”

“But if they were able to carry a fertilised egg, probably implanted via IVF (In-Vitro Fertilisation), and have the baby delivered by caesarean section, that would still be a tremendous advance for those women.”

“I fundamentally think that it will be possible and when we do see that happening it will be a major advance for this unfortunate group of women.”

It’s not new that people are willing to go to great lengths and expense to become parents.

As a parent who for quite some time faced the very real prospect of never having children, and was lucky enough to conceive thanks to talented doctors and scientists, I’d be loath to ever tell someone to just give up.

But there has to come a point, surely, where people don’t have to give up hope as such, but perhaps change what they hope for.

How far should we as a society be prepared to go to give women the chance to carry their own babies?

One fertility specialist I dealt with told me a colleague was about to put a woman through her 23rd round of IVF. She was well into her 40s and the chance of success was so tiny as to be negligible.

I would argue, and most doctors would probably agree, that this woman needed counseling, not hormone injections.

The two Swedish women who have undergone surgery now have a year to prepare themselves for the possibility of disappointment.

One of them had lost her uterus to cancer, another was born without one.

That biological motherhood is even an option for them is amazing really. Their drive to get pregnant, as opposed to adopting one of millions of parentless children or finding other ways to be fulfilled, must be overwhelming.

That it even crossed their minds to ask their mothers to donate the very wombs from which they came is evidence of that drive.

They are not to be judged here. But there’s a legitimate debate to be had about what people can expect, and what hope the medical community should offer.

Comments on this piece close at 8pm AEST

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49 comments

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    • SAm says:

      02:28pm | 19/09/12

      I cant really judge anyone wanting to be parents, we were incredibly fortunate to be able to do the whole thing naturally and love every minute with my kids. I see your point Tory, but I feel that if the technology is there, then go for it, if you can afford it. But dont have false expectations, thats the main thing to remember.
      And adoption shouldnt be so hard. Plenty of kids need parents and theres plenty of parents wanting to do it, but the red tape is rediculous

      Reply

    • iMitchy says:

      02:31pm | 19/09/12

      I have some pretty strong opinions on this subject - and they all come down to my belief that “7 billion is plenty”.

      I think it’s great that the woman born without a uterus gets a chance. The woman who lost her womb falls into the following qualifier.

      I believe that fertility treatment should be restricted to women that have never had a child.
      While we are touching on the subject though, I also believe that countries with over 100 million people should have a two child policy, and countries with less than 100 million a four child policy.
      (And by “child” I mean “successful full term pregnancy resulting in a living child/children” - as a parent who got twins on what we agreed would be our second and last child, I understand that things don’t always go to plan).

      I don’t think that it is responsible, as a member of the human race, to have four children and be trying for more. And that “four” is a fair compromise, it’s still probably too many IMO.

      Reply

    • Tubesteak says:

      02:36pm | 19/09/12

      “But there has to come a point, surely, where people don’t have to give up hope as such, but perhaps change what they hope for”

      The same thing could be said to heart and lung transplant recipients.

      Personally, I would not say such a thing but your suggestion seems similar to this.

      Reply

    • Bec says:

      04:17pm | 19/09/12

      The difference being that women do not need a baby to survive.

    • scott says:

      02:36pm | 19/09/12

      I am conflicted on this issue.

      If a woman cannot fall pregnant naturally, surely that is nature’s way of saying that they have undesirable traits and should not be reproducing and further polluting the gene pool.

      Look at the animal kingdom, it is survival of the fittest.

      Reply

    • St. Michel says:

      03:03pm | 19/09/12

      “Nature’s way”? Just insert the word “God” for “Nature” and be done with it, with all the silliness that implies.  Nature doesn’t have any complex plan for evolution, and some so-called “undesirable” or even just serendipitous traits have turned out to be highly desirable if not essential to the propagation of certain species.

      Animals do not have human consciousness, cannot avert their own extinction, and cannot change their own destiny.  Human beings are rather different to that.

    • Alex says:

      03:26pm | 19/09/12

      Have you seen some of the people who reproduce naturally??  (and more to the point, accidentally)

    • Drama Queen says:

      03:27pm | 19/09/12

      Scott not being able to fall pregnant naturally does not mean that you will pass on any undesirable traits (I’m not sure to which undesirable traits you are actually referring) to children you may have through artificial means. By your logic people should not be using IVF to fall pregnant at all, not to mention the handicapped, mentally ill or criminals.

      Sounds more like you’re referring to something the Nazi’s did in WWII than to anything medical.

    • Dave says:

      03:34pm | 19/09/12

      Many women can’t conceive naturally because of past cancer treatments and complications from conditions such as HPV and endometriosis (which is quite common). This has nothing to do with so-called ‘undesirable traits’. Look at it this way, if a man can’t ejaculate during intercourse with his partner (more common than you might think), then is that nature’s way of telling him his genes should be removed from the gene pool?

    • Karl says:

      03:36pm | 19/09/12

      i agree entirely. logically this makes complete sense, unfortunately you could never state this logic in a public arena lol

    • amy says:

      04:02pm | 19/09/12

      DERPSCIENCE! the best kind of science there is

    • Ben says:

      04:06pm | 19/09/12

      Who said the Neanderthals were extinct?

    • AFR says:

      04:25pm | 19/09/12

      I can try to rationally see your argument, Scott, but every day all sorts of people have kids they shouldn’t, whilst others who would make awesome parents miss out due to something beyond their control. My own marriage collapsed primarily under the financial, physical and emotional strain of several unsuccessful IVF attempts followed by a miscarriage.

      I would almost call reproduction a basic human right. As someone else said, if the technology is there, why not?

    • scott says:

      04:32pm | 19/09/12

      @ Drama Queen

      IVF is allowing older women who could not conceive naturally to have their own kids.  It is scientific fact that the older the parents are, the higher likelihood of their offspring being born with defects, as well as higher risks to the mother during pregnancy.

      Science is interfering with nature, and I think that is wrong.

      @ Alex

      I am not sure what point you are trying to make, but I guess you are talking about ‘bogan’ parents.  They still give birth to fit and healthy children.

      @ St. Michel

      But nature has a plan to stop old people from spreading their genes, it’s called menopause and impotence. 

      @ Dave

      Serious question:  Would the offspring of a mother who had cancer be pre-disposed to getting cancer themselves when they are older?

    • Anne71 says:

      05:00pm | 19/09/12

      Hey, Scott - it could be Nature’s way of saying that the FATHER has “undesirable traits”. Thought of that? No, you ‘re still stuck in the mindset that if a woman is unable to conceive, she’s the one to blame - it’s never the father’s fault!

    • Justme says:

      05:11pm | 19/09/12

      I’m pretty sure Scott wasn’t referring to personality traits, but genetic problems. If two people can’t reproduce naturally then maybe there is something in the genetic combination of those two that prevents this. Maybe there is a biological reason for it. Who knows what can of worms is being opened when we “force” a pregnancy. At least, I think that is what Scott is saying

    • Mark says:

      05:13pm | 19/09/12

      Certainly in the case of men and women who can’t conceive naturally because of health reasons, Scott is absolutely right. Natural selection doesn’t care for socially desirable traits, just those traits that help us reproduce. You can be a highly intelligent, caring man or woman who would make a great parent, but if you have a low sperm count, faulty sperm/eggs or biological condition that prevents you from carrying a child to full term, then you are of no help to the continued survival of the population. The risk with technological intervention to overcome these defects, particularly where the cause is genetic, is that the defects may be passed on to the offspring.

    • tez says:

      03:04pm | 19/09/12

      As woman are willing to pay big dollars for fertility treatment medical reserch will keep discovering new, amazing and expensive ways to produce children.

      Reply

    • bananabender says:

      05:52pm | 19/09/12

      The patient usually only pays a tiny fraction of the cost of fertility treatment. The taxpayer subsidies for fertility treatment can exceeed $150,000.

    • Jimbo75 says:

      03:16pm | 19/09/12

      Part of the legitimate debate must also be about affordability and efficiency to the taxpayer. The Government provides significant funding for each and every IVF attempt. Similarly hospital and health specialist resources are also taken up.

      While having a baby is an emotive issue, if you take that out of it would anyone support the Government spending money on something that has already failed 22 times?

      Reply

    • Markus says:

      03:32pm | 19/09/12

      When the parents expect the government, through Medicare, to subsidise their quest to produce an offspring.
      Inability to bear children is not fatal or debilitating, or even something that has a negative impact on standard of living, and so is not something that the government should be subsidising through Medicare.

      Mind you, the government shouldn’t be subsidising those who can (and are) having kids either, but that is another rant altogether.

      Reply

    • Tim says:

      04:34pm | 19/09/12

      Agree.
      I don’t think the government should be subsidising anyone for IVF, It’s not like we have a shortage of people on the planet.

      If you want the procedure, then you can pay for it.

    • Virginia says:

      03:33pm | 19/09/12

      I’ve only recently had to change what I’d hoped for. I’m in my mid 40s and I’d always wanted a child. But life doesn’t go according to plan and by the time I met my 2nd longterm partner, I was in my late 30s. Circumstances, and a few failed attempts to conceive, have led me to realise that it’s just not on the cards for me. But it’s a hard pill to swallow - especially with the media ramming down our throats the daily worship of the mother: super mum, yummy mummy, mumpreneur…  And I tend to agree with Scott and iMitchy - the planet is already overcrowded - to the point that, for a Western family to have lots of kids, I think is greatly irresponsible. And who are we to mess with natural selection? Well, we mess with a lot of things don’t we? Perhaps my genes simply aren’t strong enough to pass on… Sure, medical advances have saved and create a lot of lives, but at what cost long term? The planet only has so much in the way of resources. And there are too many kids with awful parents - what parents might they become? For me, now, I just have to grow comfortable with being childless - and enjoy being a mother to my darling dogs.

      Reply

    • Kel says:

      03:51pm | 19/09/12

      You speak a lot of wisdom & strength, Virginia.  Keep it up - your attitude is very inspiring >:o)

    • iMitchy says:

      04:02pm | 19/09/12

      Kudos Virginia,
      What a fantastic attitude toward the situation you find yourself in.

      “Sure, medical advances have saved and create a lot of lives, but at what cost long term? The planet only has so much in the way of resources.”
      There’s an irony in this - that the people responsible for the largest population growth are often not privy to these kinds of medical advancements.
      What’s interesting though, is that for many families in the third world, children are a sort of superannuation. The more children you have, the lower the percentage of their income each must pay to support you when you can no longer work, and the higher your standard of living will be.

    • tez says:

      04:16pm | 19/09/12

      Go girl like your attitude

    • Virginia says:

      06:19pm | 19/09/12

      I have to confess, this attitude hasn’t come easily and there are still moments when I get sad, angry, bitter and self-pitying. Two of my friends in their 40s conceived naturally, which did rub salt into the wound initially, but you have to come to an acceptance eventually. I have considered adoption, but with all the hoops you have to jump through, I wonder is it worth it? And given my age, it becomes harder, because - adopted or biological - the older the parent, the greater the chance of that parent not being around long enough to see their child grow into their 20s, 30s, 40s themselves… My parents were older when I was born and both died in their 70s. Perhaps that’s evidence enough to explain my circumstances!

    • Kel says:

      03:33pm | 19/09/12

      I too am conflicted.

      I’m a woman and I am confident enough in myself and value life’s gifts enough to say, if I couldn’t conceive naturally, it’s the nature’s way of saying “someone else needs you” and adopt.  It’s that beautiful execution of “unconditional love”.

      I feel by taking advantage of modern medicine to conceive is an action driven by ones ego and nothing more.

      Man has messed with nature time & time again (some more drastic than others) and all we see are negative consequences.  It’s time people started paying attention to things outside their ego and appreciate the natural things in life that essentially bring true happiness. 

      “Wants” and “needs” are 2 completely different things.  It’s time for a shift in attitude.  It’s time to re-educate.

      Reply

    • St. Michael says:

      03:44pm | 19/09/12

      “Man has messed with nature time & time again (some more drastic than others) and all we see are negative consequences.”

      Right.  Down with vaccines! Smallpox, tetanus, diptheria, mumps, and the measles really should still be ravaging our populations.  And milk should just not be pasteurised - all those lethal bacteria are actually good for you!  Kids born with a sixth toe or finger deserve to be cast into the streets because they’re unnatural!  Gotcha.

      It’s easy to say “I’d accept it if I couldn’t conceive naturally” when in fact you can conceive.  If you don’t have the option your perspective might be just a little bit different.

    • Fence-Sitter says:

      03:54pm | 19/09/12

      That’s a really beautiful way to put it, Kel - “nature’s way of saying “someone else needs you”’.  Fantastic!  It’s such a hard topic.  As a newly married woman who is yet to start trying for kids, I don’t know how I would feel if I weren’t able to naturally.  As someone who thinks this world is already over-populated, I feel the red-tape associated with adoption should be abolished and couples should take that route, instead.

    • AFR says:

      04:33pm | 19/09/12

      Adoption is great in theory - however, unless you are Elton John, it’s not as easy as adopting a puppy, especially from overseas.

    • Smurf Silva says:

      05:21pm | 19/09/12

      “Adoption is great in theory - however, unless you are Elton John, it’s not as easy as adopting a puppy, especially from overseas.” - AFR

      Because transplanting a uterus is a walk in the park. :p Adoption is hard and it is expensive but no more or less than IVF.

      However, maybe we should be putting just as much time and energy into making adoption a more viable option. The Australian adoption laws in most states are archaic and need to be seriously looked at. It is a long, arduous, emotionally and financially draining endeavour that does not come with a guarantee. But all of that also applies to IVF.

      But that argument aside, I disagree with IVF because there are millions of children out there who NEED a safe place to grow up and parents to love them. Opting for IVF out of a need - no, desire to have a “closer bond” with the child you carried within your womb or to create another being with a specific set of genetics smacks of selfishness to me.

    • Kel says:

      05:46pm | 19/09/12

      @ St. Michael

      I don’t believe in most vaccines, I don’t consume milk & kids being born with a sixth toe or finger is COMPLETELY NATURAL!!  How disillusioned & condescending to these kids to think of them otherwise?

      If we were to discuss this on a deeper level, medical advances (in short) are allowing us to live longer or have another chance at life,  however we end up at a point where we meet the “7 Billion” topic.  The subjects involved are endless.

      And I actually do not know if I can conceive naturally.  Thanks for letting me know!!  Lets hope you’re right (that’s my ego talking there)

      @ Fence-Sitter & AFR
      The policies involved in adoption definitely need an upgrade, that’s for sure.  Lets hope this happens sooner rather than later!

      And Fence-Sitter, thanks for your kind words & all the best with your future family together smile

    • andrew says:

      03:58pm | 19/09/12

      i can say that from an ethics point of view i support this experiment - the prospective grandmother has no further use for her uterus so unlike donating a kidney there should be no negative side effects for the donor, and as the uterus will be removed from the recipient (hopefully after a completed pregnancy) - no need for long term immunosupression drugs either. Also it is obvious that the mother-to be really wants a baby if she is willing to go to all that trouble to get pregnant.

      As i see it the only argument against this is an economical one - given the choice between funding a heart transplant or a uterine transplant obviously i would choose the life saving heart transplant. This is also the case for any IVF treatment though, should taxpayers be funding any of it?? I personally am undecided on that.

      Reply

    • andrew says:

      04:16pm | 19/09/12

      i would also add if i was responsible for deciding what medicare does and does not fund there would be many other treatments i would refuse or reduce funding for before this - including anything that could have been prevented by avoiding obesity.

    • iMitchy says:

      04:37pm | 19/09/12

      I like your point about the grandmothers not needing the uterus anymore. I wonder if there is similar transplant schemes for people who are blind due to damage to the visual cortex to donate their eyes to someone who is blind due to eye damage/loss (or similar).
      The case could be made that the donor loses the benefit of blindsight though I guess. But the principle remains.

    • stephen says:

      04:02pm | 19/09/12

      Women who don’t have kids have more tantrums, and they cry a lot, and I gotta tell yer, if there’s anyway they can be mothers, natural, unnatural, preternatural, then they should try for it, and the taxpayer should foot the bill.

      ps gals who goochie-goo don’t boo-hoo.

      Reply

    • Smurf Silva says:

      05:09pm | 19/09/12

      LMAO!!!! Nice logic!

    • Kika says:

      04:10pm | 19/09/12

      It’s definitely an emotive issue and likely to drum up all sorts of old fashioned ideas of women not being real women until they’ve had a child and that they’re likely to have all sorts of mental issues if they don’t etc etc. I have no idea because it’s not really happened to me, but sometimes when women want to have a child nothing will ever stop them from fixating on this until they achieve their goal.

      My aunty went 11 years through IVF and countless of cycles. She finally found the right doctor and after 11 years she fell pregnant with twins. We all thought the same - enough is enough - it’s not meant to be. But she kept believing and it worked.

      As for womb transplants - why not? What if you suffered from horrendous endometriosis and having a transplant would mean you could have a normal period for once…? Who says that someone with a liver transplant is more worthy of this than the woman who wants to have a child?

      Reply

    • John says:

      04:12pm | 19/09/12

      Creepy Corey says it’s unnatural. Next thing you know, women will want to have dog wombs inserted in them and give birth to puppies.

      Reply

    • Sickemrex says:

      05:37pm | 19/09/12

      You win the internets today.

    • Kel says:

      05:57pm | 19/09/12

      The sad thing is, it’s not surprising!

    • Stephen says:

      04:41pm | 19/09/12

      Its a pity that the medical industry cannot also develop some way of providing people with the capacity to be better parents.

      Reply

    • Mark says:

      04:55pm | 19/09/12

      Having a child is a privilege, not a right. No woman (or man) has a right to have a child.

      I’m opposed to taxpayer-funded IVF. Unfortunately, some people, either because of birth defects, medical conditions or lifestyle choices, are just not meant to have children and I am yet to be convinced why taxpayers’ money should be used to help them do so.

      Ultimately, if some women want to spend thousands of dollars of their own money on IVF, then that is their choice and they should be able to do so. However, if it gets to a point where chances of success are negligible, IVF clinics and general practitioners should have a responsibility to discourage further attempts.

      Reply

    • Ben says:

      06:03pm | 19/09/12

      I am the father of a beautiful son, thanks to the wonders of IVF.

      In a previous career, I saw many bruised and battered children, all of whom were probably conceived the old-fashioned way, which you seem to put so much faith in.

      In one way I agree with you. Having a child certainly is a privilege. Going through the IVF program, my wife and I met many wonderful people, all of whom I have no doubt would make wonderful parents. Why? Because their experience made them realise that children truly are a gift.

      Incidentally, I don’t dispute your right to say that there should be no taxpayer-funded IVF. Likewise I don’t dispute your right to arbitrarily dismiss assisted reproduction on the basis that “some people are not meant to have children.

      By the way, in just about every capital city there are a number of fertility centres. Every morning, you’ll see many couples gathering there. They’re a mixed bag. Funny enough, you don’t see any bearded ladies in there or people with two heads. What is common about them though is the expressions on their face, a mixture of determination, resolution, sadness and angst.

      Less then half of them will realise their dream.

      I’d really like to watch someone like you go in and tell them that they weren’t meant to have children, hero.

    • Sickemrex says:

      05:44pm | 19/09/12

      Wasn’t the right to have babies covered in Life of Brian? I can see the point about taxpayer subsidies but can’t really comment on the emotional side. When we decided to start a family when I was 35, I said if I couldn’t conceive, I wouldn’t do IVF. Maybe that means I didn’t want kids enough? Moot point as it turned out given I was pregnant both times within weeks of stopping contraception. But I really feel for couples who can’t.

      Reply

    • Vanessa says:

      06:04pm | 19/09/12

      This would be an easy question to pose, if, you as the writer, have two children yourself, despite the fact it took you a while to get there. Try being a completely healthy woman surrounded by pregnant friends or friends with little kids, who has been trying for years with no luck, then tell me you think we should be telling women (and men) to ‘change what they hope for’. Easy to say when it doesn’t need to apply to you.

      Reply

    • Super D says:

      06:31pm | 19/09/12

      If they can transplant a working womb into a woman what’s to stop them transplanting one into a man?

      Reply

    • Miss Nae says:

      07:43pm | 19/09/12

      It’s often “easier”** and cheaper to put yourself through IVF than the adoption process whether local or international. So you can all shut up about those children waiting to be adopted - they don’t exist. A significant number of countries will no longer adopt outside of the country.
      ** Nothing is easy about IVF

      Reply
 
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