In the Near Future: Uterus Transplants

The New York Times November 13 print edition ran an article by Denise Grady that announced "Uterus Transplants May Soon Help Some Infertile Women in the U.S. Become Pregnant." The Times considered the news so big that a press release came to my in-box. It's all going down at The Cleveland Clinic, where doctors expect to become the first in the US  to transplant a uterus into a woman who lacks one—whether due to congenital factors, injury, or illness. The procedure would eliminate the need for a gestational surrogate.After giving birth to one or two children—by C-section—the woman receiving the transplanted uterus would have it removed so she can quit taking anti-rejection meds. An estimated 50,000 women in the United States might be candidates. Currently, eight have begun the screening process.The transplant team would remove the uterus, cervix, and part of the vagina from a recently deceased organ donor. (The uterus, if kept cold, can survive outside of the human body for six to eight hours.) The recipient's ovaries and fallopian tubes would be left in place, and after one year of healing, she would undergo an IVF/embryo transfer procedure.Sweden is the only place where doctors have already successfully completed uterine transplants. Nine recipients have delivered four babies. Another is due January 2016. Two failed and had to be removed—one, due to a blood clot; the other, due to infection. The Cleveland doctors plan to use deceased donors, so they won't put healthy women at risk. For a live donor, the operation takes seven to eleven hours and requires working near vital organs.Recipients must have ovaries. But because the fallopian tubes won't be connected to the transplanted uterus, a natural pregnancy will be impossible. 

Bioethics in the News

Thanks to the Center for Bioethics and Human Dignity for flagging these stories. 

Lots of People on Antidepressants (Scientific American) – The Mayo Clinic says about 13% of Americans, —more than 1 in 10—, take an antidepressant. Of women between the ages of 50 and 64, nearly 25% take an antidepressant. (Read More)

No Bucket Challenge for Ebola

(ABC News) – While aid organizations need funds to fight the worst-ever Ebola outbreak in West Africa, officials say a lack of interest has made it difficult to highlight the need for more money and medical supplies.  (Read More)  For a dramatic video of one person's ending, watch this short NPR video. 

A British Surrogate Mother Rejects Her Disabled Twin

(The Telegraph) – A British surrogate mother of twins, one of whom was born disabled, has said the intended mother rejected the unhealthy child, referring to her as a “dribbling cabbage.” (Read More)

Will Stem Cells Replace Heart Operations?

(Daily Mail) – Patients with chronic heart failure are to receive pioneering stem cell treatment in a new trial which could herald a cure for the biggest killer "in the industrial world."  (Read More)

Scientists Have Coached Lab Cells to Make a Working Human Organ

(The Guardian) – Reprogrammed cells created in a laboratory have been used to build a complete and functional organ in a living animal for the first time. British scientists produced a working thymus.  (Read More) 

Crime and IVF

(Reuters) – A Thai doctor who performed in vitro fertilisation (IVF) for women involved in a surrogate baby business dubbed the “baby factory” has agreed to turn himself in, police said on Monday. 

No More Reading Glasses in the Future?

(The Telegraph) – Reading glasses could be banished forever after scientists developed a technique to reverse problems in aging eyes.  (Read More)

Do We Need a Different Approach to Cancer? 

(The Telegraph) – Most cancers cannot be cured and scientists should give up trying and, instead, look for ways to manage the disease, the director of the Centre for Evolution and Cancer at The Institute of Cancer Research, has claimed.  - (Read More)

Lack of Toilets Puts Women's Health and Safety at Risk

(The Guardian) – In the evening gloom of their dirt courtyard, Raj Beti and her six daughters are growing desperate. They last answered nature’s call 13 hours ago, but it’s not yet dark enough to venture into the fields. For - (Read More)

Japanese Man Overdoes It with Surrogacy

(ABC.net) – Japanese national Mitsutoki Shigeta used his sperm to have the children with eleven surrogate mothers. He said his motives were pure and all he wanted was a large family.  (Read More)

Bioethics in the News This Week

Thanks to the Center for Bioethics and Human Dignity for flagging these. 

AlternativePap Smear Approved  
(ABC News)– US health regulators have okayed a genetic test as a first-choice screening option for cervicalcancer. 

Autism and Genetic Discovery Inches Closer to Answers 
(Medical Xpress)– A new study from investigators with the world’slargest research project on identifying genes associated with risk for autism,has found that a certain kind of genetictesting offers an important tool in diagnosis and treatment ofautism.

Transplant Drug May Aid Treatment of HIV 
(InfectiousDisease Special Edition) – A drug designedto prevent rejection of transplanted organs —also may combat HIV.  

Veterans Die Waiting for Medical Access 
(CNN) –At least 40 U.S. veterans died waiting for appointments at the Phoenix VeteransAffairs Health Care system, many of whom were placed on a secret waiting list.The list was designed by VA managers trying to hide that 1,400 to 1,600 sick veteranswere forced to wait months to see a doctor.  

Gene Therapy May BoostCochlear Implants
 (Washington Post)–Researchers using technology to beam gene therapy into the ears of deafanimals found that the combination improved hearing. The approach reported isn’t ready for humans, but it’s part of growing research intoways to let users of cochlear implants experience richer, more normal sound.

Animals with Human Rights MakeResearchers Run Scared 
(Nature)– Animals are gaining more rights, and as they do so, researchers fear judges could extend theserights to lab animals, curbing experimentation. The trend also disturbs veterinarians who fear accusations of malpractice if pets are ruled worth more than their simple economic value.

Trafficking Ring Lured Vulnerable Women to Turkey for Organ Harvesting (Jerusalem Post)– Young Israeli women in dire economic straits were lured toTurkey to donate their kidneys and other organs on the promise of quick cash.  

Adult Stem Cell Research ShowsPromise 
(FDA.gov)– A large team of FDA scientists are studying adultmesenchymal stem cells (MSCs) —cells that could eventually be used to repair,replace, restore or regenerate cells in the body, including those needed forheart and bone repair.

Almost Blind Man Improves Thanks to New Retina Procedure  
(Associated Press)– A man diagnosedwith retinitis pigmentosa as a teenager, has been almost completely blindfor years. Now, thanks to the surgicalimplantation of a “bionic eye,” he’s regained enough of his sight to catch glimpses of his wife, grandson and cat.

FDA Discourages Use ofTissue-Shredding Tool 
in Women's Surgeries (Nature)– The FDA now recommends that surgeons refrainfrom using tissue-grinding tools to remove uteruses or uterine growths becausethese tools increase the risk of spreading undetected cancer.  

Childless ChineseTurn to American Surrogates
 (NPR) –Chinese couples unable to have children get around China's ban on surrogacy as well as birth limits by hiring American surrogates. Having American-born children also guarantees them something many wealthy Chinese wantthese days: a U.S. passport.

New Initiative Could Ban Funding ofEmbryonic Stem Cell Research in Europe 
(Forbes)– The US bans patenting oftechnologies that use human embryonic stem cells, so a group of pro-lifeorganizations has launched an initiative which, if it passes, will cut fundingof embryonic stem cell research there. 

Virtual Doctor Visits Gaining Steamin “Geneticist Deserts”
 (ScientificAmerican) – Videoconferencing for genetic consultation —telegenetics —saves patients time, the cost and burden of transportand the need to find day care or take time off from work. Fordoctors, the approach can expand their reach while limiting travel. 

Bioethics in the News

Skills matter.  Research has confirmedwhat patients have long suspected and trainees have long known –the dexterity of a surgeon’s handscan account for much of the differences in how well patients do. (New York Times)

Belgium considering kids’ euthanasialaw. In Belgium, where euthanasia is now legal for peopleover the age of 18, the government is considering extending it to children and adultswith early dementia. Imagine a teen with angst being allowed to get help tocommit suicide. Right. (ABC News)

How much does a patient invegetative state know? An analysis of brainactivity in 21 patients and eight healthy volunteers showed one of the patientscould pick out individual sounds. (BBC)

Fertility: Race matters. Maternal ethnicity is a significant determinant of successfuloutcomes after fertility treatment.  (Medical Xpress)

Too many, too young.
One in every five girls (about 19%) gives birth before sheturns 18 in developing countries. Of the 7.3 million girls who give birth everyyear, 2 million of them are under the age of 14. (CNN)

Progress with breast cancer.
A test that identifies seven classes of breast cancer could beavailable within two years. (BBC)

Curbing drug-induced abortion.
 If a U.S. court decides to hear an appeal in a case aboutdrug-induced abortion, it could clarify how far states can go in restrictingabortions. (The Wall StreetJournal)

Syria polio cases confirmed by WHO.Ten polio cases have been confirmed in Syria, the first confirmed outbreak there in 14years. (The Guardian)

DNA and full disclosure.
A recommendation earlier this year that people who have theirDNA sequenced should be told of certain risk factors, regardless of whetherthey want to know, has sparked an ongoing debate among physicians and ethicists.(Boston Globe)

4 babies, 2 surrogates, 1 set oftwiblings.
A British couple are to becomeparents of two sets of twin babies carried by two Indian surrogate women theyhave never met. Experts say twiblings, or children born to separate surrogatesbut created from the same batch of embryos, are common in India. The four babiesare the result of a commercial surrogacy agreement with a clinic in Mumbai. (BBC)

Bioethics in the News

Shutdown harms the sick. Clinical trials continue, but only ata crawl. The government has continued to enroll critically illpeople in clinical trials at NIH, but many of the sick are having to wait. (New York Times)

Number of surrogate births rising.
Clients come from all over the U.S. and Europe to have theirsurrogate babies in Illinois, which has surrogacy-friendly laws. (Chicago Tribune)

Alzheimer’s breakthrough hailed as“turning point.”
The discovery of the firstchemical to prevent brain tissue death in a neurodegenerative disease has beenhailed as the “turning point” in the fight against Alzheimer’s disease.Scientists say a resulting medicine could treat Alzheimer’s, Parkinson’s, Huntington’sand other diseases. (BBC)


Conscious or not? Now a bedside scan can show embers ofconsciousness in coma patients, revealing anactive mind hidden inside an unresponsive body. Tests are also under way alsoto monitor people under general anesthetic, to make sure they do not regainconsciousness during operations. (New Scientist)

Secrets of trial data revealed.
Groups are in a deadlock over plans to make public somesensitive data gleaned from clinical trials. And a study reveals why the restrictedinformation could be valuable. (Nature)

TB and AIDS linked. Most new TB cases are in sub-Saharan Africa: more than 260people (vs. France’s 4) per 100,000 in 2011. And the region is in the grips ofan HIV epidemic. TB kills more people living with HIV than anything. (Nature)

Medical tourism on the rise.  America spendsmore on health care than any other nation. And the cost can force uninsured orunder-insured Americans to travel abroad for treatments, many times at afraction of the cost. (CBS News)

Amniotic stem cells may help repaircardiac birth defects. Researchers at the U. ofMichigan are testing an alternative to embryonic stem cells that could one dayregenerate muscle tissue for babies with heart defects. (Medical Xpress)

Breakthroughs in prenatal screeningannounced.
The newest screening test, highlyaccurate and noninvasive, is available commercially. The test is so accurate indetecting Down syndrome that few, if any, affected fetuses are missed. Now farfewer women need an invasive procedure to determine if Down is present. (New York Times)

Big pharma not exactlydisinterested. A scientific panel that shaped U.S.policy for testing painkillers was funded by major pharmaceutical companiesthat paid hundreds of thousands of dollars for the chance to influence the FDA.(The Star Tribune)

Fake paper exposes failed peerreview
The widespread acceptance of an atrocious manuscript,fabricated by an investigative journalist, reveals the near absence of qualityat some journals. (The Scientist)

Once again, this list is brought to you in part by the good folks at the Center for Bioethics and Human Dignity. 

Bioethics in the News

Most of these news items are adapted from a list provided weekly by the Center for Bioethics and Human Dignity: 

Offsprings' rights: The neglected factor in third-party reproduction. If you read nothing else on the following list, read this powerful piece titled “What Are the Rights ofDonor-Conceived People?” It looks at third-party reproduction from theperspective of a donor-conceived person. (The Public Discourse)

Killer foot cream. 
A common nail fungus drug is eradicating HIV. And the virus isn’tbouncing back when the drug is withheld. So it may not require a lifetime ofuse to keep HIV at bay. This is great news, people! (ScientificAmerican)

Should surrogacy qualify one formaternity leave? An Irishteacher claims she was denied unfairly her paidadoption or maternity leave following the birth of her child via a surrogate.The court was to decide on that one today. (Irish Times)

A brain controls a bionic leg. A team of software and biomedical engineers, neuroscientists,surgeons and prosthetists has designed a prosthetic limb that can reproduce afull repertoire of ambulatory tricks by communicating seamlessly with a humanbrain. (Los AngelesTimes)

SARS doctor pleads for assisted suicide.
The infectious disease doc who helped Toronto through the SARScrisis ten years ago made a video before his death pleading for Canada tolegalize assisted. (The ChronicleHerald)

Number of Dutch killed by physicianassisted suicide rises by 13 per cent.
Voluntaryeuthanasia, where a doctor is present while a patient kills him- or herself (usuallyby drinking a strong barbiturate potion) has been legal in the Netherlands foreleven years. Requests have risen steadily since then. (The Telegraph)

Cancer: More Good news.  National CancerInstitute statistics show that in the U.S. an overall five-year cancer survivalrate for children under 19 with cancer has increased from 62 percent in themid-1970s to 84 percent today. For the most common type of childhood cancer,acute lymphoblastic leukemia, the cure rate is now over 90 percent. Woohoo! (ABC News)

Gene therapy offers hope forpatients with Duchenne muscular dystrophy. Scientistssay the technique or related ones might also point the way to treatments forother inherited diseases, including Huntington’s. (New York Times)

Bioethics: Making Headlines

Lots of interesting developments inthe field of bioethics this week. Take a look at these top stories, reported bythe Deerfield, Illinois, Center for Bioethics and Human Dignity:

Most detailed 3D map of human brain
 Adeceased 65-year-old woman has provided scientists with the material for thefirst super high-resolution, three-dimensional digital model of the humanbrain. (The Telegraph)

FDA approves morning after pill for women of childbearing age
 TheU.S. Food and Drug Administration approved Plan B emergencycontraceptive without a prescription for all women of childbearing age,officials say. (UPI)

In new tools to combat epidemics, the key is context
 Now a newproject called BioMosaic is building a more comprehensive picture offoreign-borne disease threats in the United States, by merging three separatedata tools into a single app for guiding decisions at the time of an outbreak.(New York Times)

HPV vaccine is credited in fall of teenagers’ infection rate
 Theprevalence of dangerous strains of the human papillomavirus (HPV) the mostcommon sexually transmitted infection in the US and a principal cause ofcervical cancer, has dropped by half among teenage girls in recent years, astriking measure of success for a vaccine against the virus that was introducedonly in seven years ago. (New York Times)

Egypt girl’s death puts spotlight on genitial mutilation
 The deathof a 13-year-old girl during a genital mutilation procedure has brought theissue back into the spotlight in Egypt. While some Egyptians fight for eradicationof the practice, others justify it in on religious grounds. (BBC)

New study tracks emotional health of “surrogate kids” 
Over thepast decade the number of births involving surrogacy with donor eggs and spermhas surged. What, experts wondered, does this mean for the mental and emotionalhealth of the growing number of kids who may or may not know the truth abouttheir distinctive origins? (Today)

Japan experts mull rules on chimeric embryos
 Japaneseexperts were on Tuesday set to discuss rules for experiments with animal-humanembryos, as scientists seek permission for tests that could see human organsproduced inside the growing body of an animal. (Fox News) Another news story suggested that human organs could be grown in animalswithin a year.  (The Telegraph)

Abortion restrictions in states
 Forty-onestates have enacted abortion restrictions at different stages of pregnancy. (New York Times)

High court rules ‘pay-for-delay’ drug deals can face antitrustsuits
 A brand-name drug maker can be sued for violating antitrustlaws if it agrees to pay a potential competitor to delay selling a genericversion, the Supreme Court ruled. (Los Angeles Times)

Be prepared for the big genome leak
 Mostpeople in the US could soon know someone whose genome is held in a researchdatabase. Concerns are growing about our ability to control access to thatinformation. But many scientists feel that restricting access to genomic datafetters research. How long will it be until an idealistic and technicallyliterate researcher deliberately releases genome and trait information publiclyin the name of open science? (Nature)

Directed in vitro (IVF) technique may increase insulinresistance among offspring
 A special type of IVF may increase the riskfor insulin resistance among high-tech babies. (E! Science News)

IVF: First baby born using ’safer’ method
 In aworld first, a healthy baby has been born using a “safer” method of theinfertility treatment IVF, using a natural hormone to kick-start his mother’sovaries. (BBC)

Surrogate Refuses Offer of $10,000 to Abort

Bioedge reports that a couple in the Northeast offered their surrogate mother (CrystalKelley) $10,000 to abort their baby because it had acleft lip and palate, a brain cyst, and an abnormal heart. When Crystal refused, the couple's lawyer sent a demand letter insisting that she abort the baby, along with the financial incentive. The attorney also said the couple would give up custody to the state if the childwere born. 

Crystal didn't want the child going to state care, so she moved to Michigan, where surrogates are considered the children's legal parents. She then found adoptiveparents, to whom she gave the baby shortly after birth.

Some argue that Crystal's rights over her own body trump the rights of the legal parents: "If we have any pretensions about defending a woman'sright to choose, then we must defend that right even when, likeKelley, she chooses to change her mind."

Another commentator disagreed, arguing that the parents' legal rights trump any concerns ofthe surrogate: "It seems absurd to make demands on the parents andto further those demands by claiming emotional attachment to the child youare carrying." 

Crystal herself says that she stands by her decision and ishappy the child has lived, despite its disabilities.

  

Bioethics News

From the Center for Bioethics and Human Dignity

Featured ResourceThis week we present a talk given by CBHD's Executive Director, Paige C. Cunningham, JD, at The Family Research Council onMarkets and Consumers: The Commodification of Women and Girls. The talk was a part of FRC's lecture series and the Witherspoon Lecture for 2012.

CBHD Academy of Fellows ConsultationShould we be able to create synthetic sperm and eggs for reproductive purposes? Will children born from such procedures be at elevated risk for biological and/or sociological problems?
Explore cutting-edge ethical and theological questions surrounding the development of novel procedures in the artificial creation of human gametes.

Saturday, November 3rd, 2012
10am to 5:30pm
Trinity International University
Kantzer Hall - KANT 141
Admission is free but registration is required

Uruguay senate approves first-trimester abortions
Uruguay’s Senate approved a bill on Wednesday that allows women to have abortions during the first trimester of pregnancy for any reason, opening the way for one of the most sweeping abortion rights laws in Latin America. (New York Times)

Over my dead body
Helping the terminally ill to die, once taboo, is gaining acceptance. (The Economist)

Synthetic biology raises playing God fears
Is it safe to let humans play God and create new organisms - animals and plants - that have never existed in Mother Nature? The ongoing UN Convention on Biodiversity here [Hyderabad] is going to address this question on Friday evening, when it decides if countries need to put their heads together to study the new field of synthetic biology. (Times of India)

California enacts landmark legislation giving same sex parents via surrogacy equal parenting rights
California has taken the unprecedented step of changing the legal definition of “intended parent” to be “an individual, married or unmarried,” making it legislatively illegal to discriminate against same sex parents both before and after their children are born from surrogacy arrangements. (Sacramento Bee)

Blood or bone marrow better for stem cell transplants?
Study found no survival differences, but blood cells may be associated with more chronic side effects.
(U.S. News and World Report)

Stem cells from cadavers? Pluripotent stem cells can be derived from dead bodies, research shows
Death will come for us all one day, but life will not fade from our bodies all at once. After our lungs stop breathing, our hearts stop beating, our minds stop racing, our bodies cool, and long after our vital signs cease, little pockets of cells can live for days, even weeks. Now scientists have harvested such cells from the scalps and brain linings of human corpses and reprogrammed them into stem cells. (Huffington Post)

Shinya Yamanaka interview: 2012 Nobel Prize winner on stem-cells, ethics and the future of medicine
In a conversation with Technology Academy Finland (TAF) at the time of his winning the Millennium Technology Prize earlier this year, and published today exclusively by the Huffington Post, Shinya Yamanaka said a future in which medical drugs are made to order is closer than ever. (Huffington Post)

Should we ration end-of-life care?
A panel debated the pros and cons of both sides in the latest edition of Intelligence Squared U.S. They faced off two against two in an Oxford-style debate on the motion “Ration End-of-Life Care.” (NPR)

Claims of first human stem cell trial unravels
It has been a crazy week for stem cell research. After the high of a Nobel prize for Japan’s Shinya Yamanaka, the pioneer of cellular reprogramming, events took an alarming and surreal turn when a little-known compatriot – Hisashi Moriguchi – claimed to have already run a clinical trial in which similarly reprogrammed cells were injected into people. (New Scientist)

Tracking a killer: Cell phones aid a pioneering malaria study in Kenya
A pioneering study into malaria transmission in Kenya, using data gleaned from the cell phones of nearly 15 million people, has given scientists new clues into how the deadly disease spreads. (CNN)

Bioethics In the News

Let's Limit Embryo Transfers:  
A new fertility-treatment study has found that women who receive three or more embryos have no better odds of giving birth than those who receive only  two embryos. (Washington Post)


FDA Warning: About Illegal Stem Cell Treatments
The FDA announced this week that patients' hopes for cures leave them vulnerable prey for providers of illegal and potentially harmful stem cell treatments. (Medical Daily)


Surrogacy: A Growing International Injustice
International surrogacy is a growing business thanks to Westerners hiring poor women in developing countries to carry their babies. But media attention could change that. (Slate)


Skipping the Banks, Making Online Deals
Women are increasingly making online connections with men willing to donate sperm for free, skirting the expensive option of using a sperm bank with all its regulations, tests, and verifications. (ABC News)


  

Here are three news stories of interest relating to the fertility industry:

The government of India proposes womb banks to legalize surrogacy.

Women using ARTS who are overweight have a sharply increased miscarriage rate

Donor conception: An increasing number of men offer their sperm (and/or bodies) online for insemination, skirting regulation