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India’s first uterus transplant carried out at Pune hospital
Namrata Devikar | Thursday, 18 May 2017 AT 11:57 PM IST
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PUNE: India’s first uterine transplant was carried out at the Pune-based Galaxy Care Hospital on Thursday. The procedure on the 21-year-old woman, who will be the recipient of a live uterus, started on Thursday at around 12 noon and by late evening, the organ had been retrieved from the donor.

The procedure is expected to go on till late night and further updates will be available on Friday morning. A team of 12 doctors is performing this complicated operation. Another uterine transplant will take place this month at the same hospital.

The transplant may cost up to Rs 25 lakh including the surgery and post-surgery treatment. The patient who was operated on on Thursday does not have a uterus while the other one has Asherman’s Syndrome. Most patients with Asherman’s Syndrome have scanty or absent periods leading to infertility. The donors for these patients are their own mothers and the hospital management has announced that they will perform womb transplant procedure on first three patients free of cost. Dr Shailesh Puntambekar, a key surgeon in this transplant, said in the previous cases of uterine transplant in other countries, the recipient’s body rejected the uterus from the cadaver. “However, trials in Sweden has been successful due to a live donor,” said Dr Puntambekar.

POST SURGERY CARE
Dr Puntambekar noted that after the surgery, the patient will be in the Intensive Care Unit (ICU) for two days and will be monitored continuously for three weeks. “The recipients will be monitored by clinical examination twice weekly during the first month, once weekly during two to three months and thereafter every other week. The recipient will also be on a immuno-suppressive therapy after the transplant to make the body less likely to reject a transplanted organ. The woman can then conceive a child through IVF. After the child turns one, the transplanted uterus will be removed to avoid further complications,” said Dr Puntambekar.

He said the uterus has to be removed after two pregnancies to avoid complications.

WHO ARE THE CANDIDATES FOR UTERINE TRANSPLANT?
- In India, the overall prevalence of infertility is between 3.9 per cent and 16.8 per cent.
- Among the reasons for infertility, the uterine factor is the cause in 20 per cent of the cases. The uterine factor can be due to:
- MRKH syndrome type 1 (congenital absence of uterus) prevalence 1 in 4,500
- Uterine malformations type I and VII
- Genital Tuberculosis: 18 per cent
- Ashermann’s Syndrome
- Patients with surgical removal of the uterus for cancers and who are long-term survivors.

‘Womb transplants debatable’
PUNE: The first uterine transplant in the country which happened on Thursday has been a technological breakthrough for medical sciences in the country.

However, it has also raised a lot of questions surrounding a woman’s choice of giving birth and the glorification of childbirth. City-based activists and lawyers feel that though deciding to give birth is a woman’s right, however, the choice may not be entirely her’s in this case.

Noted women’s activist Kiran Moghe asked why should a woman undergo a surgery when she can adopt or choose surrogacy.

“The transplant involves a lot of risks and the only person who suffers throughout the treatment - not just physically but mentally too - is the woman,” said Moghe.

“However, she already has the choice of adopting a child or getting a child through surrogacy. By such transplants, the idea of caste, class and religious identity is carried forward. By adoption, one tends to break it,” said Moghe.

City-based lawyer Asim Sarode echoed similar views by stating that the woman should be a part of the decision making.

“The woman should have an informed consent or educated consent to make sure that she is taking a decision after knowing the side effects of such a medical advancement. In most cases, in India, we witness that women are subjected to injustices and torture for infertility,” said Sarode.

He also mentioned that a woman can take a decision independently only if she is financially independent.

Activist Varsha Deshpande also said that the government should make sure that in the future, when such transplants come up, the woman takes a decision without any societal pressure.

“Wanting a child is a human nature. However, the risk involved in that should be properly understood by the woman. Hence, I think that the technological advancement is most welcome but the implementation of this should be monitored by the government authorities so that no woman faces injustice in the process of becoming a mother,” said Deshpande.
 
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