Making global headlines last week was news from the USA that a Cleveland fertility clinic had announced the birth of a baby following a uterus transplant from a deceased ‘donor’, the first such successful birth in North America.
According to the Cleveland Clinic press release, the transplant and birth are part of an ongoing clinical trial, “Uterine Transplantation for the treatment of Uterine Factor Infertility”. This trial aims to enrol 10 women aged 21-39 who were born without a uterus or have had their uterus removed, and is the only program in the USA to focus on uterus transplants from a deceased donor. The trial has so far completed 5 uterus transplant surgeries: “3 transplants were successful and 2 resulted in hysterectomies. Currently, 2 women are awaiting embryo transfers while several more candidates are listed for a transplant.”
The gushing press release and news coverage paint this as a medical miracle with the potential to transform lives. And while it should go without saying that women experiencing infertility deserve the opportunity to overcome medical conditions that might otherwise prevent them from having a baby, they also deserve better than to be mined as a resource by an industry predicted to be worth US$38 BILLION by 2026.
Take the Cleveland Clinic. Sounds intimate, right? You don’t immediately think of this news as coming from a health care giant with 66,000 employees, a 165-acre ‘campus’, 11 hospitals, 180+ global outpatient locations, and an annual US$8.4 billion revenue.
The health sector in the USA is not operated for the benefit of patients, many of whom end up in crippling debt or bankruptcy for seeking treatment for even minor conditions – and pregnant women are a reliable income stream. In the USA, the average cost of giving birth is $32,093, an average IVF cycle costs $12,000 (plus an additional $1500-3000 for medications). A uterus transplant costs an estimated $200,000 – more than many houses are worth in the US – but is not covered by insurance. If the possibility of having a baby was not motivation enough, surely the fact that hospitals performing uterus transplant trials cover the bottom line has potential to influence a woman’s decision to volunteer for experimental therapies.
The fertility industry (which also encompasses commercial surrogacy) wants us to believe that the work that they do is all for the benefit of families in heartbreaking situations. But don’t for a moment believe that there is anything altruistic about a vested interest in developing technologies which will underpin future market expansion. Women’s grief and loss is a lucrative opportunity which becomes commodified to justify using us as experiments or cash cows.
Lest this seem too cynical, consider the way that IVF statistics are twisted so that a failure rate of 65-90% is presented as a “success rate”, for example in this sales pitch from an Australian clinic:
Likewise, the Cleveland Clinic completely glosses over the fact that their uterus transplant procedure has so far seen a 40% failure rate (did they think we wouldn’t notice if they just relabelled transplant failure as ‘hysterectomy’?). What happens to the women whose procedure resulted in infection, or whose transplanted uterus fails to successfully carry a baby to term? What is the impact of the fertility treatments, anti-rejection drugs, and surgery on their health and wellbeing?
These and other risks – glossed over in marketing material and counselling – are significant or simply unknown. Lupron, the drug commonly used to assist in stimulating ovulation and egg harvesting (and which is also widely prescribed as a ‘puberty blocker‘ to gender dysphoric children) has had over 10,000 adverse event reports filed with the US FDA for conditions ranging from degenerative bone conditions, chronic pain, mood disorders, and seizures. Women prescribed Lupron as part of fertility treatment are not told about the online ‘Lupron Victims’ groups in which thousands of women are agitating for the drug to be taken off the market. Nor are they told that women who develop breast or ovarian cancer after IVF treatment typically have their cancer written off as linked to their infertility, rather than investigated as possibly attributable to the fertility treatment.
And all of this is a separate consideration to the way in which these pioneering surgeries are legitimising a trade in human organs for lifestyle reasons, not only fuelling the black market in body parts but resting on a long history of surgery and obstetrics built on grave robbery and live experimentation on black women and slaves. Of course this also is spun as positive by the Cleveland Clinic, who Really Care About Women. So much so, that their innovative program seeks to utilise the uteri of deceased women “in order to eliminate risk to a healthy, living donor” (at least they are willing to admit that removing the uterus from a healthy woman presents enough risk to justify seeking an alternative). Convenient for the Cleveland Clinic is that their new living-donor-friendly procedure also broadens the pool of available uteri by allowing them to harvest the body parts of dead
baby factories women too.
We all know someone who has suffered from infertility. We all have beloved children in our life who exist because of reproductive medicine. This is why we almost never discuss the dark side of the fertility industry as a predatory business which mines the grief of childless mothers under a facade of compassion and making dreams come true. We can’t, because any criticism of industry practices is quickly reframed as criticism of families who exist because of those practices. This is how the global fertility business model hides behind women and babies, using their lives and stories as a shield to deflect scrutiny of their barely regulated corporate greed.
If this all sounds a bit familiar, it’s because this is not the only multi-billion dollar industry masquerading as a benevolent friend to mothers, hiding predatory marketing tactics behind a veneer of choice, minimising the risk of their product and framing criticism of their practices as a judgmental wedge amongst women. I’m talking, of course, about the formula industry, whose product has now been indirectly (and in some tragic instances, directly) associated with the deaths of 800,000 infants and 20,000 women annually.
A friend of mine recently described the artificial feeding of entire generations of infants as “the largest uncontrolled randomised experiment inflicted on humans”; it’s not hyperbole to put assisted reproductive technologies up there too. Since 1978, there have been more than 8 million babies born from IVF alone, with each successful pregnancy representing an average of 2.7 IVF cycles (the UK NICE recommends a minimum of 3 cycles be offered to women under 40) and the accompanying cocktail of synthetic hormones and fertility drugs. Who is keeping track of long term health impacts of these procedures, including epigenetic factors, especially now that anti-rejection drug regimens are being introduced to the mix? Who is ensuring that safeguards are in place to prevent egg or uterus trafficking, particularly in countries with high levels of poverty and corruption? Who is protecting the rights of vulnerable women to adequate disclosure of risk and informed decision-making?
Women’s experience of grief and loss in infertility is real, and complicated. The desire to be or become a mother, and what it means to a woman to be pregnant or give birth, has many influences. No woman should ever be required to justify her desires to be (or not be) a mother. But regardless of why a woman wants to have a baby, she deserves better than to be used as an interchangeable incubator for the financial gain of others. Women are more than the sum of our reproductive parts, and our motherhood is so much more than the babies that can be made through us.