"From Machon Puah"

Uterine Transplants - A Historical View

We saw last week the recent report from Sweden of two cases of mothers donating their uterus to their daughters, and the medical procedure during which the uterus was removed from the donor and transplanted in the body of the recipient.
While this is a new procedure the halachic literature contains a discussion of such a case which was due to the misunderstanding of a medical procedure. In 1906, an American gynecologist, Dr. Robert Tuttle Morris, reported a case in which he had transplanted the ovary from one woman to another. We discussed this case in previous articles that dealt with ovarian transplants. Morris’s report also created a stir among the medical community worldwide in his day, and has later been refuted although not conclusively and there are several suggestions that explain what he observed which are still discussed today. While it is accepted that Morris was not a charlatan and an outright liar, it is widely thought that he was mistaken in his observation and his report was about a century premature.
But what exactly happened in Dr. Morris’s clinic is irrelevant for our discussion. What is important was a short piece published in a Hungarian halachic journal called VaYelaket Yosef. Hearing of this new procedure the editor, Rabbi Yaakov Gordon, raised a few questions based on this new technology that sparked a number of responses. He wrote that a doctor in London had transplanted a woman’s reproductive organs, and is this permitted from a mother to a daughter? Who is the mother of any child born, the donor or the recipient? Would the child be considered a firstborn?
Rabbi Gordon was mistaken in writing that the procedure was performed in London, but several of the Rabbis who responded made another mistake. They understood that the doctor had transplanted the uterus and not the ovaries, and they based their answers on their mistaken understanding. Therefore it is their mistake which will help us understand this new procedure that can currently be performed, namely uterine transplantation.
There is a fascinating passage of Gemara (Chulin 70a) which discusses the case in which the uteri of two animals are joined. An unborn animal transports from one uterus to the other and is born. The Gemara asks whether the offspring would be considered the first born of either of these animals and leaves the question unanswered, but the case seems to be very similar to the case of uterine transplants where instead of the child moving from one uterus to the other, the uterus itself moves from one location to another. So we see that our Sages already discussed similar concepts millennia ago. - More on this next week.

Rabbi Gideon Weitzman

The Puah Institute is based in Jerusalem and helps couples from all over the world who are experiencing fertility problems. Puah offers free counseling in five languages, halachic supervision, and educational programs. Offices in Jerusalem, New York, Los Angeles and Paris. Contact: (02) 651-5050 (Isr). http://www.puahonline.org

• Other "From Machon Puah"
• What is a Miracle?
• Between Conception and Birth
• The Pregnancy in the Bathtub