People can be so insanely desperate to have children exactly in some arbitrary and specific way.
I mean, this woman went through a very dangerous and expensive transplant surgery that then required the use of immunosuppressant drugs to prevent organ rejection, when she could have used a surrogate or, gasp, adopted.
I hope they had to pay for this surgery with their own cash. There is absolutely no medical necessity behind it.
Edit: This comment seems to be eliciting some disapproval. I'm curious why; please let me know what you're thinking.
You're attacking people for their inherent wish to be 'normal' and just have a kid like every other couple on this planet.
If we throw out the 'insane' label, I'd rather apply that to your position here. There's nothing wrong with adoption, but it's not the same thing (and usually not the first choice). I cannot even begin to imagine what you're complaining about here and why you consider that attitude worth sharing.
>I cannot even begin to imagine what you're complaining about here
It seems pretty simple to me: it's stupid to waste hundreds of thousands of dollars (at least) to satisfy "their inherent wish to be 'normal'".
>and just have a kid like every other couple on this planet.
There are many couples who don't have any kids. This doesn't mean it's not OK to want to have children if you can't; it just demonstrates that it's probably pretty silly to waste a ton of (public?) money and risk your life just for the sake of having children, particularly when you can acquire them in other ways.
>It seems pretty simple to me: it's stupid to waste hundreds of thousands of dollars (at least) to satisfy "their inherent wish to be 'normal'".
I have two issues with your attitude.
1) The 'waste' here is money spent on scientific progress. The most expensive part is probably caused by the leading word in the headline: 'First'. It's probably a safe bet that this will become cheaper with time.
2) You're again calling these people (I assume you target both the couple and the people that made this possible?) stupid because .. you seem to feel different?
>There are many couples who don't have any kids.
Those are obviously not related/not the couples I was referring to.
>This doesn't mean it's not OK to want to have children if you can't; it just demonstrates that it's probably pretty silly to waste a ton of (public?) money and risk your life just for the sake of having children, particularly when you can acquire them in other ways.
That just shows that you're talking about things you aren't familiar with (no offense: I used to be there right with you). Let's just ignore the part where you call others silly again or the part where you judge for others what is worth risking your very own health/body/life for: Getting kids 'one way or another' is not the same thing. It's not like a random gadget and whether you're soldering it at home or order it from Alibaba is really just the same (and .. people _will_ probably disagree with even that statement, deeply caring about some perceived difference in that case).
The mother in this case was able to carry a baby inside of her body for 32 weeks. I (father of two) cannot begin to imagine what that means to a woman and by your comments you're even further away from understanding any of this.
I guess it's fine if you "don't get it". But it seems you attack that report without any clue on that matter AND you seem to imply that this is a stupid thing in general, for everyone. That's the most arrogant thing I've read on this site for a while.
This comment seems to be eliciting some disapproval. I'm curious why; please let me know what you're thinking.
I expect due to the implied tone. I agree with the general sentiment: there are much easier ways to get a kid, adoption arguably has more positive social impact, so why did they go with this route? But the way you phrase it, it seems rather like an attack that does not leave much room open for discussion.
I am reminded of discussions I had with people about the article "War in the Womb" about what babies do to the mom. Both here on HN (https://news.ycombinator.com/item?id=8155574) and elsewhere, I talked a bit with people about how the cells left behind by the baby might impact my genetic disorder.
There is an awful lot we do not know about what motivates people to want a particular thing. Coping with my genetic disorder has been a long strange journey and has made me aware of a lot of weird potential explanations for why people sometimes go to crazy lengths for something.
We can never know what the path not taken would have led to for this woman. We can never know how her life would have turned out had she simply adopted instead or used a surrogate. We can do studies and we can talk about statistical correlation and so on, but there will never the chance to A/B test this for this specific individual. Maybe she did what was best for her, even if some total stranger on the Internet doesn't approve.
You're saying that the specific manner of giving birth to a child you carry in a womb in your own body over 9 months that is of your own genetic makeup is "arbitrary," despite the fact that this is the exclusive mechanism of human procreation up until recent history.
Yes. If you're asserting that "giving birth to a child you carry in a womb in your own body over 9 months" is somehow inherently preferable or special compared to any other form of child rearing, your argument that "this is the exclusive mechanism of human procreation up until recent history" is an argumentum ad antiquitatem and/or argumentum ad naturam fallacy.
I am not making the argument that natural childbirth is a superior form of childbirth, nor ought it be preferred in all cases because it is the way things work normally.
I am making the argument that saying that that particular form of procreation is 'arbitrary' is ridiculous. It's clearly not arbitrary: it is the way healthy, normal humans have children, and is the form of childbirth that was selected by evolution. That may or may not mean that it should be preferred by couples (though in reality, it certainly seems to be) but that's a far cry from saying there is nothing particularly unique about it.
Of course, by assuming it is an arbitrary form of childbirth, which it's not, you fall into the trap of claiming that it should not be given undue weight for couples looking to have children. I'd argue that the burden of proof is on you to show this to be the case, since after all, you are (most likely) living, breathing proof of the multi-generational long term effectiveness of this method.
edit: Also, as an aside, your citation of an appeal to nature logical fallacy is only relevant if the argument being made is that something is inherently good because it is natural, full stop. When it comes to something like procreation, you can clearly make the argument that humanity itself is an existence proof of the effectiveness of that natural mechanism, therefore for that particular case (or really, any case where evolutionary pressure has resulted in a objectively effective solution to a problem) that logical fallacy does not seem to apply.
A meta observation: naming someone's logical fallacies seems to be positively correlated with being wrong and/or arrogant, and generally tends to derail discussions quickly.
The failure mode Eliezer used to write about[0] seems to be true - in many, learning about logical fallacies tends to induce dysrationalia. Instead thinking about what other side says, one can just pattern-match anything they disagree with to a fallacy and cry foul.
> Way to slam me without really addressing anything I said. You managed to say I was wrong and attack my character in one fell swoop!
I was trying to make a meta-point; I used your comment as an anchor. After re-reading my post I realize it might come off condescending and personal, I sincerely apologize. I stand by my meta-point though, i.e. most of the comments I see that enumerate logical fallacies are written as a way to implicitly attack the other commenter (I admit that my previous comment did exactly this to you), and are also often wrong.
As for addressing what you said: my belief is that the argumentum ad naturam here is justified given how the "natural" child bearing and birth processes are strongly tied to body chemistry, as well as being important in our culture since forever. It's not inherently special in an ontological way, but we are hard-wired to prefer it.
> Is there anything wrong with this? People should probably try not to argue anything that is obviously a fallacy.
Yes, because a/ just because something is a logical fallacy, doesn't mean it's wrong (see: fallacy fallacy, aka. argumentum ad logicam) and b/ you can pattern-match anything to some fallacy if you try hard enough, which people often do (one common failure mode is forgetting that all fallacies are defined with additional conditions that must be met; if those conditions are not satisfied, then the very same sentence becomes a perfectly valid argument).
> It's not inherently special in an ontological way, but we are hard-wired to prefer it.
I agree with you. However, being hard-wired for something doesn't make it right. One might argue humans are hard-wired for war, rape, etc.
>Yes, because a/ just because something is a logical fallacy, doesn't mean it's wrong (see: fallacy fallacy, aka. argumentum ad logicam)
An argument being a fallacy does mean it's wrong. However, it doesn't mean the conclusion is wrong. The fallacy fallacy is as follows:
A proves B → B (this is true)
¬(A proves B) → ¬B (this is the fallacy)
All the fallacy fallacy says is that "Just because an argument is fallacious doesn't mean that its conclusion is wrong".
It may well be true that "natural" births are better for some reason. I was simply saying that gfodor's explanation for why this might be the case is wrong.
I would suggest considering that rationality is not how people work and that it's easy for professing surprise when people don't happen to be rational to come off as a lil' bit douchey.
The counterargument is of course that transplants and immunosuppressant drugs are also artificial, and even more recent. Also, adoption has always been possible. I guess the main point is that it feels closest to the natural method.
And essentially all adoption in Sweden is international - only about 100 adoption cases a year involve Swedish births. Foreign adoptions are troublesome enough to make a womb transplant look like a reasonable alternative. Now you know why this would happen in Sweden.
So since you're curious, wyager, it seems a little hand-wavy to say "she could have used a surrogate or, gasp, adopted." Combining sarcasm and hand-waving makes for poor commentary.
I went and checked the statistics. The were 586 domestic adoptions in Sweden in 2014, slightly more than the 546 international adoptions. I assume most of the domestic adoptions are to people who were already close to the child, such as relatives or a parents new partner. In fact 61% were above 18 years old.
Medical necessity is determined by the needs of the patient, which can be physical or psychological. That's really a standard view in medicine, and thus justifies insurance payments for any required procedures. Examples would be gender reassignment, or plastic surgery.
> Examples would be gender reassignment, or plastic surgery.
Almost nowhere (as far as I'm aware) offers taxpayer-funded plastic surgery, except perhaps in cases of extreme congenital deformation.
I don't think the case presented here is comparable. Many people are sterile, and it doesn't tend to have a cripplingly negative impact on their lives.
I would phrase that as "having children of their own is goal number one for [all adaptively-fit lifeforms that undergo sexual selection pressure]." The genes of all plants and animals alive today came from the subset of their species that wished to procreate.
Or, to put it another way, among gene sequences that attain fixation through sexual selection pressure, any sequence that impels procreation as a terminal goal is going to be fixated more quickly than any other.
What I don't understand is the medical effort to do this in a world overrun with humans. It seems to be that we could be making better use of our time.
So tell me, are you American? Do you have a car? Do you eat everyday? Are you gainfully employed? Do you have any savings?
Surely you should be concerned about starving people in Africa or something instead of, say, wasting time on Hacker News?
We all put our time and effort into things that make sense for us. You are free to invest your time, money and effort in those things that matter to you. This mattered to them.
The amazing part here is that the immune system is very much involved in the early parts of the pregnancy. Successful "implantation" of an embryo in a transplanted womb with an immune-suppressed host is no mean feat...
I don't understand why the successful implantation of the embryo is amazing.
Many women take immunossupressants while pregnant, and many undergo IVF to give birth, some of which to allogeneic embryos (egg donations). This last one doesn't seem to affect significantly implantation, with the main concern being a higher risk of pregnancy hypertension[1]. I expect conceiving with an allogeneic uterus would be similar, since in both the genetic differences between embryo and uterus are comparable.
Succeeding in combining the two is just a matter of probability, which I don't think is that low. Especially if you consider that the uterus had to come from a compatible donor, so the number of HLA mismatches will be lower.
Genes of the baby are 100% determined by the fertilized egg. The genes will be from whoever donated the egg. This is usually the mother in practice, but since you need to do In-Vitro Fertilization anyways, there's no fundamental reason it couldn't be someone who is genetically unrelated to either the mom or womb-donor.
Note that genetics are not 100% in control, and the conditions of the pregnancy affect the outcome of the pregnancy. We don't know the full effects of this, and we certainly don't know which aspects of it are from the womb specifically vs other biological aspects of the mother (e.g. blood chemistry). Health of the mother certainly has correlations with birth weight and developmental progress, but the extent & mechanisms are still pretty opaque.
Edit: usually. As for nuclear DNA, keep in mind all of the weird crossover failures that are rather common in a large population. These typically result in gene dosing problems and can lead to fetus inviability.
Then consider the epigenome, selected immune recognition, and microbiome. These can be/are environmental.
50/50 is the textbook story we teach before undergrad. It's easier to learn and still conveys the central idea of the model.
The only thing that made me weary here was having a baby on immunosuppressants, and the danger that could present for the fetus. Anyone knows if this can affect the baby on the long term (associated with premature birth)?
During pregnancy the mother was on a triple immunosuppressant regimen: azathioprine, tacrolimus, and prednisolone (corticosteroid). The first is a Pregnancy Class D drug (some reports of human birth defects), and the two are class C (birth defects only in animal studies)
A study on azathioprine use in early pregnancy found an increased risk of congenital malformations which wasn't statistically significant (from 4.7% to 6.2%) , and an association with preterm birth and low-weight[1].
But a later meta-analysis concluded only the increased risk of preterm birth was significant for this class of drugs[2]
It's mentioned in the article that the mother developed pre-eclampsia (simply put, hypertension during pregnancy, which can lead to eclampsia, with seizures and coma). This should also be a concern for the other women in the study[3]:
Firstly, immunosuppressants might increase pre-eclampsia, since the risk is about double in women with a kidney transplant (22%).
Also, the age of the donated uterus should be considered: the risk increases seven-fold for pregnancies after 50, though it hasn't been shown the problem is in the uterus itself.
Finally, the risk is higher for IVF conception.
Given this accumulation of risk, I'm curious how the other pregnancies carry on.To understand what's at risk, being born preterm is associated with increased morbidity and mortality, as well as lower achievement in general. Some papers point towards epigenetic changes (DNA methylation) as the etiology.
> The drugs used to prevent the womb being rejected would
> be damaging in the long term - so the couple will either
> try again or have the womb removed.
In the US the word "womb" has a vaguely archaic or religious feel, but it seems to be much more current in UK English (and the link here is to the BBC). I've seen "womb" used regularly on UK sites. US-based news feeds (that I've seen) have indeed generally used the term "uterus transplant" about this story.
That's the other way around. Thomas Beatie was assigned female at birth. The GP is talking about someone assigned male at birth, I'm pretty sure. That's what 'm2w' or 'mtf' generally means.
I mean, this woman went through a very dangerous and expensive transplant surgery that then required the use of immunosuppressant drugs to prevent organ rejection, when she could have used a surrogate or, gasp, adopted.
I hope they had to pay for this surgery with their own cash. There is absolutely no medical necessity behind it.
Edit: This comment seems to be eliciting some disapproval. I'm curious why; please let me know what you're thinking.