A team of doctors in Brazil have announced a medical first that could someday help countless women unable to have children because of a damaged or absent uterus. She gave birth to a baby girl on December 15, 2017, by caesarean section. The transplanted uterus was removed during the caesarean section and showed no anomalies.
The mother, a 32-year-old woman, was born without a uterus due to Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, a condition affecting one in 4,500 women. Seven months after the surgery, an embryo was implanted and her pregnancy was confirmed.
Previously, there have been 10 other uterus transplants from dead donors attempted in the United States, Czech Republic and Turkey, but this is the first to result in a live birth.
It is hoped that this, the first ever uterine transplant involving a deceased donor and the first uterine transplantation in Latin America, could enable more women struggling with fertility issues to undergo treatment without having to wait for a live donor.
"The Brazilian group has proven that using deceased donors is a viable option", said the clinic's Dr. Tommaso Falcone, who was involved in the OH case. Most transplant teams envision one day using uteruses from both living and deceased donors.
It was then transplanted to the woman who was given medication to weaken her immune system so her body would not reject the uterus.
Four years ago, a 36-year-old Swedish woman also successfully delivered a healthy child using IVF via a womb provided by an unrelated benefactor.
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"They should promote education and guidance so that the groups performing uterus transplantation for the first time can benefit from the experience of the pioneers".
"I think the women involved obviously have to have careful counselling about whether or not that's something they'd be willing to take on, that kind of risk", she said.
In a transplant surgery that lasted more than ten hours, doctors had to connect the donor's uterus with the veins, arteries, ligaments, and vaginal canal of the recipient.
But there are far more women in need of transplants than there are potential live donors, so doctors wanted to find out if the procedure could work using the uterus of a woman who had died.
The uterus transplant, in this case, happened in September 2016.
There is still so much testing to be done, and researchers say there is so much important information to be learned from the procedure. "It is also a source of hope for those patients who [do not have a uterus] or who have lost it unexpectedly and do not have a family member or close friend to donate the uterus". Falcone said the fact that the transplant was successful after the uterus was preserved in ice for almost eight hours demonstrated how resilient the uterus is.
Two months later eight fertilised eggs were implanted into the womb.
These are still early days for uterine transplants, says Kate O'Neill, co-lead investigator for the University of Pennsylvania's uterus transplant program, who was not part of the work in Brazil. "It may give us a bigger supply of organs than we thought were possible".