WORLD'S FIRST CHILD BORN AFTER UTERUS TRANSPLANTATION
In a ground-breaking
research project at the University of Gothenburg, seven Swedish women have had
embryos reintroduced after receiving wombs from living donors. Now the first
transplanted woman has delivered a baby -- a healthy and normally developed
boy. The world-unique birth was acknowledged in The Lancet on 5
October.
The uterus
transplantation research project at the University of Gothenburg started in
1999 and has been evaluated in over 40 scientific articles. The goal of the
Gothenburg project is to enable women who were born without a womb or who have
lost their wombs in cancer surgery to give birth to their own children.
Live donors
Nine women in the
project have received a womb from live donors -- in most cases the recipient's
mother but also other family members and close friends. The transplanted uterus
was removed in two cases, in one case due to a serious infection and in the other
due to blood clots in the transplanted blood vessels.
The seven remaining
women have in 2014 tried to become pregnant through a process where their own
embryos, produced through IVF, are reintroduced to the transplanted uterus.
First child from a
transplanted uterus
The first early
pregnancy was confirmed in the spring after a successful first pregnancy
attempt in a woman in her mid-30s, a little over a year after her
transplantation.
In early September,
the woman successfully delivered a baby by caesarean section, making her the
first woman in the world to deliver a child from a transplanted uterus. Her
uterus was donated by a 61-year-old unrelated woman.
The caesarean section
had to be performed earlier than planned: the woman developed preeclampsia in week
32 of her pregnancy and the CTG indicated that the baby was under stress. A
caesarean section was performed in accordance with normal clinical routines so
as not to risk the health of the mother and child.
Developing normally
According to Professor
Mats Brännström, who performed the caesarean section, the perfectly healthy
newborn boy is developing normally. The baby weighed 1,775 grams (3 lbs 14.6
oz) at birth, which is normal size considering the gestational age at delivery.
'The baby screamed
right away and has not required any other care than normal clinical observation
at the neonatal unit. The mother and child are both doing well and have
returned home. The new parents are of course very happy and thankful,' says
Professor Mats Brännström, who is leading the research project.
'The reason for the
woman's preeclampsia is unknown, but it may be due to her immunosuppressive
treatment combined with the fact that she is missing one kidney. The age of the
donated womb may also be a factor. Also, preeclampsia is generally more common
among women who have become pregnant through IVF treatment.'
Mild rejection
episodes
The woman has had
three mild rejection episodes since the transplant, one of which occurred
during the pregnancy. The rejection episodes, which are often seen also in
other types of transplants, could be stopped with immunosuppressive treatment.
Followed closely
The research team
followed the pregnancy closely, carefully monitoring the growth and development
of the foetus with a special focus on the blood supply to the uterus and
umbilical cord.
'There were concerns
that the blood supply may be compromised since we had reattached the blood
vessels to the womb. But we did not notice anything unusual concerning the
function of the uterus and the foetus, and the pregnancy followed all normal
curves,' says Brännström.
Major step
The successful
delivery is considered a major step forward.
'It gives us
scientific evidence that the concept of uterus transplantation can be used to
treat uterine factor infertility, which up to now has remained the last
untreatable form of female infertility. It also shows that transplants with a
live donor are possible, including if the donor is past menopause,' says
Brännström.
Several research teams
around the world have been awaiting the results of the Gothenburg study in
order to launch similar observational studies. The pregnancy attempts are
ongoing with the other six women in the project.
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