Scientists have reported the first successful birth of a baby from a transplanted uterus from a deceased donor. The breakthrough may open the way for many more women with infertility issues.
For some women receiving a uterus, transplant is the only way to get pregnant. However, until now, getting donations has been limited to donations from volunteers.
Low numbers of donated organs make procedure development slow
Donating a uterus is a serious decision and a complicated procedure. So far only 39 transplants have been conducted worldwide resulting in just 11 live births since 2013.
Being able to use the uterus from deceased patients opens up the possibility of more organs being available but in the ten attempts so far only this most recent birth has resulted in a successful birth.
Scientists from the University of San Paulo have published the case study of the successful transplant and birth in the journal The Lancet.
Transplant donor born without a uterus
The birth mother and donor-recipient was a 32-year-old woman who was born without a uterus as a result of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome.
The donor was a 42-year-old woman who died from a stroke.
Several months before the transplant the recipient went through an IVF procedure and had 8 fertilized eggs frozen. The uterus transplant took 10.5 hours to complete.
Healthy baby girl born without complications
The recipient showed no sign of organ rejection and after five months was even experiencing regular menstruation. Seven months after the intensive surgery, the fertilized eggs were implanted and a healthy pregnancy proceeded.
The baby girl was born early at 35 weeks via cesarean section, the healthy baby weighed in a 2.5 kg (5.5 lb). The donated uterus was also removed during the cesarean section.
Using deceased donors opens doors to more fertility treatment
In the months following the birth, neither the baby nor its mother has experienced any problems.
"The use of deceased donors could greatly broaden access to this treatment, and our results provide proof-of-concept for a new option for women with uterine infertility," says Dr. Dani Ejzenberg.
Dr. Ejzenberg ,Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, led the research.
"The first uterus transplants from live donors were a medical milestone, creating the possibility of childbirth for many infertile women with access to suitable donors and the needed medical facilities.
However, the need for a live donor is a major limitation as donors are rare, typically being willing and eligible family members or close friends.
The numbers of people willing and committed to donate organs upon their own deaths are far larger than those of live donors, offering a much wider potential donor population."
Doctors to continue research
While the doctors the thrilled with the results they warn the procedure is still in its in early stages and will require more research and collaboration before it becomes a widely spread option for infertile women.
"All in all, the research to be done in this field (whether from alive or deceased donors) should maximize the live birth rate, minimize the risks for the patients involved in the procedures (donor, recipient, and unborn child), and increase the availability of organs.
With the expansion of the field, the number of procedures will increase, and this will allow the community to set different types of study designs, such as comparison studies (ideally randomized) or long prospective series.
In an expanding field such as uterus transplantation, the role of collaborative networks and societies such as the International Society of Uterus Transplantation or new interest groups in already existing scientific societies will be crucial.”