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| Infertility affects 10 to 15 percent of couples |
In a medical first, a mother who received a uterus transplant from a dead donor gave birth to a healthy baby, researchers reported Wednesday.
The
breakthrough operation, performed in September 2016 in Sao Paulo, Brazil, shows
that such transplants are feasible and could help thousands of women unable to
have children due to uterine problems, according to a study published in The
Lancet.
The baby
girl was born in December 2017, the medical journal added.
Until
recently, the only options available to women with so-called uterine
infertility were adoption or the services of a surrogate mother.
The first
successful childbirth following uterine transplant from a living donor took
place in 2014 in Sweden, and there have been 10 others since then.
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.
Ten
attempts were made -- in the United States, the Czech Republic, and Turkey --
before the success reported Wednesday.
Infertility
affects 10 to 15 percent of couples.
Of this
group, one in 500 women have problems with their uterus -- due, for example, to
a malformation, hysterectomy, or infection -- that prevent them from becoming
pregnant and carrying a child to term.
"Our
results provide a proof-of-concept for a new option for women with uterine
infertility," said Dani Ejzenberg, a doctor at the teaching hospital of
the University of Sao Paulo.
He
described the procedure as a "medical milestone".
"The
number of people willing and committed to donate organs upon their own death
are far larger than those of live donors, offering a much wider potential donor
population," he said in a statement.
The
32-year-old recipient was born without a uterus as a result of a rare syndrome.
Four months
before the transplant, she had in-vitro fertilisation resulting in eight
fertilised eggs, which were preserved through freezing.
The donor
was a 45-year-old woman who died from a stroke.
Her uterus
was removed and transplanted in surgery that lasted more than ten hours.
Proof of
concept
The
surgical team had to connect the donor's uterus with the veins, arteries,
ligaments, and vaginal canal of the recipient.
To prevent
her body from rejecting the new organ, the woman was given five different
drugs, along with antimicrobials, anti-blood clotting treatments, and aspirin.
After five
months, the uterus showed no sign of rejection, ultrasound scans were normal,
and the woman was menstruating regularly.
The
fertilised eggs were implanted after seven months. Ten days later, doctors
delivered the good news: she was pregnant.
Besides a
minor kidney infection -- treated with antibiotics -- during the 32nd week, the
pregnancy was normal. After nearly 36 weeks a baby girl weighing 2.5 kilograms
(about six pounds) was delivered via caesarean section.
Mother and
baby left the hospital three days later.
The
transplanted uterus was removed during the C-section, allowing the woman to
stop taking the immunosuppressive drugs.
At age
seven months and 12 days -- when the manuscript reporting the findings was
submitted for publication -- the baby was breastfeeding and weighed 7.2
kilograms.
"We
must congratulate the authors," commented Dr. Srdjan Saso, an honorary
clinical lecturer in obstetrics and gynaecology at Imperial College London,
describing the findings as "extremely exciting".
Richard
Kennedy, president of the International Federation of Fertility Societies, also
welcomed the announcement but sounded a note of caution.
"Uterine
transplant is a novel technique and should be regarded as experimental,"
he said.
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