In September 2014 the first baby conceived in a transplanted uterus was born. The mother, a Swedish citizen of 36 years, remains anonymous. This news brings hope to women born without a uterus, or who have undergone a hysterectomy due to a disease.
The medical magazine The Lancet, announced this birth that has revolutionized the world of gynaecology, obstetrics and medical transplants. The team who has achieved this birth is directed by Mats Brännström, a gynaecologist at the University of Gothenburg.
The mother is one of 9 women included in the experimental uterus transplant program held in 2013. In this case, the patient was born without a uterus due to a genetic alteration and received the uterus donation from a 61 years old woman, friend of the family, who was already in menopause.
The baby's mother had functional ovaries capable of producing eggs, but, due to a genetic alteration, had no uterus where the baby could nest and grow. Through a cycle of ovarian stimulation, the doctors managed to extract 11 eggs that were, subsequently, fertilized in the laboratory as in any IVF procedure. The embryos were then vitrified and preserved until the transfer could be made.
One year after the uterine transplantation, one single embryo was transferred and, three weeks later, and after the quantification of the beta hCG hormone, a pregnancy was confirmed. Brännström explained in a press release that the entire pregnancy occurred without incident until week 31, "We only had to deal with one rejection episode during pregnancy, which was treated with corticosteroids. The woman kept on working until the day of the birth."
Childbirth was scheduled for week 34 of pregnancy through a caesarean. However, the mother suffered from preeclampsia and due to her high pressure, the caesarean had to be done two weeks before the scheduled date. As was mentioned by the program's leader, the reason why the patient suffered from this medical complication of the pregnancy is unknown. This disorder is more common in women who have undergone an in vitro fertilization treatment and the fact the woman had only one kidney and was being administered immunosuppressive drugs in order not to reject the donated uterus, might have influenced the development of the preeclampsia.
The birth was by caesarean, and even though the baby's heart rhythm was abnormal, he was born without any complications. A typical premature baby of 32 weeks, the child weighted 1,775 kg and had 40 inches. The happy mother said "Mats told us that there were no guarantees, but my partner and I like to take risks and thought it was a perfect idea." The mother's blood pressure has gone back to normal after the preeclampsia but she’ll keep on doing the immunosuppressive treatment until the transplanted uterus is removed. The doctors say it is safe to attempt a second pregnancy, prior to removing the donated uterus.
Future of uterine transplant
The Gothenburg University explained to the press that this project begun in 1999 with the aim of making the dream of many women who are born without a uterus, or who had to remove it due to a cancer, come true. In 2013, 9 women received transplanted uterus, two of which had to be withdrawn, one due to an infection and the other due to problems related to the irrigation of the blood vessels. At this very moment, other women with a transplanted uterus are pregnant and the success of this first childbirth can be repeated.
A prestigious team of professionals from more than 10 different countries has been involved in the various transplantations.
Following the interventions of 2013, Mats Brännström stated that he could not talk about successful uterus transplantations until the first child was born. Now, celebrating the happy news, he clarifies this is not a routine treatment and will not be for several years, "we have to study the results of both the efficiency and the safety of the transplantations."
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