A woman was recently the first in the United States to give birth after receiving a uterus transplant.
As part of a clinical trial at the Baylor University Medical Center, a total of eight women have had transplants. The trial has been designed to investigate fertility options for women who don’t have a functioning uterus.
This irreversible condition, where a woman’s uterus is non existent or not functioning, is called absolute uterine infertility (AUI). It’s believed to affect about 5% of women worldwide.
The weight, gender and birth date of the baby have not been disclosed, with the parents asking for their privacy to be respected. A 36-year-old nurse donated the transplanted uterus.
According to a TIME magazine exclusive, eight women received transplants in the trial. Four transplants failed due to poor blood flow, two women are currently trying to conceive, and one woman is pregnant.
Most of the women in the trial have a condition called Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome.
In the United States, approximately 75,000 women are affected by MRKH. It is a congenital disease where women have functioning ovaries but are without a functioning uterus, cervix, and upper vaginal canal.
Until now, these women have been told they would never be able to fall pregnant or give birth to a baby. However, this new clinical trial holds hope for many women with AUI and MRKH.
Facts About Uterus Transplants
While this is the first baby to be born in the US after a uterus transplant, it is not the first baby in the world.
In 2014, a 36-year-old woman gave birth to the world’s first baby after a uterine transplant in Sweden.
In the three years since, a total of eight babies have been born in Sweden, following successful uterus transplants.
The first attempt to transplant a uterus from a living donor occurred in 2000 in Saudi Arabia. The uterus was removed not long after the surgery.
A decade later, in Turkey, a uterine transplant resulted in several pregnancies, followed by miscarriage.
How Does Uterine Transplant Work?
The uterine transplant trial at Baylor involved several steps. The women selected to be involved in the trial were healthy, were aged between 20 and 35 years, and had working ovaries.
They were given hormone treatments to make their ovaries release multiple eggs, which were then harvested, fertilised and frozen.
When the uterus and cervix transplant is performed, the women must take immuno-suppressant drugs to ensure the donated organs aren’t rejected.
Once the women have recovered from surgery and begun menstruating, about a month after the transplant, the frozen embryos can be transferred.
The Swedish team waited for a year before moving to embryo transfer. The US team decided to reduce the waiting time, proceeding a few months after surgery, when menstruation had begun.
The transplant isn’t permanent and the organs are removed after the first or second pregnancies.
Is Uterus Transplant Risky?
Transplants are performed around the world every day but uterus transplants represent a new frontier.
A donated uterus can be from a deceased person or a living donor. Living donors must undergo an operation, which takes up to five hours and removes more tissue than a standard hysterectomy. This is followed by a 3-month recovery period.
The uterus transplant also takes up to five hours and the recipient faces surgical risks. If the embryo transfer is successful, the resulting pregnancy is also considered high risk.
High risk pregnancy requires special care, which involves tests and procedures to check on the ongoing health of mother and baby. Babies are born via c-section, as a normal labour is considered too much of a strain on the transplanted uterus.
All the births which have occurred after uterine transplant have been premature – occurring between 32 and 36 weeks.
The anti-rejection drugs have long term health risks, which means women cannot continue to take them for extended periods. This means the transplanted uterus must be removed after one or two successful pregnancies; this poses further surgical risks.
The cost of the transplant is estimated to be up to USD$500,000. As with other fertility procedures, it’s rare for insurance companies to cover the transplant procedure, and very few women will be able to afford this option.