Woman without womb gives birth to boy in medical first

Bloomberg

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A woman born without a uterus because of a genetic condition has given birth to a healthy baby boy following a womb transplant, a medical first, according to the journal Lancet.
The 36-year-old Swedish woman received a donated uterus from a 61-year-old family friend, who had gone through menopause seven years earlier. The baby was conceived using eggs from the patient, whose ovaries were intact, through in-vitro fertilization using her partner’s sperm, according to the report. The infant boy was born healthy last month weighing 3.9 (1.8 kilograms) pounds.
The surgical team led by Mats Brannstrom, professor of obstetrics and gynecology at the University of Gothenburg, worked for more than a decade to develop the technique, combining animal research and surgical training. The mother was one of nine women in Sweden who received uterus transplants from live donors in 2013, according to the report.
The success “opens up the possibility of treating many young females worldwide that suffer from uterine infertility,” Brannstrom said in a statement from the journal. “What is more, we have demonstrated the feasibility of live-donor uterus transplantation, even from a post-menopausal donor.”
In the procedure, the doctors transferred a single embryo into the woman’s womb a year after the uterus transplant. Three weeks later a pregnancy test came back positive. The woman had three episodes of mild rejection of the uterus, including one during the pregnancy. They were successfully treated with steroids.
Caesarean section
She was admitted to the hospital 31 weeks into the pregnancy with preeclampsia, a complication marked by high blood pressure that can be fatal for the mother and infant. A caesarean section was performed because the baby’s heartbeat was high.
The mother was released from the hospital after three days, while the baby remained for 10. Both are healthy, the doctors said.
The approach holds promise for women with “absolute uterine infertility,” the only type of female infertility that is currently untreatable, the researchers said. Of the nine women who participated in the team’s research, seven began menstruation within three months and the donated organs remained viable. The other two were removed because of blood clots and severe infection.
‘Lifelong use’
The woman was born with Rokitansky syndrome, marked by an underdeveloped or missing uterus and vagina and only one kidney. She and her partner have 10 additional frozen embryos. Her uterus should be removed after two pregnancies at most, the researchers said in the report.
“Uterus transplantation is the first ephemeral type of transplantation that has been introduced in which the graft is not intended for lifelong use,” the researchers said. Removing the organ would reduce the long-term side effects from drugs the patient must take to prevent rejection.
Research on uterine transplants began after the first human hand was transplanted in 1998. The procedure broadened the idea of what a transplant could be, expanding to include the replacement of non-vital organs that could markedly improve a patient’s quality of life.

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