A 36-year-old Swedish woman has become the first in the world to give birth from a transplanted womb, after delivering a healthy baby boy weighing 1775g (3.9lbs) in September, 2014.
The unidentified woman, who has a genetic condition that means she was born without a womb, was one of nine Swedish women who received a uterus transplant from a live donor in 2013. The transplanted womb was donated by a 61-year-old family friend, who had gone through the menopause 7 years before the surgery.
The recipient, who had intact ovaries, was able to produce eggs that were fertilised using IVF prior to the transplant, and 11 embryos were cryopreserved (frozen). One year after her womb transplant, researchers led by Mats Brännström, Professor of Obstetrics and Gynaecology at the University of Gothenburg, transferred a single embryo to the new womb, which resulted in a positive pregnancy test 3 weeks later.
Foetal growth and blood flows through the uterine arteries and umbilical cord were normal throughout the first 31 weeks of pregnancy. “We found only one episode of mild rejection during the pregnancy that was successfully treated with corticosteroids, and the woman was working full time until the day before delivery”, says Professor Brännström.
At 31 weeks, the woman was admitted to hospital with preeclampsia and 16 hours later a caesarean section was performed due to an abnormal fetal heart rate (on cardiotocography). A healthy boy was delivered with a normal birthweight for gestational age (1775g) and with Apgar scores of 9, 9, and 10 (Apgar is a system for determining a newborn's health at 1, 5 and 10 minutes after birth, using a scale of zero to 10, with 9-10 being fully normal).
The mother was discharged from hospital after 3 days, and the baby was discharged from the neonatal unit in good health 10 days after delivery. Both continue to do well.
According to Professor Brännström, “Our success is based on more than 10 years of intensive animal research and surgical training by our team and opens up the possibility of treating many young females worldwide that suffer from uterine infertility. What is more, we have demonstrated the feasibility of live-donor uterus transplantation, even from a postmenopausal donor.”
In the UK alone, it is estimated that more than 12 000 women of fertile age have uterine factor infertility. This can be due to the woman being born without a uterus (Mayer-Rokitansky-Küster Hauser syndrome), having undergone a life-saving hysterectomy because of cervical cancer or obstetric bleeding, or having a uterus which is not functional because of congenital malformation or intrauterine adhesions.