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First Baby Born after Transplantation of Uterus

October 16, 2014
By Dr. Randall Loy

The world’s first baby has been born after transplantation of a uterus. This remarkable research, carried out at Sweden’s University of Gothenburg, was reported on October 5, 2014 in the British journalLancet and was headed by Mats Brännström, M.D., Ph.D.  Until this report, eleven human uterus transplantation (UTx) attempts had been performed worldwide but none resulting in live births. This uterine transplantation research began in 1999 and involved animal studies. In rodent models, the Gothenburg team studied rejection patterns of the uterine graft, immunosuppression to avoid graft rejection as well as pregnancies and live-born offspring after UTx.

Nine women in the human study have received a uterus from living donors, mostly from close family members and friends. In two cases, the UTx was removed, one for an infection and the second for blood clots in the transplanted uterine vessels. Of the remaining seven, all have had menstrual function and have been attempting pregnancies via IVF using their own embryos. This extraordinary surgery is the first available treatment for absolute uterine infertility caused by either congenital absence of the uterus or the presence of a non-functional uterus.

In 2013, a 35-year-old woman with congenital absence of the uterus (Rokitansky syndrome) underwent UTx with a uterus was donated by a living, 61-year-old woman. The recipient and the donor had essentially uneventful postoperative courses. The recipient's first menstruation occurred 43 days after transplantation and she continued to have regular menstrual cycles.  In vitro fertilization treatment of the recipient and her partner had been done before UTx and 11 embryos had been cryopreserved.

The recipient underwent her first single embryo transfer one year after UTx, which resulted in pregnancy. She was then given immunosuppression using three different medications which were continued throughout pregnancy. Early pregnancy was confirmed in the spring of this year and the patient delivered via caesarean section at almost 32 weeks of gestation due to preeclampsia and fetal stress. A baby boy with normal birth weight for gestational age (3lbs 15 oz) was born. “The mother and child are both doing well and have returned home. The new parents are, of course, very happy and thankful,”  Dr. Brännström stated.

This report is a major step forward in UTx can be a treatment for uterine factor infertility. In addition, the study demonstrates the feasibility of live uterus donation, even from a 61 year old donor!

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