The recent achievement of successful uterine transplant by Professor Brannstrom from Europe opens up a new excitement in the field of reproductive medicine. This new surgical technology gives hope to women with uterine factor infertility, to conceive. Currently, the European team had reported five babies born to mothers with transplanted uteruses
On February 25th, 2016, the Cleveland Clinic in United States, similarly reported its successful uterine transplant, using a uterus from deceased donor. However, the recipient developed complications within a week. This had led to removal of the transplanted uterus on March 8th. The preliminary report showed that the complication was due to infection that compromised the blood supply to the newly transplanted uterus. The US team is actively looking into improving the protocols to reduce the risk of this complication in the future.
The transplant medicine is not new – we have heard of kidney and liver transplant as common procedures. However, I was excited by the report of a successful pregnancy following a uterine (womb) transplant.
A uterine transplant is the surgical procedure whereby a healthy womb from a donor is transplanted to a recipient who was born without a womb or had womb removed in cancer surgery.
The uterus allow a normal reproduction process whereby the fertiled egg implant and grow into a fetus. This uterine transplant is a potential treatment for women with no uterus.
The first successful uterine transplant was performed in Turkey in 2011 for a women who had been born without the uterus. She managed to conceive in 2013 but had a miscarriage at 8 week gestation.
This success was followed by a more ambitious project undertaken by Professor Brannstrom and team at the University of Gothenburg, Sweden. The team performed uterine transplant on nine women. Only seven of them proceeded to embryo transfer following an IVF treatment. In 2014, they reported the first livebirth from a uterine transplant recipient, by caesarean section at 32 weeks. The baby weighed 1.7kg at birth.
The transplanted uterus is intended to be temporary and will be removed once successful pregnancies are completed. This is to avoid the need for long term immunosuppressant treatment. Immunosuppresant drugs are used in transplant medicine to avoiud graft rejection.
Currently this procedure remains experimental and is expensive. However, this successful pregnancy outcome is yet another major medical milestone in reproductive medicine.