Turkish donor womb recipient becomes pregnant

One of the first women to receive a womb or uterine transplant is pregnant, the treating hospital has disclosed. A spokesperson said that early test results were 'consistent' with signs of pregnancy.

Derya Sert, a Turkish women who was born without a uterus, received a womb transplant from a deceased donor in 2011. She became pregnant following IVF using her own eggs obtained and stored before the operation, which was performed at Akdeniz University Hospital in Antalya, Turkey.

Doctors waited 18 months before implanting reportedly at least one embryo fertilised using her husband's sperm. A statement from her doctor, Mustafa Ünal, said she was 'doing fine'. If the pregnancy continues successfully, the doctors propose to deliver the child by Caesarean section before removing the donor womb to avoid further complications.

Ms Sert was the first woman to receive a womb from a deceased donor, but was not the first to undergo womb transplantation. In 2000, a woman in Saudi Arabia received a womb from a live donor, which had to be removed after 99 days when a clot developed due to poor blood flow. Although it appears Ms Sert's donated womb is functioning correctly to date, no child has yet been born following a womb transplant.

Only a very small number of women have received womb transplants, with two women in Sweden receiving a womb donated by their mothers in 2012 (reported in BioNews 674), and a further two receiving wombs from live donors that year.

A charity to raise money for research into womb transplantation, Uterine Transplantation UK, was set up by a team of UK surgeons in July last year (reported in BioNews 665). It estimates that around 15,000 women in the UK of childbearing age have no womb, known as absolute infertility, either because they were born without one or it had to be removed. For these women, womb transplantation means they can avoid the need for adoption or surrogacy.

Uterine Transplantation UK aims to perform five womb transplants in the UK in 2014. Dr Srdjan Saso of Uterine Transplantation UK says six transplants are planned for 2013, with teams in the UK and USA waiting for the go-ahead. The Swedish team has also been granted ethical approval for ten more transplants.

Womb transplantation raises ethical and safety concerns yet to be fully explored in clinical trials. Professor Charles Kingsland, spokesman for the Royal College of Obstetricians and Gynaecologists, said last year: 'Significant concerns need to be addressed to everybody's satisfaction before we go ahead and offer this as a viable option'.

Recipients of donated wombs must take immunosuppressant drugs to reduce the risk of the body rejecting the donated organ that would be required for the duration of the pregnancy. Arthur Caplan, professor of bioethics at NYU Langone Medical Center, USA said the effects of those drugs and the risks to the developing embryo are unknown. 'I'm not convinced they have done this enough in animals to merit going to human trials yet', he was quoted in Take Part as saying last year.

However, Uterine Transplantation UK says on its website that over 15,000 births have taken place from women taking immunosuppressant drugs for other transplanted organs and that the 'evidence supports the safety of various immunosuppressive regimens'.