Womb transplant mother pregnant again

A Swedish woman who gave birth in 2014 following a womb transplant is pregnant with a second child.

The woman is one of nine patients without a functioning uterus who received a womb transplant as part of a clinical trial led by Professor Mats Brännström of the University of Gothenburg, Sweden. The wombs were donated by living donors, in most cases from the recipients' own mothers but also from friends and other relatives.

The trial has so far resulted in five births using embryos created by IVF. The participants are to be offered a chance of a second pregnancy six months after the first, but after that the uterus would then be removed (see BioNews 775).

The transplantation procedure isn't without risk, however. The procedure requires the recipient to take strong immunosuppressive drugs to stop the body's immune system from rejecting the donated womb, and two women had their transplanted wombs removed after complications involving an infection and thrombosis. In this case the donor, who was the woman's grandmother, the mother and first child are all healthy three years after transplantation procedure.

Announcing the news of the pregnancy at the annual meeting of the Royal College of Obstetricians and Gynaecologists (RCOG) in Birmingham, Professor Brännström said the future lies in attempting to grow a womb from a woman's own stem cells.

'The concept is: you create from stem cells of the recipient and transplant that into the recipient,' Professor Brännström said. 'You have a substitute for a damaged organ and keep it without immunosuppression.'

He added: 'We have started in a rat, and we have now published a paper where we have not been able to create a whole uterus but uterus-patches, bio-engineered. These may be the future, but we'll of course need a lot of research.'

Womb transplants offer an alternative to surrogacy or adoption for women affected by absolute uterine-factor infertility, or who have had to remove their womb due to disease such as cancer. Transplants are currently being planned in the UK using deceased donors, after Imperial College London received ethical approval last year to start a clinical trial involving ten patients (see BioNews 823).

Commenting on the news, Professor Richard Smith who is leading the UK's efforts to perform womb transplants, said: 'Absolute uterine infertility is a huge and growing problem affecting tens of thousands of women in this country – and the success of the Swedish team shows that at least some of these women will be able to bear their own child where before there was no hope.'

Professor Alan Cameron, RCOG's vice president of clinical quality, said: 'The RCOG congratulates the scientific advances made by Professor Mats Brannstrom and his team.'

He added: 'Uterine transplantation is still a very new and experimental procedure, which is currently only conducted through clinical trials.'