Womb transplants successful for nine women

Nine women have received transplants of uteruses donated by their
mothers or other living relatives in an ongoing trial of an experimental
procedure at the University of Gothenburg in Sweden.

The transplants began in September 2012 (reported in BioNews
674) and the women are said to be doing well. Some of
the women's uteruses have already showed signs of healthy functioning
and although some of the patients experienced minor rejection issues,
none required intensive care after surgery, the researchers said. The
hospital had initially planned to perform ten surgeries in total, but
one woman had to drop out for medical reasons.

The women, most of whom are in their 30s and were either born without
wombs or had them removed because of cancer, will soon attempt to
become pregnant via IVF. The surgery did not connect the
uteruses to the women's fallopian tubes, so the women will not be able
to conceive naturally. However, they do all have functioning ovaries and
their eggs were used to create embryos that were cryopreserved before
the operation.

Doctors have previously managed to achieve a pregnancy in previous
womb transplants, but no babies have yet been born following the
procedure. A Turkish woman became the first person to receive a womb
from a deceased donor in 2011 but her pregnancy was terminated after
eight weeks (reported in BioNews 705). Doctors had
waited 18 months before attempting implantation. In 2000, a woman in
Saudi Arabia received a uterus from a live donor but it had to be
removed after three months when a clot developed due to poor blood flow.

'This is a new kind of surgery', Dr Mats Brännström, who is leading the initiative at the University of Gothenburg, said in an interview. 'We have no textbook to look at'.

Dr Brännström and colleagues are
planning to run a workshop on the technique next month and to publish a
scientific report on their method soon.

A potentially controversial aspect of the Swedish trial is that the
transplanted wombs were from living donors. The researchers explain that
taking uteruses from living donors means they are generally in a better
condition and that using the patient's relatives as donors leads to a
better immunological match.

In contrast, plans to perform the surgery in the UK and in Turkey
would only use a uterus donated by dead or dying people to avoid putting
donors through major surgery.

'Mats [Brännström] has done something amazing and we understand
completely why he has taken this route, but we are wary of that
approach', said Dr Richard Smith, head of the charity Womb Transplant UK, which is trying to raise the funds to carry out the operation on five women in Britain.

Experts are now waiting to see whether the pregnancies will succeed.
Dr Smith said 'the principal concern for me is if the baby will get
enough nourishment from the placenta and if the blood flow is good
enough'.

According to Womb Transplant UK, around 15,000 women of child-bearing
age are born without a womb, and could potentially benefit from the
development of the technique.

Dr Yacoub Khalaf,
director of the Assisted Conception Unit at Guy's
Hospital, London, said 'what remains to be seen is whether this is a
viable option or if this is going to be confined to research and limited
experimentation'.