In what could prove to be a major advancement for couples facing infertility, the first baby born from a deceased donor uterus transplant was successfully completed at the University Of Sao Paulo School Of Medicine in Brazil, according to a report in the scientific journal Lancet.
But a viable procedure to transplant uteri from deceased women could drastically increase the availability of the organs. But donors are hard to find and the surgical procedure to remove the womb from a living person can be unsafe.
The healthy baby girl was delivered last December to a 32-year-old woman who wasn't born with a uterus.
Four months before the transplant, she had in-vitro fertilisation resulting in eight fertilised eggs, which were preserved through freezing. The donor was a 45-year-old woman who died of a stroke. Ten previous attempts using deceased donors in the Czech Republic, Turkey and the US have failed.
11 other births have resulted from living donors, including women who donated their uteruses to their daughters. But they said that relying on deceased donors could expand the options for women who do not have a friend or family member willing to donate or that would be a good match.
Dr. Richard Kennedy, President of the International Federation of Fertility Societies, who was not involved in the work, commented that the organization "welcomes this announcement, which is an anticipated evolution from live donors with clear advantages and the prospect of increasing supply for women with hitherto untreatable infertility". Though it's never been done before, Ejzenberg says "theoretically, it may be possible" to someday use such discarded organs for secondary transplants. Likewise, the mother's health required months of ongoing monitoring to ensure that she didn't suffer any adverse effects from having the uterus transplanted and then later removed.More news: How to Watch XFL Team Reveal Livestream
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With this recent success comes not just the promise of greater access to donor organs, but vital information on what a transplanted uterus requires to successfully carry an embryo to full term.
The researchers in Brazil reported that the uterus was ischemic - meaning, off a blood supply - for nearly eight hours, essentially double the reported time from any of the living donor transplants. Ejzenberg says he wanted to deliver the baby a few weeks early to avoid potential problems late in the pregnancy.
"The first uterus transplants from live donors were a medical milestone, creating the possibility of childbirth for many infertile women".
In a surgery lasting 10.5 hours, the uterus was removed from the donor and transplanted into the recipient, where it was connected to the recipient's veins and arteries as well as her ligaments and vaginal canals.
"I don't know that they're highlighted enough when we're celebrating these kind of breakthroughs", she said.
The uterus transplant, in this case, happened in September 2016. But making the transition period even five months shorter means the recipient will need that much less medical care and powerful immunosuppressant drugs for their uterus to stay healthy. Fifteen were fertilised, with 8 resulting in embryos that were subsequently preserved for later implantation.