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6 October 2014

First womb transplant baby celebrated

A boy has been born in Sweden after his 36-year-old mother had a womb transplanted from a close family friend who had completed her family. She is part of a clinical trial of nine women, two more of whom are due to have babies by the end of the year.

The mother, whose identity has not been revealed, was born without a womb, a rare condition that affects 5,000 girls born in Britain each year, the Daily Telegraph reports.

However Dr Brannstrom, the surgeon responsible, of Sahlgrenska Academy at University of Gothenburg, in Sweden, said womb transplants could be offered to a much wider group of women who have lost their womb after suffering cancer or other diseases, complications after birth and those who had deformed wombs or have adhesions or scars. He said even women who have suffered repeated miscarriages with no cause found could be offered ‘the solution’ of a womb transplant.

“Certainly the indications for this surgery could be wider. I have had emails from ladies with all these conditions from all over the world,” he told the Telegraph. “Some are telling me their stories, some also want to donate. These women have usually had two or three children and are going for sterilisation and ask if they can donate their uterus. In the future it is not going to be a problem to get a donor, not like a kidney, heart or liver. It is a sisterhood thing. Women are saying that they have had their children and why shouldn’t they help another women to have the same joy?”

British doctors are due to submit documents for ethics approval to carry out the first five womb transplants here next year and there are 60 women on the waiting list.

The Swedish mother learned she did not have a womb at the age of 15, she said in an interview with Associated Press. “I was terribly sad when doctors told me I would never carry my own child. Mats told us there were no guarantees, but my partner and I, maybe we like to take risks, we thought this was the perfect idea,” she said.

The woman’s mother had wanted to be a donor but wasn’t a match. Instead, she received her new womb from a 61-year-old family friend, who had previously had two sons and has now been through the menopause. The womb donor is now baby Vincent’s godmother and her two sons have also come to visit the family.

“She is an amazing person and she will always be in our lives,” the mother said. “And she has a very special connection to my son.”

Brannstrom and colleagues transplanted wombs into nine women over the last two years as part of a study, but complications forced removal of two of the organs. Earlier this year, Brannstrom began transferring embryos into the seven other women, two of whom are more than 28 weeks pregnant.

The women have all conceived through IVF and Dr Brannstrom told the Telegraph that due to the surgery it is impossible for them to conceive naturally. However the women can have two babies this way before the uterus will be removed, he said. This is to minimise the amount of time they are taking powerful drugs to stop their bodies rejecting the organ rather than any stress on the womb itself.

The women will be advised to wait no longer than six months between the birth of their first child and getting pregnant with their second.

The drugs are taken continuously during pregnancy and experience with kidney transplant recipients who have had babies shows that they do not affect the baby’s growth or development. However the babies born following womb transplants will all be followed up carefully for many years, Dr Brannstrom said.

The research was paid for by the Jane and Dan Olsson Foundation for Science, a Swedish charity and the British operations will also be funded through charitable donations to Womb Transplant UK.

The baby, Vincent, was born early by caesarean section after his mother developed pre-eclampsia 32 weeks into the pregnancy and was admitted to hospital. Tests showed the baby was in distress and the team took the decision to operate. They had planned to deliver the baby by caesarean at 34 weeks to avoid the woman going into natural labour which place unnecessary stress on the womb. He weighed 3.9 pounds (1.8kg) – normal for that stage of pregnancy – and he was released from the neonatal unit 10 days after birth, according to details published in The Lancet medical journal.

Dr Brannstrom said that the success in Sweden will make it much easier for the British team to follow. Richard Smith, consultant gynaecological surgeon at Queen Charlotte’s Hospital in London, is due to submit for ethics approval in the next few weeks and that the technique has already been proven will make that process more straightforward.

There are other teams working towards womb transplants in China, France, Belgium, Spain and America he said.

Dr Dagan Wells from Oxford University said: “The successful womb transplant is a great achievement and good news for many women who are desperate to start a family, but unable because they do not have a functional womb. About five per cent of women are born with a womb malformation and in some cases this can prevent embryos from implanting or cause repeated miscarriages. In some cases the womb is entirely absent, eliminating any possibility of a pregnancy. Additionally, some women have to have their womb surgically removed due to cancer or other conditions.

“Compared to donation of other organs, there are a couple of unusual things about womb transplantation. Women who have gone through the menopause are no longer fertile, yet their wombs usually retain the ability to carry a baby.”

Womb transplants: hope for tens of thousands of women in Britain. Daily Telegraph, 5 October 2014

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