Health  

How first baby was born from transplanted womb


*Woman, 32, who was given dead stranger’s uterus gives birth to healthy daughter
*Children born through IVF more likely to suffer from asthma because of fertility drugs

A baby has been born to a mother who received a transplanted womb from a dead woman in a world-first medical procedure.Now almost one year old, the healthy girl was born weighing 5lbs 10oz (2.55kg) in December last year to a 32-year-old woman in Brazil.

The landmark birth marks a huge fertility breakthrough, which scientists say offers hope to thousands of infertile women.Eleven babies have been born from living uterus donors but the procedure has never succeeded when using an organ from a deceased woman.

Doctors published details of the milestone birth in the prestigious medical journal The Lancet. Doctors at the Hospital das Clinicas at the University of Sao Paulo implanted the dead donor’s uterus into the mother in September 2016.

The new mother was born without a womb because of a condition called Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH).In the pioneering 11-hour operation, medics implanted a uterus donated by a 45-year-old woman, who was a mother herself, who died of a stroke. She also gave away her heart, liver and kidneys. It is unclear if any other patients have benefitted from her organs.

The woman spent two days in intensive care and was given immunosuppression drugs to stop her body rejecting the new organ.After having the womb transplanted, the unnamed woman had her first period after 37 days then menstruated regularly until she became pregnant seven months later.Her eggs had been frozen before the transplant took place and the woman became pregnant on the first attempt at implanting an embryo fertilised through In Vitro Fertilisation (IVF).

The baby was born by caesarean section after 35 weeks and three days, and measured 45cm in length – average for a newborn.When the baby was removed, surgeons took out the transplanted uterus at the same time. Usually, they are left in for a while when taken from a living donor.

“The use of deceased donors could greatly broaden access to this treatment,” said Dr. Dani Ejzenberg, author of the study reporting the woman’s case.“The first uterus transplants from live donors were a medical milestone, creating the possibility of childbirth for many infertile women with access to suitable donors and the needed medical facilities.

“However, the need for a live donor is a major limitation as donors are rare, typically being willing and eligible family members or close friends.“The numbers of people willing and committed to donate organs upon their own deaths are far larger than those of live donors, offering a much wider potential donor population.”Also, a study suggests that thousands of children born each year by IVF could be at risk of asthma. Researchers found IVF increases the risk of childhood asthma by 22 per cent.

Scientists from the Norwegian Institute of Public Health, who tracked more than 500,000 children, believe the drugs given to mothers during the IVF process might cause asthma in their children.The way embryos are handled and manipulated before they are implanted in the womb might also play a role, they said.

More than eight million children have been born across the world via IVF since the technology was pioneered in Britain 40 years ago.In the UK alone 20,000 children are born each year using IVF. The figure is closer to the 60,000 mark in the US.Experts have repeatedly warded off fears that children born this way might have poor health in later life.

They often argue that if there are any health impacts, it is more likely to be linked to a mother’s underlying infertility, rather than the IVF itself.But the Norwegian scientists, whose work is published in the BMJ journal Thorax, claim they have shown that while asthma is partly linked to a mother’s fertility problems, a major part is down to the IVF procedure itself.

Initially they found that children born using IVF were 42 per cent more likely to develop asthma by the age of seven than children conceived naturally.But they then compared the IVF children to those born naturally but whose parents who had taken more than 12 months to conceive.They found the additional asthma risk was smaller, but still remained at 22 per cent, suggesting half the risk was linked to fertility problems and half to the IVF procedure.

They wrote: “Several steps in the assisted reproductive technology treatment may alter the natural course of the fetal development.“For example, medications taken to induce ovulation and to ensure that the pregnancy stays intact during the early phases, the type of medium used for the culture, freezing and thawing cycles, the possibility of polyspermic fertilisation, the hormonal environment and/or manipulation of the embryo.”

Meanwhile, as many as 15 per cent of all couples of reproductive age are affected by infertility – approximately 3.5million people in the UK and 6.1million in the US.Hundreds of women, such as those with MRKH, live without wombs, meaning they cannot conceive naturally or through IVF alone.

For them, a womb transplant is the only option but the procedure has only started to become successful in recent years, with only 11 live births so far.How did the womb transplant work? The womb and blood vessels supplying it were removed from a 45-year-old woman – herself a mother – who had died of a stroke.

They were then implanted into the new mother, who was born without a womb of her own, in an almost 11-hour operation, and the blood vessels connected to her own.She began to menstruate 37 days after the operation and then had regular periods until she became pregnant seven months later.An embryo was implanted using eggs, which had been taken from her ovaries before the womb transplant procedure and fertilised using IVF.

The baby grew healthily and was born after 35 weeks and three days by caesarean section. During the caesarean section the woman’s implanted womb was also removed and both mother and baby recovered normally. The first transplant from a living donor was attempted in Saudi Arabia in 2000, but there were no live births until 2012 in Sweden.

Eight babies have been born in Sweden from nine living womb transplants since the original breakthrough. Two more – including one earlier this year – have been born in Dallas, Texas. A third was announced in Serbia last year.

A woman is currently pregnant in India after having a womb transplanted from a living donor in 2017, the medics wrote in the report.There have been a total of 39 attempts to transplant wombs from living donors, but procedures in Lebanon, Czech Republic, Germany and China have not yet resulted in pregnancies.

And researchers in the United Kingdom (UK) hope to start trials of womb transplants to help the thousands of women born without wombs. Transplanting from dead donors, however, has only been attempted 11 times – in Turkey, Ohio and Texas in the US, Czech Republic and Brazil.

The first attempt in Turkey, back in 2011, did result in a pregnancy but the mother miscarried – this is the first time the procedure had worked.“This is the first case of a successful pregnancy from a deceased donor,” confirmed Professor Andrew Shennan, of King’s College London.

“Successful pregnancy, without evidence of any compromise in spite of the uterus being without oxygen for eight hours before transplant, was unique.“This opens the possibility of women donating their womb following death, as with many other organs.“This allows a further option for women with uterine problems preventing them having a baby to carry their own child, rather than relying on live donors, a surrogate or adoption.”And researchers in the UK hope to start trials of womb transplants to help the thousands of women born without wombs.

In this article:
Dani EjzenbergIVF
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