A nurse handles an ultrasound machine. Photo: Christopher Furlong (Getty Images) A group of doctors in Brazil has announced a…
A nurse handles an ultrasound machine. Photo: Christopher Furlong (Getty Images)
A group of doctors in Brazil has announced a medical understanding that can ever help countless women who can not get children due to a wounded or absent uterus. In a case report published Tuesday in Lancet, they claim that they have successfully helped a woman born with a transplanted womb from a deceased donor.
According to the report, the group performed the operation of a named 32-year-old woman in a Brazilian hospital in September 2016. The woman was born with a rare genetic condition who left her without uterus, known as Mayer-Rokitansky-Küster-Hauser syndrome, but she otherwise be healthy. The donor was a 45-year-old woman who had suddenly died of stroke; She had had three successful pregnancies previously delivered vaginally.
An illustration of how uterine transplant was performed. Illustration: Ejzenberg, et al. (The Lancet)
Four months before transplant, the recipient woman had received in vitro fertilization, which gave eight live embryos frozen. After the 10-hour operation, which connects the uterus and a portion of the vagina of the donor against the vagina and circulatory system of the recipient, the woman then took a regime of immunosuppressive drugs that kept her body from rejecting the donor’s uterus. Seven months later, she had successfully implanted an embryo. And 35 and a half weeks after, she born a seemingly healthy girl, delivered through Caesarean section without complications.
Since 2013 there have been at least 10 reported live pregnancies from women with transplanted uterus. However, according to the authors, they are the first to achieve it with uterus from a deceased donor (it was a proven trial in 2011, but the pregnancy ended in miscarriage). The party is something that can make the process a much more appealing and realistic way for some women to become pregnant.
“The first uterine transplant from living donors was a medical milestone that created the possibility of giving birth to many inability women with access to appropriate donors and necessary medical facilities. However, the need for a living donor is a major limitation, as donors are rare as usually are willing and legitimate family members or close friends, “said author Dani Ejzenberg, a gynecologist at Hospital das Clínicas, University of Sao Paulo’s School of Medicine, said in a statement. “The number of people willing and committed to donating organs on their own deaths is much greater than the offer of living donors and offers a much wider potential donor population.”
In addition to relying on a deceased donor for his uterine transplant, may also have made the procedure cheaper and more dangerous. Earlier, with living donors, doctors have waited at least one year after transplant to begin trying with a pregnancy. But the authors believed that they could safely shorten the time to six months.
Finally, they held another month after the test suggested that the donor uterus fed was not sufficiently thick to support implantation. But making the transition period up to five months shorter means that the recipient needs so much less care and powerful immunosuppressive drugs for the uterus to stay healthy. And unlike most organ transplants, a donated uterus can be safely removed after a successful pregnancy, so the woman stops taking the drug from rejection.
The authors say that their version of the procedure is not intended to replace the possibility of using a living donor, but rather to give women with uterine problems another option. And there are still many questions about how to better refine the procedure. During the transplant there was a period of blood loss that eventually managed but could be avoided in the future by changing the way the body was originally reconnected to the woman’s circulatory system, according to the study. And it is possible that patients do not need as many immunosuppressants as they currently have to ward off organ rejection.
There is no shortage of women and couples who may want to take advantage of the procedure because it becomes easier and safer to perform. According to researchers authored by the authors, 10-15 percent of couples who theoretically have and want children may be infertile in any way, one in 500 women in this population is infertile due to lack of uterus. Genetic conditions like Mayer-Rokitansky-Küster-Hauser syndrome can cause this, but more often it is because women undergo an unexpected hysterectomy to prevent cancer or treat painful diseases such as endometriosis.
As for the Brazilian woman and her children, a representative of Ejzenberg told Gizmodo by email, both of which appear to be completely healthy. The child will actually celebrate her first birthday in about two weeks. The team is now authorized to carry out the procedure in another two women.