Here's why that's a big deal for women with uterine factor infertility.

By Sarah Klein
December 05, 2018

For the first time, a baby has been born from a . This medical marvel, performed by doctors at the University of Sao Paulo in Brazil, was reported in The Lancet this week. While babies have previously been born to women who received uterus transplants, the organs have always come from living donors—until now.

The procedure is still very new; only 11 babies have ever been born from a transplanted uterus worldwide. But if wombs from deceased donors are proven to be a viable option, the use of this pioneering fertility treatment may expand. 

"The use of deceased donors could greatly broaden access to this treatment, and our results provide proof-of-concept for a new option for women with ," lead author Dani Ejzenberg, PhD, said in a statement. "The first uterus transplants from live donors were a medical milestone .... 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."

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The baby girl is about to celebrate her first birthday; she was born by C-section on December 15, 2017, according to the case report. Her mother underwent uterine transplant surgery in September 2016, when she was 32. The unnamed woman had been born without a womb, thanks to a rare genetic condition called Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, which affects about 1 in every 4,500 women and causes the vagina and uterus to either not form at all or only form partially.

Uterus transplants can also be used for women with other forms of uterine factor infertility, including those who have previously had their wombs removed.

To prepare for her transplant, the woman in the case report completed a round of IVF and had eight embryos frozen. The donated uterus came from a woman who had died at 45 after giving birth three times.

After eight days in the hospital recovering from the transplant, the woman went home with immune system–suppressing meds to keep her body from rejecting the new organ. Just 37 days after her transplant, she had her first period, and she continued to menstruate regularly after that. Seven months after receiving her new uterus, doctors implanted one embryo. She was officially pregnant 10 days later

Other than a kidney infection, which was treated with antibiotics, the woman had a healthy pregnancy, and she delivered via Caesarean around her 36th week. The donated uterus was also removed at this time. (Uterine transplants are not meant to be permanent.) Seven months after delivery, the researchers began writing up the case study, and they reported that both mom and baby were happy and healthy at that time.

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There are still many unknowns about uterus transplants in general, particularly when the donor organ comes from a deceased woman. As it stands, uterus transplants remain incredibly difficult. "It is exceptionally hard to perform a uterine transplantation due to the abundance of blood vessels that bring blood from the pelvic region into the uterus," ob-gyn Shahin Ghadir, MD, a partner at the Southern California Reproductive Center, explained in a previous interview with Health. "All of these blood vessels need to be reconnected in a satisfactory manner in order to provide the blood flow needed for the uterus to survive." 

Still, the case study authors are hopeful that their results will contribute to “a path to healthy pregnancy for all women with uterine factor infertility, without need of living donors or live donor surgery.” 

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