Nine women have received transplants of uteruses donated by their mothers or other living relatives in an ongoing trial of an experimental procedure at the University of Gothenburg in Sweden.
The transplants began in September 2012 (reported in BioNews 674) and the women are said to be doing well. Some of the women's uteruses have already showed signs of healthy functioning and although some of the patients experienced minor rejection issues, none required intensive care after surgery, the researchers said. The hospital had initially planned to perform ten surgeries in total, but one woman had to drop out for medical reasons.
The women, most of whom are in their 30s and were either born without wombs or had them removed because of cancer, will soon attempt to become pregnant via IVF. The surgery did not connect the uteruses to the women's fallopian tubes, so the women will not be able to conceive naturally. However, they do all have functioning ovaries and their eggs were used to create embryos that were cryopreserved before the operation.
Doctors have previously managed to achieve a pregnancy in previous womb transplants, but no babies have yet been born following the procedure. A Turkish woman became the first person to receive a womb from a deceased donor in 2011 but her pregnancy was terminated after eight weeks (reported in BioNews 705). Doctors had waited 18 months before attempting implantation. In 2000, a woman in Saudi Arabia received a uterus from a live donor but it had to be removed after three months when a clot developed due to poor blood flow.
'This is a new kind of surgery', Dr Mats Brännström, who is leading the initiative at the University of Gothenburg, said in an interview. 'We have no textbook to look at'.
Dr Brännström and colleagues are planning to run a workshop on the technique next month and to publish a scientific report on their method soon.
A potentially controversial aspect of the Swedish trial is that the transplanted wombs were from living donors. The researchers explain that taking uteruses from living donors means they are generally in a better condition and that using the patient's relatives as donors leads to a better immunological match.
In contrast, plans to perform the surgery in the UK and in Turkey would only use a uterus donated by dead or dying people to avoid putting donors through major surgery.
'Mats [Brännström] has done something amazing and we understand completely why he has taken this route, but we are wary of that approach', said Dr Richard Smith, head of the charity Womb Transplant UK, which is trying to raise the funds to carry out the operation on five women in Britain.
Experts are now waiting to see whether the pregnancies will succeed. Dr Smith said 'the principal concern for me is if the baby will get enough nourishment from the placenta and if the blood flow is good enough'.
According to Womb Transplant UK, around 15,000 women of child-bearing age are born without a womb, and could potentially benefit from the development of the technique.
Dr Yacoub Khalaf, director of the Assisted Conception Unit at Guy's Hospital, London, said 'what remains to be seen is whether this is a viable option or if this is going to be confined to research and limited experimentation'.