A 43-year-old mother in India became the first in her country to be a uterus organ donor. The recipient was her daughter, a 21-year-old woman born without a uterus.
A uterus transplant is specifically for otherwise healthy women who don’t have functioning wombs. This condition affects about 1.5 million women in the world. And such transplant would offer the opportunity for these women to bear children of their own, rather than go down the path of adoption or surrogacy. Currently, the uterine transplant is the only option that would allow a woman with uterine factor infertility to biologically carry her own baby
Arguably, the procedure is more complicated and lengthy than other organ transplants. First, the woman undergoes ovarian stimulation treatment to allow eggs to be collected. Doctors will then use in vitro fertilization (IVF) to fertilize these eggs with her partner’s sperm. The fertilized eggs will wait, frozen, for a year or more before implantation.
Then, a compatible uterus has to be harvested from the donor and transplanted into the recipient. The actual transplant process takes a mere six to eight hours; however, it takes a whole year for the donated uterus to completely heal inside the recipient’s body. After this period, the frozen fertilized eggs are thawed and implanted, one at a time, into the recipient’s uterus until she becomes pregnant.
Throughout pregnancy up to delivery, the mother-to-be is monitored closely by a high-risk obstetrics team. In addition to taking immunosuppressant drugs to prevent organ rejection, she will also undergo monthly cervical biopsies to confirm the organ is still intact. The birth of the baby is strategically carried out via a scheduled cesarean section to prevent labor strains to the transplanted uterus.
Preserving the transplanted uterus is critical for women who elect to be pregnant again, as doctors will implant another of the in vitro fertilized eggs that she has in reserve. But because pregnancy requires the woman to be on anti-rejection medications, there is a limit to how many babies the donated uterus can bear. Once the pregnancy is over and the medications stopped, and the transplanted uterus can either be surgically removed (hysterectomy) or allowed to wither away inside the body.
So far, the team of doctors in India are reporting both mother and daughter are doing well after their nine and a half hour operation.
Of note, uterus transplant is still a relatively new procedure - the case in India marks the 30th attempt of this procedure in the world. For the US, the first uterine transplant occurred in early 2016. But Sadly, just shy of the two-week milestone, the transplanted organ had to be removed due to a yeast infection. So far, just six babies have been birthed from a transplanted uterus, and they were all performed by a Swedish team. For the patient in India, only time will tell if her transplant will result in a successful birth.
Additional source: CNN
