Childbirth after uterus transplant

Print edition : January 18, 2019

The journal “Lancet” has reported the first known case of live birth following a uterine transplant in a 32-year-old woman lacking a uterus because of a genetic condition, by a team of medical scientists, Dani Ejzenberg and associates, from the University of Sao Paulo, Brazil.

This remarkable feat comes three years after scientists from the University of Goteberg, Sweden, had, in a series of transplantations from live donors in 2014-15, achieved successful transplantation of the uterus. However, no case of live birth via deceased donor uterus had been hitherto achieved, “raising doubts about its feasibility and viability, including whether the uterus remains viable even after prolonged ischaemia [lack of oxygen supply that can lead to cell death due to the elapsed seven hours between death and transportation to the clinic in Sao Paulo].”

The woman with the congenital uterine absence (due to Mayer-Rokitansky-Küster-Hauser [MRKH] syndrome) underwent uterine transplantation in Hospital das Clínicas, University of Sao Paulo, from a 45-year-old donor who died of a stroke and associated subarachnoid haemorrhage. The donor had had three previous vaginal deliveries.

The scientists report that the recipient had one in vitro fertilisation (IVF) cycle four months before the transplant, which yielded eight cryopreserved viable blastocysts (the early stage of cell formation, which become embryos). Seven months after the transplantation surgery, which lasted for over 10 hours, the woman received IVF-generated viable embryos, and 36 weeks later, the recipient delivered a child through C-section. Both the mother and child are reportedly doing fine.

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