In a significant milestone, the UK’s inaugural womb trans
trans+plant involved a successful donation from one sister to another who was unable to conceive.
This breakthrough offers hope to numerous British women who otherwise might face challenges in childbirth.
The 40-year-old donor, a mother of two, generously provided her womb to her younger sister who was born without one due to a medical condition. Her aspiration to start a family with her husband has now been given a new possibility.
The complex procedure of extracting the womb from the donor and transferring it to her sister required two teams and eight surgeons working in adjacent operating rooms.
The surgery lasted over 17 hours, surpassing the initial timeframe. Nonetheless, the operation was deemed successful, and the transplanted womb is reported to be fully operational as confirmed by the participating surgeons.
The 34-year-old recipient of the womb is reportedly ecstatic about the outcome, expressing great excitement about the opportunity to start a family. She told to her doctors: ‘I want to have as many children as I can’.
Although the recipient was born without a womb, she possesses functioning ovaries and had her own eggs previously collected and fertilized through IVF.
The plan now involves potentially implanting one of her five stored embryos in the upcoming autumn at a London fertility clinic. A leading surgeon indicated that her chances of a successful pregnancy are “over 80 percent.”
Should a baby result from this, it would be delivered through a caesarean at 37 weeks to alleviate stress on the donated womb. Subsequently, the recipient has the option to retain the womb for one more pregnancy or have it removed.
Professor Richard Smith, a consultant gynaecological surgeon from Imperial College Healthcare NHS Trust, one of the lead surgeons, shared that there were touching moments as the medical team met with the woman and her family shortly after she was discharged from the hospital, ten days following the transplant operation. Her sister had been discharged five days earlier.
‘We were all in tears,’ he said.
‘It was emotional for all the medical staff and for her and her entire family – it was a hugely big deal to us all.’
According to Professor Richard Smith, the recipient has a very promising chance of a successful pregnancy.
The surgeries took place in February at the Churchill Hospital, a part of Oxford University Hospitals NHS Trust. They were kept confidential due to the recipient’s desire for anonymity and to ensure the operation’s success. The collaborative effort involving staff from five different hospitals has now come to light as details are being published in the medical journal BJOG: An International Journal of Obstetrics and Gynaecology.
This breakthrough could hold potential benefits for thousands of women in the UK. Conditions like Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKH) lead to around one in 5,000 women being born without a viable womb. Other women may have their wombs removed due to conditions like endometriosis or cancer.
Previously, women without a womb who wished to have a family had limited options such as using a surrogate or seeking womb transplant surgery abroad, which was often impractical.
The world’s first womb transplant was conducted in Saudi Arabia in 2000, but due to complications, the transplanted womb had to be removed after three months.
In September 2014, Malin Stenberg from Sweden made history by becoming the first person to give birth following a womb transplant. This milestone was achieved after a 61-year-old family friend generously donated her womb. Since then, approximately 100 womb transplants have been performed worldwide on women from various countries, resulting in the birth of around 50 healthy babies.
The successful surgery in the UK marks a significant advancement. It could have occurred sooner, but challenges like regulatory processes and funding hindered progress. Miss Isabel Quiroga, a consultant transplant surgeon and co-leader of the operating team, highlighted that the regulatory process can be time-consuming. Funding has also been a hurdle. The charity Womb Transplant UK covered the operation costs through donations and fundraising events, including bake sales. Each surgery costs around £25,000, and while medical professionals involved volunteered their time, funding for the procedure itself was essential.
The team was initially prepared to proceed with a living donor in March 2020, but the COVID-19 pandemic intervened. They have now obtained approval from regulatory bodies such as The Human Tissue Authority for two programs: one involving five women who will receive wombs from live donors, and another encompassing ten patients who lack suitable living donors and therefore will seek wombs from deceased donors.
Womb Transplant UK has received interest from 500 women interested in participating in the program. They have identified around a dozen potential patients who either possess stored embryos or are currently undergoing IVF and could potentially become patients. Among them is a woman who lost her womb due to uterine cancer.
Womb Transplant UK has managed to raise £200,000 so far towards their research program’s cost. However, they still face a funding gap of £300,000. With the available funds, they plan to proceed for now. Professor Smith noted that the team will be prepared to perform the next transplant once all personnel involved return from their summer breaks.
He emphasized the importance of offering this service within the UK, highlighting that some patients are traveling to the United States due to the lack of access in the UK. However, this relocation is a significant undertaking, and providing the option domestically is crucial for the well-being of British women.
Eligibility for the programs is limited to those who qualify for NHS care, reside in the UK, and are aged between 24 and 40 (or 42 if embryos were cryopreserved before the age of 38). Accepted candidates undergo comprehensive physical and psychological evaluations and are informed about the associated risks.
Comparatively, the failure rate for womb transplants is higher than for other life-saving transplants. About 25% of womb transplants fail, as opposed to just 1% for kidney transplants, for instance. Approximately 20% of these failures occur with living donors, while 28% occur with deceased donors. This is a topic of concern, as highlighted by a review published this year in the Journal of Clinical Medicine by the Keio University School of Medicine in Tokyo, Japan.