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First mother-to-daughter uterine transplants offer fertility hope for cancer survivors

After nearly ten years of research, a team of 20 doctors and specialists at the University of Gothenburg in Sweden, have performed the first mother-to-daughter uterine transplants in two Swedish women.

The two women, both in their 30s, received new wombs donated by their mothers on September 15th and 16th without complications.  One of the women was born without a uterus, while the other, a cervical cancer survivor, had to have her uterus removed many years prior.

The uterine transplant procedure was developed as a reproductive technology to allow women of childbearing age, who lack a uterus, to bear children.    Both women began hormonal treatments for in-vitro fertilization before the surgery.  Frozen embryos will be thawed and transferred to their new wombs once doctors have determined that they are healthy enough to support a pregnancy.

According to the Centers for Disease Control (CDC), more than 600,000 hysterectomies are performed annually in the US.  Although the vast majority of hysterectomies are performed electively as a treatment for symptoms associated with gynecologic disorders, removal of the uterus is frequently recommended when cancer of the cervix, uterus, vagina, fallopian tubes and/or ovaries is invasive.  Similarly, hysterectomy is recommended in cases of uterine fibroid tumors, endometriosis and uterine prolapse.

Uterine transplants are unique amongst organ transplants in that they are not required as a life-saving intervention.  Because the procedure is not regarded as life-saving, researchers had to perfect the procedure to make it as safe as possible using non-human primates.  The first successful transplant for the team was reported via a series of publications lead by Mats Brannstrom around 2003.  The team of more than 10 surgeons who performed last weeks uterine transplants, trained together for several years first with mice, reporting successful pregnancy and offspring.  The team has since been successful in other animal models including baboons.

Although it is too soon to know, the mark of success for these transplants, and one performed last year by Turkish doctors using a womb from a cadaver, is a successful pregnancy.  If successful, the option of uterine transplant may affect thousands of women of reproductive age that have had to have their uterus removed due to uterine or cervical cancer, endometriosis, and those born without a uterus due to genetic disorders such as Turner’s Syndrome.

 

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