Surgeons have performed the first womb transplant on a woman in the UK, opening up the possibility for dozens of infertile women to have babies every year. The woman’s sister was the living donor of the womb.
The 34-year-old was “incredibly happy” and “over the moon” with the success of the nine-hour operation, according to the medical team behind the pioneering procedure. She now plans to have two children using IVF.
The married woman was born with a rare condition, meaning her original womb was underdeveloped. She received a donor womb from her 40-year-old sister, who already had two children of her own.
More than 90 womb transplants have been carried out internationally, including in Sweden, the US, Saudi Arabia, Turkey, China, the Czech Republic, Brazil, Germany, Serbia and India, with most involving a living donor. About 50 babies have been born as a result.
The co-lead surgeon Isabel Quiroga, a consultant surgeon at the Oxford Transplant Centre, part of Oxford University hospitals, said she was “thrilled” and “extremely proud” the surgery had been a success.
The patient is “incredibly happy”, she said, adding: “She was absolutely over the moon, very happy and is hoping that she can go on to have not one but two babies. Her womb is functioning perfectly and we are monitoring her progress very closely.”
A second UK womb transplant on another woman is scheduled to take place this autumn, with more patients in the preparation stages. Surgeons have approval for 10 operations involving brain-dead donors plus five using a living donor.
The recipient, who lives in England and asked not to be named, received her sister’s uterus in an operation in February at Churchill Hospital in Oxford. It took nine hours and 20 minutes and she was well enough to leave the hospital after 10 days.
The co-lead surgeon Prof Richard Smith, the clinical lead at the charity Womb Transplant UK and a consultant gynaecological surgeon at Imperial College London, said the operation had been a “massive success”.
“It was incredible,” he said. “I think it was probably the most stressful week in my surgical career but also unbelievably positive. The donor and recipient are over the moon, just over the moon.
“I feel emotional about it all. The first consultation with the recipient post-op, we were all almost in tears.
“I’m just really happy that we’ve got a donor who is completely back to normal after her big op and the recipient is, after her big op, doing really well on her immunosuppressive therapy and looking forward to hopefully having a baby.”
The woman receiving the womb was born with Mayer-Rokitansky-Küster-Hauser syndrome (MRKH), a rare condition affecting about one in every 5,000 women.
With MRKH, women have an underdeveloped vagina and an underdeveloped or missing womb. The first sign of the condition is when a teenage girl does not have periods.
However, their ovaries are intact and still function to produce eggs and female hormones, making conceiving via fertility treatment a possibility.
Before receiving her sister’s womb, the woman had two rounds of fertility stimulation to produce eggs, followed by intracytoplasmic sperm injection (ICSI) to create embryos.
Five embryos reached the blastocyst stage – which means they have a good chance of success in IVF – and were frozen for when the patient undergoes treatment at the Lister fertility clinic in central London later this year.
Smith said the transplanted womb was functioning exactly as it should and plans for IVF were on track. The woman will need to take immunosuppressant drugs throughout any future pregnancy to prevent her body from rejecting the donor organ.
The transplant is expected to last a maximum of five years before the womb is removed.
The day of the surgery, which involved more than 30 staff, began with the removal of the older sister’s womb, which took eight hours and 12 minutes. One hour before the womb was extracted, surgeons began operating on the younger sister.
Before surgery, the sisters underwent extensive counselling and were reviewed by gynaecologists, transplant surgeons, obstetricians, psychologists, anaesthetists and pharmacists.
They were also assessed by a Human Tissue Authority (HTA) independent assessor to ensure they were aware of the risks and to confirm they were entering into the surgery of their own free will.
The case was reviewed by an HTA panel before permission was granted to proceed. The £25,000 transplant cost was paid for by donations to Womb Transplant UK.
Asked how many UK women could benefit from womb transplants in future, Smith said: “Realistically you’re talking maximum numbers of 20 to 30 per year on the living donor side for the foreseeable future.”
Transplants could help women born without a functioning womb and those who lose their organ to cancer or other conditions.
Surgeons also hope to use living donors who are not relatives but are offering their organs altruistically.
Quiroga said: “We have women contacting the charity … such as young women who say ‘I don’t want to have children but I would love to help others have a child’ or ‘I’ve already had my children I would love other women to have that experience’. So yes, there will definitely be a time in which that is a main source of donors.”
