After having successfully received transplant wombs donated by relatives, nine women in Sweden will now try to get pregnant, the doctor in charge of the pioneering project disclosed.
Mostly in their 30s and being born either without a uterus or having it removed due to cervical cancer, these women participated in the first major experiment to test whether it's possible to transplant wombs into women so they can give birth to their own children, the Associated Press reported.
With transplants of organs such as hearts, livers and kidneys being done as a life-saving measure for decades, doctors have started to increase the transplant of hands, faces and other body parts in order to improve patients' quality of life.
The womb transplant is the first of its kind and is meant to remain temporary. Although it is being tested for childbearing purposes only, the transplant does raise some new concerns, the AP reported.
"This is a new kind of surgery," Dr. Mats Brannstrom told the AP in an interview from Goteborg. "We have no textbook to look at."
Brannstrom, chair of the obstetrics and gynecology department at the University of Gothenburg, and his colleagues will run the first-ever workshop next month on how to perform womb transplants and they plan to publish a scientific report on their efforts soon.
Out of the nine womb recipients, many have already experienced their periods six weeks after the transplants, an early sign that the wombs are healthy and functioning, the AP reported. While one woman got infected in her newly received uterus, others had some minor rejection incidents. None, however, required any intensive care and were discharged from the hospital within days, Brannstrom said.
The transplants for the unidentified women began in September 2012 and the donors list included mothers and other female relatives of the recipients, university spokesman Krister Svahn said.
According to the AP, "The transplant operations did not connect any of the women's uteruses to their fallopian tubes, so they are unable to get pregnant naturally. But all who received a womb have their own ovaries and can make eggs. Before the operation, they had some removed to create embryos through in-vitro fertilization. The embryos were then frozen and doctors plan to transfer them into the new wombs, allowing the women to carry their own biological children."
Known as MRKH, about one in 4,500 girls are born with a syndrome where they don't have a womb. Although the project has been recognized as a significant effort by fertility experts, it remains to be seen whether the transplanted wombs will result in healthy babies.
"Mats has done something amazing and we understand completely why he has taken this route, but we are wary of that approach," said Dr. Richard Smith, head of the U.K. charity Womb Transplant UK, which is trying to raise $823,000 to carry out five operations in Britain.
According to the AP, Smith said the biggest question is how any pregnancies will proceed.
"The principal concern for me is if the baby will get enough nourishment from the placenta and if the blood flow is good enough," he said.
Anti-rejection medicines will have to be taken by the women. Data from women who have received kidney transplants doesn't suggest their babies are at any increased risk from the drugs, Smith said. Embryos will be transferred by Brannstrom and his colleagues into some of their patients within some months, the AP reported.
Animals including mice, sheep and baboons have previously had successful uterus transplants, but no offspring from the primates were produced, the AP reported. The wombs will be removed after a maximum of two pregnancies so that the women can stop taking the anti-rejection drugs, which can cause high blood pressure, swelling and diabetes and may also raise the risk of some types of cancer.
Other experts said if the operations are successful, womb transplants could be an alternative for women who have few choices.
"What remains to be seen is whether this is a viable option or if this is going to be confined to research and limited experimentation," said Dr. Yacoub Khalaf, director of the Assisted Conception unit at Guy's and St. Thomas' hospital in London, who was unconnected to any of the womb transplant projects.
Brannstrom warned the transplants might not result in children but remained optimistic, according to the AP.
"This is a research study," he said. "It could lead to (the women) having a child, but there are no guarantees ... what is certain is that they are making a contribution to science."
