WUNRN
SWEDEN - DOCTORS TRANSPLANT WOMBS TO
WOMEN WHO HOPE TO HAVE CHILDREN
.13, 2014
STOCKHOLM
— Nine women in Sweden have successfully received transplanted wombs donated
from relatives and will soon try to become pregnant, the doctor in charge of
the pioneering project has revealed.
The women were born without a uterus or had it removed
because of cervical cancer. Most are in their 30s and are part of the first
major experiment to test whether it's possible to transplant wombs into women
so they can give birth to their own children.
Life-saving transplants of organs such as hearts, livers
and kidneys have been done for decades and doctors are increasingly
transplanting hands, faces and other body parts to improve patients' quality of
life. Womb transplants — the first ones intended to be temporary, just to allow
childbearing — push that frontier even farther and raise some new concerns.
There have been two previous attempts to transplant a womb
— in Turkey and Saudi Arabia — but both failed to produce babies. Scientists in
Britain, Hungary and elsewhere are also planning similar operations but the
efforts in Sweden are the most advanced.
"This is a new kind of surgery," Dr. Mats
Brannstrom told The Associated Press 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, is leading the initiative. Next
month, he and colleagues will run the first-ever workshop on how to perform
womb transplants and they plan to publish a scientific report on their efforts
soon.
He said the nine womb recipients were doing well. Many
already had their periods six weeks after the transplants, an early sign that
the wombs are healthy and functioning. One woman had an infection in her newly
received uterus and others had some minor rejection episodes, but none of the
recipients or donors needed intensive care after the surgery, Brannstrom said.
All left the hospital within days.
None of the women who donated or received wombs have been
identified. The transplants began in September 2012 and the donors include
mothers and other female relatives of the recipients. The team had initially
planned to do 10 transplants, but one woman couldn't proceed due to medical
reasons, university spokesman Krister Svahn said.
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.
The transplants have ignited hope among women unable to
have children because they lost a uterus to cancer or were born without one.
About one in 4,500 girls are born with a syndrome, known as MRKH, where they
don't have a womb.
Fertility experts have hailed the project as significant
but stress it's unknown whether the transplants will result in healthy babies.
The technique used in Sweden, using live donors, is
somewhat controversial. In Britain, doctors are also planning to perform uterus
transplants, but will only use wombs from dying or dead people. That was also
the case in Turkey. Last year, Turkish doctors announced their patient got
pregnant but the pregnancy failed after two months.
"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 500,000 pounds ($823,000) to carry out five operations in
Britain.
He said a womb transplant was like a radical hysterectomy but it requires
taking a bigger chunk of the surrounding blood vessels to ensure adequate blood
flow, raising the risk of complications for the donor. Smith said British
officials don't consider it ethical to let donors take such chances for an
operation that isn't considered life-saving.
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.
All of the women who received womb transplants will need to
take anti-rejection medicines, but Smith said data from women who have received
kidney transplants doesn't suggest their babies are at any increased risk from
the drugs.
Brannstrom said using live donors allowed them to ensure
the donated wombs were functional and didn't have any problems like an HPV
infection.
Doctors in Saudi Arabia performed the first womb transplant
in 2000, using a live donor, but that uterus had to be removed after three
months because of a blood clot.
Brannstrom said he and his colleagues hope to start
transferring embryos into some of their patients soon, possibly within months.
The Swedish researchers and others have previously reported successful uterus
transplants in animals including mice, sheep and baboons, but no offspring from
the primates were produced.
After a maximum of two pregnancies, the wombs will be
removed so 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.
Lise Gime, 35, who was born without a womb, said she
thought many women with the MRKH syndrome would be interested if the operation
proves to be safe and effective. Gime runs an organization for women with the
syndrome in Norway.
"If this had been possible when I was younger, no
doubt I would have been interested," she said. Gime, who has two foster
children, said the only option for women like her to have biological children
is via surrogacy, which is illegal in many European countries, including Norway
and Sweden.
Brannstrom warned the transplants might not result in
children but remained optimistic.
"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."