Uterine Transplants

Advances are bringing new hope to women born without a uterus

Brazilian doctors recently announced the birth of the world’s first baby whose mother had received a transplanted uterus from a deceased donor. This milestone garnered global attention, especially among women who were born without a uterus. This achievement has offered them renewed hope to be able to experience a pregnancy and deliver a baby.

Born without a uterus

One in 4500 newborn girls is born with Mayer-Rokitansky-Küster-Hauser syndrome, better known as MRKH. It is a congenital condition characterized by an underdeveloped or absent vagina and uterus though women have normal external genitalia, pubic hair, and functioning ovaries and fallopian tubes. Most females do not realize they have this disorder until they have not had their first menstrual period, usually between the ages of 15 to 17.

Doctors have not found a cause for MRKH, named after the doctors who discovered it. But they know something happens that causes the female reproductive system to stop fully developing when a girl fetus is in her mother’s womb.

Psychological impact

One of the most distressing results of MKRH is how the diagnosis affects young women’s self-esteem as they are growing from girls to young women. The ramifications can last a lifetime.

Even though it may come as a relief to know the reason they are not menstruating, MRKH can have detrimental emotional repercussions. Teenagers discovering their sexuality may feel less of a woman than their friends. The news they cannot naturally carry a baby without assisted reproductive technologies is devastating, shattering long-held dreams. Once they decide to have children, their alternatives for family building include in vitro fertilization and surrogacy.

Uterine transplants

In 2014, the world’s first uterine transplant from a living donor took place in Sweden. The Swedish specialists were determined to share their knowledge with colleagues in other countries, which helped several U.S. medical centers develop living transplant programs.

The separate surgeries take five hours each for donor and recipient. The recipients usually achieve menstruation four to six weeks later and can attempt pregnancy three to six months after that. Even though the recipients have functioning ovaries and fallopian tubes, they still must undergo in vitro fertilization because of the complexity of reattaching these reproductive organs to the new uterus.

There have been several successful births from a uterine transplant with a living donor; the Brazilian delivery was the first from a deceased one. After the women are finished with childbearing, surgeons remove the transplanted uterus.

The procedures are costly, and infections and organ rejection are possibilities, but the doctors who are performing these groundbreaking transplants are hopeful they will become more commonplace. Donation from deceased women would simplify the process, eliminating the risks to the selfless women who want to help other women experience the joy of childbirth.

This medical miracle is something to celebrate in the new year and beyond.

 

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