December 6, 2017

BUMC delivers first child born after uterus transplant in the US

Daily Briefing

    Baylor University Medical Center on Friday announced that a woman who previously had received a transplanted uterus has given birth, marking a first in the United States.

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    Since 2014, eight infants have been born to women with transplanted uteruses at Sweden's Sahlgrenska University Hospital, which "pioneered the procedure," according to the Washington Post's "To Your Health."

    Uterus transplants are considered a source of hope for women who were previously unable to have children because they were born without a uterus or lost their uterus due to an illness, such as cancer, the New York Times reports.

    Baylor's clinical trial

    The latest birth is part of a clinical trial Baylor is running on uterus transplants. The trial is designed to include 10 women, and so far eight—including the woman who gave birth—have received a uterus from a living or deceased donor.

    Of the other seven recipients, one is pregnant, and two others are trying to conceive. In the four remaining cases, the transplants failed and the uteruses had to be removed, according to Giuliano Testa, leader of the Baylor trial and surgical chief of abdominal transplant for Baylor Annette C. and Harold C. Simmons Transplant Institute

    The trial recipients are ages 20 to 35 and have normal ovaries. The living donors are ages 30 to 60.

    The uterus transplants are not intended to be permanent; plans call for the transplanted organ to be removed surgically after a woman has one or two children.

    Before the transplant, recipients must take hormone treatments that cause their ovaries to release multiple eggs. Those eggs are harvested and frozen to be implanted via in vitro fertilization (IVF) after the transplant. Doctors attempt IVF after the woman has recovered from the transplant surgery and begun menstruating.

    The pregnancies are considered inherently high risk, according to the Times, and the babies are delivered via caesarian section to avoid straining the uterus.

    The new baby boy

    Baylor announced that the woman gave birth to a healthy baby boy last month.

    The family of the new baby has requested that their name, hometown, and the infant's birth date be withheld to protect their privacy, according to a Baylor spokesperson.

    While the Swedish team waited a year after transplant to attempt pregnancy, the team at Baylor attempted pregnancy sooner. Testa said he hoped to proceed as quickly as possible to remove women from the transplant anti-rejection drugs. He said, "We went shorter ... I think we were right." 

    Liza Johannesson, a uterus transplant surgeon who left the Swedish team to come to Baylor, said the case was especially significant because it demonstrated that the process could be replicated outside of the Swedish hospital. "To make the field grow and expand and have the procedure come out to more women, it has to be reproduced," Johannesson said.

    Both Johannesson and Testa said they were motivated in large part by meeting patients who could not have children and learning how devastated they felt. And, according to Baylor, there is interest among women to become a donor. The hospital said about 70 women have expressed interest in donating their uteruses.

    The uterine donor in the latest birth, Taylor Siler, is a 36-year-old RN in Dallas who has two children of her own. Siler said she was not always sure she wanted children but said getting pregnant was one of the best decisions she ever made. "I just think that if we can give more people that option, that's an awesome thing" (Wootson, "To Your Health," Washington Post, 12/3; Grady, New York Times, 12/2; Sifferlin, Time, 12/1; Reuters, 12/1; Marchione, AP/Sacramento Bee, 12/1;  Park, CNN, 12/4).

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