
In what could prove to be a major advancement for couples facing infertility, the first baby born from a deceased donor uterus transplant was successfully completed at the University Of Sao Paulo School Of Medicine in Brazil, according to a report in the scientific journal Lancet.
Uterine factor infertility is infertility in women born without a uterus; loss of the organ due to hysterectomy, cancer or postpartum haemorrhage; or a congenital defect, such as the rare Mayer-Rokitankshy-Kuster-Hauser syndrome, which was the reason for the Brazilian woman's infertility.
The surgery described in the case study took place in September 2016, and notes that a 32-year-old woman who had been born without a uterus was the recipient of the transplant.
Just seven months after the operation, doctors were able to begin in vitro fertilization, using the patient's own eggs harvested before her transplant surgery. The baby girl was born via caesarean section at 35 weeks and three days, and weighed nearly 3 kgs.
In 2011 a team in Turkey was the first to transplant a uterus from a deceased donor, but the procedure did not lead to a live birth.
The current norm for receiving a womb transplant is that the organ would come from a live family member willing to donate it.
Since then there have been 39 such procedures, resulting in 11 live births.
In 2016, doctors at the Cleveland Clinic in OH transplanted a uterus from a deceased donor, but it failed after an infection developed.
This was the first uterine transplantation in Latin America.
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The surgery involved connecting the donor uterus' and recipient's veins and arteries, ligaments, and vaginal canals.
Five months after the transplantation, the uterus showed no signs of rejection. This is the first time a woman has given birth with a deceased donor's uterus; some organs from live donors have figured in past births.
The recipient was given drugs that weakened her immune system to prevent her body from attacking and rejecting the transplant. The uterus is removed and immunosuppressants are stopped after birth, according to the Royal College of Obstetricians and Gynaecologists.
Professor Lois Salamonsen, research group head of endometrial remodelling and Adjunct Professor at Monash University's Department of Obstetrics and Gynaecology said she had received a few calls form Australian women over the years asking why uterine transplantation wasn't done in Australia.
Both-mother and the baby were discharged three days after birth.
Women who have irreversible infertility are the primary candidates to receive a transplant. Fifteen were fertilised, with 8 resulting in embryos that were subsequently preserved for later implantation. Previously, with live donors, doctors have waited at least a year following the transplant to begin trying for a pregnancy.
Ten days later, doctors delivered the good news: she was pregnant.
Besides a minor kidney infection - treated with antibiotics - during the 32nd week, the pregnancy was normal.
At seven months and 20 days - when the case study report was submitted to The Lancet - the baby girl was continuing to breastfeed and weighed 7.2 kg (16 lb).
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