Over 90 womb transplants have been conducted globally, spanning countries such as Sweden, the United States, Saudi Arabia, Turkey, China, the Czech Republic, Brazil, Germany, Serbia, and India

A woman in the United Kingdom who was born without a functional womb now has the chance to have a child of her own thanks to a pioneering womb transplant – a first-of-its-kind achievement in the country. The procedure was carried by a team led by experts from Imperial College London and Oxford University Hospitals.

According to a report published in the BJOG, an international journal of obstetrics and gynaecology, both the donor and recipient underwent thorough preoperative counseling and comprehensive evaluation by various medical specialists including gynaecologists, transplant surgeons, obstetricians, reproductive and transplant psychologists, anaesthetists, and pharmacists.

The recipient, a 34-year-old woman, with Type I Mayer–Rokitansky–Küster–Hauser syndrome was without any other medical or psychological history. She had not undergone previous surgery, she was a non-smoker, drank minimal alcohol, and was not taking any medication.

“She was married, and had a supportive family. Her blood group was B positive. She was comprehensively counselled regarding her other options to acquire motherhood. She specifically desired a biological relation to her offspring, and expressed the desire to gestate and give birth, instead of using surrogacy. She underwent in vitro fertilisation, including two cycles of controlled ovarian stimulation using an antagonist protocol,” the BJOG report explained.

The donor, the recipient’s 40-year-old sister, had no significant medical or psychological history. Having experienced two previous normal vaginal deliveries, she completed her family.

The donor was discharged on postoperative on the fifth day, and had an uneventful recovery. The recipient was discharged on day 10 postoperatively and her longer stay is attributed to excessive lymph output, which was resolved conservatively. Following discharge, meticulous follow-ups occurred, initially biweekly for the first month and then weekly, encompassing clinical evaluations, swabs, blood tests, and biopsies.

An independent assessor of the Human Tissue Authority (HTA) scrutinized both parties to ensure their informed consent, awareness of associated risks, and voluntary participation. Approval for the transplant was granted after a panel review by the HTA. The programme gained authorization from Oxford University Hospitals NHS Trust’s Technology Advisory Group and Senior Management Team, and received consultation and endorsement from NHS England.

In the UK, one in 5,000 women faces the challenge of being born without a viable womb, while many others lose theirs due to various illnesses.

Over 90 womb transplants have been conducted globally, spanning countries such as Sweden, the United States, Saudi Arabia, Turkey, China, the Czech Republic, Brazil, Germany, Serbia, and India. The majority of these procedures utilized living donors, leading to the birth of approximately 50 babies.

“Our case has a number of novel aspects that add to the previously published literature. First, this is the first successful case where vascular reconstruction was undertaken, Another novelty from this case is the venous drainage used; this is the first case that has used the recipient’s inferior epigastric vein for venous drainage. The typical venous drainage employed in UTx cases so far includes the uterine veins or the utero-ovarian veins, or a combination of both,” the BJOG report said.

The guardian reported the 34-year-old was “incredibly happy” and “over the moon” with the success of the nine-hour operation, according to the medical team behind the pioneering procedure. She now plans to have two children using IVF.

The co-lead surgeon Isabel Quiroga, a consultant surgeon at the Oxford Transplant Centre, part of Oxford University hospitals, said she was “thrilled” and “extremely proud” the surgery had been a success. “Her womb is functioning perfectly and we are monitoring her progress very closely,” Quiroga said.

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