THREE BRITISH WOMEN TO GET NEW WOMBS

Pioneering transplants from mothers or sisters will offer precious baby hope

THREE women are to become the first in Britain to have womb transplants.

They will undergo pioneering surgery within the next few months using wombs donated by a mother or sister. Doctors believe the procedure may allow thousands of women to realise their dream of motherhood.

‘It’s a truly exciting time,’ said Richard Smith, the consultant gynaecologist leading the project. ‘We have the opportunity to make a real difference.

‘It’s a major step forward for women with absolute uterine infertility. Until now their only options have been adoption or surrogacy, which is not always

easy.’ It means the first British baby could be born as a result of the procedure by early 2020. The surgery will take place at the Churchill Hospital in Oxford.

The world’s first successful womb transplant took place in Sweden in 2013. The UK has led the way in research but red tape and lack of funding have let other countries forge head.

The treatment, which costs around £30,000 per patient, is being funded by the charity Womb Transplant UK because it is still too experimental for the NHS.

For Mr Smith, an award-winning surgeon from Imperial College London, it is the culmination of 20 years of research by him and his unpaid team. The women are expected to be chosen within weeks from a waiting list of around 50.

All want children but were either born without a functioning womb or have had it removed due to illnesses such as cancer.

Aged between 24 and 38, they must be in long-term relationships, healthy and still have ovaries. They will also undergo psychological examination.

Prior to surgery, the successful couples will undergo IVF treatment so that the embryos can be implanted six months after the transplant. The baby will need to be delivered by caesarean section because the transplanted uterus is likely to become detached during childbirth.

Once a patient’s family is complete, the womb will be removed to stop the need for anti-rejection medication.

Eleven babies have been born worldwide as a result of 42 womb transplants, mostly in Sweden, the US and the Middle East.

In 2014, Malin Stenburg, then 36, became the world’s first woman to have a baby following a womb transplant from a donation from a 61-year-old family friend.

Vincent was born two months prematurely following treatment by Gothenburg University, which has higher success rates than traditional IVF.

Although permission was granted in the UK in 2015 for transplants using dead donors, experts generally prefer live family donors to minimise the chances of rejection. While previous transplants have taken surgeons up to 13 hours, a technique Mr Smith helped develop while treating a patient with cervical cancer will reduce this to between three and four.

Two babies have already been born using the procedure – abdominal radical trachelectomy. Womb Transplant UK has now been given the green light by the NHS to test the technique on UK patients.

Although many patients on its waiting list have relatives who are willing donors, the charity has only enough money for three procedures.

It hopes today’s announcement could generate the £400,000 needed for a further two live transplants – and ten more from dead donors – in the next two years. If the research is successful, doctors suggest the procedure could become available on the NHS by 2022. Mr Smith warned the whole process would be ‘far from easy’ for those selected for the life-changing procedure.

But the father of four added: ‘Anyone who sees the suffering these women go through – not only being unable to physically carry a child but relationships destroyed, and their heartbreaking sense of somehow being an “incomplete” – would know these are a group of women who we really do need to strive for. It is up to me and other doctors to do the best we can by them and help them to become parents.’

Some doctors have warned that womb transplants require more strictly controlled clinical trials before they can be used more widely. Experts from Japan reviewed

‘We need to strive for these women’

the findings so far and said while the technique offered ‘great hope’ for women, little was known about factors which can affect its success.

They say a more targeted approach is needed to see whether factors such as the age of donors and recipients and other health conditions are important.

Writing in the international Journal of Obstetrics and Gynaecology, they said complications have included urinary tract problems, thrombosis, infection and haematoma

‘The process will be far from easy’

in those receiving the transplant.

Immuno-suppressants, which are used to reduce risk of rejection of a transplanted womb, may also play a role in the development of pre-eclampsia, and high-risk pregnancy monitoring is necessary, said the authors. Measures for the management of treatment-resistant rejection of the womb during pregnancy were required and this remained a major task, they add.

The Japanese scientists said there had been only ‘limited success’ since the first womb transplant in 2014.