WOMB TRANSPLANTS ON THE WAY

Scots surgeon in pioneering first for the UK

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 Scots 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 Falkirk-born Mr Smith, an awardwinning surgeon at Imperial College London, it is the culmination of 20 years of research by him and his unpaid team.

The 57-year-old, a father of four, graduated as a Doctor of Medicine (MD) on cervical cancer, immunity and infection from the University of Glasgow in 1992. He is editor of the Atlas of Gynaecologic Oncology and has lectured worldwide on subjects including HIV in obstetrics, gynaecology and fertility.

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.

Although permission was granted in the UK in 2015 for transplants using dead donors, experts 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 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.

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 said: ‘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.’

Some doctors warn womb transplants need more strictly controlled clinical trials. Experts from Japan reviewed the findings so far and said the technique offered ‘great hope’ but little was known about factors which can affect its success.

Writing in the international Journal of Obstetrics and Gynaecology, they said complications have included thrombosis.

Immuno-suppressants, used to reduce risk of rejection of a transplanted womb, may also play a role in the development of pre-eclampsia, said the authors.

‘We need to strive for these women’