Human Development

Womb Transplants May be Possible Within 2 Years

London-based researchers, working with medical teams in New York and Budapest, have developed a technique for providing a transplanted womb with a reliable blood supply.

Women born without a uterus or who have undergone an emergency hysterectomy would be among those to benefit from the procedure.

The transplant would be temporary, doctors being reluctant to continue giving a patient drugs to help the body to fight rejection of the womb.

That could leave the woman two to three years to conceive and carry a baby or babies before the womb was removed.

Maintaining a reliable blood supply has been seen as crucial before the technique — which has worked in animals — can be successfully performed on humans.

The first uterus transplant, carried out on a Saudi woman in 2000, failed when a blood vessel supplying the organ developed a clot.

Richard Smith, a consultant gynaecologist at Hammersmith Hospital in West London, said: “By getting to a place where we seem to have a reliable method of giving the uterus a blood supply, that takes us a whole heap closer to being able to provide this for humans.”

Mr Smith and his team, who have been working on the project for eight years, hope that before long they will be able to transplant a womb from a deceased donor into a woman who is unable to conceive. He said: “I think that two years probably is realistic.”

Researchers in Sweden as well as Saudi Arabia are also working on womb transplants. Mr Smith said that about 30 women had expressed an interest in the procedure.

There are thought be more than 15,000 women in Britain without a uterus. At present, one option for a childless woman is surrogacy, but that brings physical and emotional complications.

Now Mr Smith and his team intend to apply for permission from his hospital’s ethics committee and the UK transplant programme to proceed with a human womb transplant.

In 2002 doctors in Saudi Arabia, where surrogacy is illegal, disclosed that they had carried out the world’s first uterus transplant two years earlier.

The patient was a 26-year-old Saudi woman who had lost her uterus because of excessive bleeding after childbirth. The transplanted womb, from a 46-year-old post-menopausal woman who had to have a hysterectomy, produced two menstrual periods before it failed and had to be removed.

Dr Wafa Fageeh, a professor at Abdulaziz University who carried out the procedure with her team at King Fahd Hospital and Research Centre in Jedda, said at the time it was a “good start”. The operation failed because a blood vessel supplying the uterus developed a clot, which cut off the blood supply, the International Journal of Gynaecology and Obstetrics reported.

Many scientists had considered womb transplants impossible, given the complex blood vessels that must be connected and because of fears that anti-rejection immunosuppressant drugs could harm a foetus.

But Mr Smith said: “There is plenty of experience of transplanting kidneys and those women getting pregnant, and there appear to be minimal problems (with reactions to immunosuppressant drugs).”

Swedish scientists have produced healthy offspring from mice with transplanted wombs.

The project leader, Dr Mats Brannstrom, of Sahlgrenska University in Gothenburg, has estimated that, in 3 per cent of infertile women, problems may be traced to the uterus.

[Ian Evans, http://www.timesonline.co.uk/article/0%2C%2C2-2342896%2C00.html, The Times, 5Sept06]