The UK’s First Womb Transplant Surgery

Written by Leanne Devine, Senior Birth Injury Solicitor

Earlier this year, surgeons at Oxford Transplant Centre, performed the UK’s first womb transplant.

This comes nine years on from the world’s first successful womb transplant, which took place in Sweden, in 2014. Since then, there have been over 100 successful womb transplants worldwide; with many babies being successfully carried and born. Although there have been successful womb transplant surgeries globally since 2014, this was the first ever to be performed in the UK.

This news is life-changing, particularly for women who are unable to conceive naturally. Additionally, patients who have had a hysterectomy due to illness, such as womb cancer, may also be eligible for the procedure. The transplant allows women an alternative to adoption or surrogacy; and allows them to carry their own children – which would otherwise be impossible for them.

Here we explore the complexities of this procedure, and highlight the careful and highly emotive considerations that eligible women are faced with when they sign on the dotted line

 

How the donor process works

For the transplant, surgeons can use the womb of either living or deceased donors. According to Womb Transplant UK; “The research team have permissions to carry out live donor operations – the Charity proposes to fund up to five living donor transplants – and a research trial of 10 operations, where the patient will receive a compatible womb from a deceased donor.”

The recipient of the womb, in the recent UK case was a 34-year-old woman, was born with a rare condition called Mayer-Rokitansky-Küster-Hauser syndrome (MRKH). This syndrome resulted in the lady being born without a womb. Women with this condition also suffer from an undeveloped vagina, an underdeveloped (or lack of), womb, and do not experience menstrual cycles.  The donor, the recipient’s sister, has two children of her own and decided to donate her womb to her sister. Both sisters went through extensive testing, including counselling, prior to the surgery.

Of course, a procedure as invasive as this comes with its risks. There are not only the physical considerations of both parties, but the emotional ones too. The donor in this case had to make an active decision that she did not want to have any further children of her own – which in itself is something not to be taken lightly. The recipient, as we will come onto, had to consider the surgery and the long-term implications for her life. Fortunately, though, the transplant was successful. Although the recipient did not have a womb prior to the transplant, she did have functioning ovaries, and as such, she has since had a successful monthly cycle.

 

The emotional considerations of eligible women

In the UK case, mentioned above, the surgery itself is only one part of the process. The hope now is that the UK recipient will be able to get pregnant and carry her own baby with the assistance of IVF. This brings into the mix the additional implications of IVF treatment – and the stress this can bring to an individual. This includes the risks associated with IVF treatment; such as headaches and hot flushes, multiple births (such as twins or triplets) and ectopic pregnancies.

Even following a successful womb transplant and IVF, there is no guarantee there will be a successful birth. The chance of a successful birth following IVF treatment decreases with age. According to the NHS website, in 2019 the percentage of IVF treatments that resulted in live births were as follows;

• 32% for women under 35
• 25% for women aged 35 to 37
• 19% for women aged 38 to 39
• 11% for women aged 40 to 42
• 5% for women aged 43 to 44
• 4% for women aged over 44

Following a successful term, the idea would be to remove the recipient’s womb once she has delivered her baby. This is so that she can stop taking the anti-rejection drugs, which are prescribed to her following the surgery to help aid a successful transplant. Having two major surgeries (one to implant the womb and another surgery to remove it) does not come without its risks. Both procedures are invasive and can have both physical and mental implications. The risks of the surgery include bleeding, infection, and an injury to the bowel or bladder.

 

So, what does this all mean?

Overall, womb transplant surgery is a significant medical advancement, as it will allow people who have been previously infertile to conceive and carry their own child. However, it is important that patients receive appropriate physical and psychological aftercare to help support patients in their recovery.