Doctors in Xi-jing Hospital in Xi’an, China, announced that they had successfully performed a uterus transplantation from mother to daughter on November 20, with a team of 38 specialists across 11 specialties. The operation took 14 hours. Surgeons used the Leonardo da Vinci surgical robot for the donor, then by microscope guided microsurgical vascular anastomosis, the uterus from the donor was implanted in the patient.
The patient recovered well, and the transplanted uterus survived. Doctors planned to implant a fertilized egg into the uterus in the near future so that the patient can have her own child.
The first human uterus transplant was performed in 2002, and 12 successful cases had been reported since then. However, only one patient delivered a new baby in 2014 in Sweden. Let us wait and see if this time, transplanted uterus can pregnant and laboring.
Women with congenital anomalies who desire a pregnancy are likely to be younger with adequate ovarian function. It is important to assess ovarian reserve prior to considering transplantation. Couples will probably require assisted reproduction following the transplant surgery. The embryo for transfer should be obtained prior to the uterus transplantation. However, if the donor is an older relative, such as a mother, it is likely that a postmenopausal uterus may limit the success of reproduction. On the other hand, if the donor is of reproductive age, then she loses the ability to become pregnant again in the future. In addition, a living donor exposes herself to surgical risks that are greater than those of a simple hysterectomy, as the procedure is more radical in order to obtain adequate vascular pedicles. A deceased (brain-dead) donor, therefore, may be ideal.
In 2000, surgeons in Saudi Arabia gave a 26-year-old woman a uterus transplant. Organ donor was a 46-year-old woman suffering from ovarian cysts. The recipient was a 20-year-old woman with her uterus removed because of bleeding from Caesarean surgery. 99 days after the transplant, blood clot appeared in artery, and the transplanted organ had to be removed. In 2011, surgeons in Turkey performed one case of uterus transplant. The recipient started a pregnancy through in vitro fertilization in 2013, but had a miscarriage afterwards. From 2012 to 2014, surgeons in Sweden had performed over 9 uterine transplants. A 36-year-old woman who received a uterus transplant from a living donor gave birth to a baby boy in September 2014. According to an article published in the Lancet, in this only successful Sweden case with 31 weeks and 5 days gestation, the patient was admitted to the hospital with preeclampsia. The baby’s heart rate was abnormal and the baby boy was delivered by cesarean section 16 hours later. The baby’s birth weight was normal for gestational age (1775 g) and his Apgar scores were 9, 9, and 10.