A successful birth from a uterus transplant outside of a clinical setting has been performed for the first time at UAB hospital.
The first healthy baby has been born from a uterus transplant at UAB hospital in May 2023.
The baby boy was born to a woman with Mayer-Rokitansky-Küster-Hauser syndrome, a condition where a woman is born without a uterus. This woman was the first to give birth via uterus transplant outside a clinical trial, and her baby was the first born from the UAB Comprehensive Transplant Institute and UAB Medicine uterus transplant program.
“The birth of UAB’s first uterus transplant program baby is an incredible milestone not just for the patient and the field, but for our multidisciplinary team here at UAB, as this marks our ability as an institution to offer another option for patients who are experiencing uterine factor infertility,” said Paige Porrett, MD, PhD, inaugural director for vascularized composite allotransplantation in UAB’s Comprehensive Transplant Institute.
Up to 5% of reproductive-aged women worldwide may be impacted by uterine factor infertility, which was once considered an irreversible form of infertility. Uterine factor infertility may be caused by birth without a uterus or uterus removal from a hysterectomy.
Uterus transplant is accomplished through 5 phases: embryo generation, transplantation, pregnancy, delivery, and uterus removal. Embryo generation occurs through in vitro fertilization, where fertility drugs are administered to produce eggs. Those eggs are then removed from the ovaries and fertilized outside the body.
In the transplantation stage, a uterus is removed from the owner and placed into the receiver through surgery. Immunosuppressive medications are also administered to prevent the transplanted uterus from being rejected. These medications will also be taken during pregnancy.
Pregnancy occurs months after transplantation, when an embryo is thawed and placed within the uterus. A maternal-fetal medicine specialist conducts frequent prenatal care visits to evaluate maternal and fetal health.
Delivery occurs through planned cesarean section as close to term as possible. Continued use of immunosuppression medications occurs if the mother wishes to have a second child, with another embryo transfer possible after 6 months. Once childbearing is finished, the uterus is removed, and the recipient no longer takes immunosuppression medications.
At UAB, this process involved specialized care from multiple departments, including the Departments of Surgery, Obstetrics & Gynecology, Radiology, Pathology, Medicine, Anesthesiology, and Pediatrics. Over 50 health care workers worked to ensure this procedure was a success.
“One of the major successes was working with the other specialties that we don’t typically work this closely with, and the ability to collectively take care of a patient with a single goal and offer our unique perspectives; to me, that was the real success — that we ended up with a healthy mom and baby,” said Brian Brocato, DO, assistant professor in the Division of Maternal-Fetal Medicine.
According to Porrett, this birth indicates the emerging technology works. With the program’s success, UAB’s team is caring for other patients receiving uterus transplants at different phases of the process. UAB hopes to make uterus transplant an, “accessible, standard care for infertility.”
UAB’s first uterus transplant recipient delivers healthy baby. UAB News. July 24, 2023. Accessed July 27, 2023. https://www.uab.edu/news/health/item/13684-uab-s-first-uterus-transplant-recipient-delivers-healthy-baby