A world first! Swedes have grafted their mothers’ wombs to two young women to enable them to have a child. Hope for thousands of women without a womb.
Giving birth to a child thanks to its mother’s womb is the unprecedented experience that two young Swedish women are about to live. Aged in their thirties, they want to become a mother but cannot because they do not have a uterus. One had her uterus removed because she had cervical cancer, and the other was born without a uterus, suffering from a rare condition called Rokitanski syndrome. For them, all the advances in medically assisted procreation have changed nothing in their lifetime. The only way out of being a mother was adoption.
Researchers at the University of Gothenburg have just given them the hope of one day bearing their child. Indeed, these two young people have just undergone a uterus transplant. And for the first time in the world, the donor is the mother of the recipient! This feat is the culmination of more than ten years of research. And no less than ten surgeons – who have also been training for several years – have performed this procedure.
How did the transplant go? Swedish doctors first of all paid particular attention to the choice of the donor-recipient “couple”. They therefore assessed the mother’s uterus to see if it was capable of accommodating an embryo and supporting its development. The quality of the bonds between mother and daughter was also studied. Then the in vitro fertilizations were performed, and the embryos were frozen. All that remained was to remove the uterus from the mother and implant it in the daughter.
Listen to Dr Pascal Piver, head of the medically assisted procreation center at Limoges University Hospital: “This surgical intervention presents risks for the donor”.
A few days after the transplant, it is therefore too early to speak of success. In 2002, a woman was operated on in Saudi Arabia. Three months after the operation, the graft was rejected. We will therefore have to wait another year before being able to implant the embryos in the two young Swedish transplant recipients and a few more months before being able to say that the pregnancy is a success. One of the questions that arises is the impact on the fetus of immunosuppressive treatments, which are inherent in any transplant. Moreover, to expose the recipient as little as possible to the side effects of these treatments, the uterus will be removed as soon as the woman has been able to give birth to one or two children, according to the couple’s wishes.
In France, is such an intervention possible? At the moment, we are at the research stage. Experiments were carried out in ewes by the Limoges University Hospital team, in order to assess the feasibility of removing the uterus. But already, Pascal Pivert does not quite agree with his Swedish colleagues who have had recourse to living donors.
Listen to Dr Pascal Piver : “It is questionable whether an organ is removed from a healthy person and transplanted a non-vital organ.”
Using samples from deceased donors is therefore the preferred route for the French. It remains to be seen whether after having removed a heart, a liver and then kidneys, it is technically possible to also remove a uterus.
The question is central because the ethical debate is not quite the same when it comes to living or deceased donors. The use of a living donor for a kidney or liver transplant seems more acceptable since the life of the recipient is at stake. Of course, for women deprived of a uterus, the work of Swedish doctors represents real hope. In France, one in 4,500 girls is affected by Rokitanski syndrome, and therefore comes into the world without a uterus. As for hysterectomies, there are about 70,000 per year but the majority concerns women who are no longer of childbearing age.
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