Saturday November 23, 2019

Australian Cervical Cancer Patient’s crazy request for New Womb makes History

Miscarriages are happening all over the place but here you have these dead uteruses that can carry a baby

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FILE - In this April 4, 2012 photo made available by the University of Goteborg in Sweden, the Swedish research team practices before the operations to transplant wombs at the Sahlgrenska Hospital in Goteborg, Sweden.(VOA)
  • Brannstrom went on to become the first doctor to deliver babies — five so far — from women with donated wombs
  • Over the next decade, Brannstrom and his team performed hundreds of uterus transplants in rats, sheep, pigs and monkeys
  • The wombs are intended to be kept for a maximum of two pregnancies and are then removed so that patients can stop taking anti-rejection medicines

Stockholm, October 8, 2016: When the young Australian cervical cancer patient learned she had to lose her womb in order to survive, she proposed something audacious to the doctor who was treating her: She asked if she could have a womb transplant, so she could one day carry her own baby.

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This was nearly two decades ago when the Swedish doctor Mats Brannstrom was training to be a physician abroad.

“I thought she was a bit crazy,” Brannstrom said.

But Brannstrom didn’t dismiss her idea. Instead, after he returned to Sweden he began a series of painstaking research projects to learn whether it might be possible to transplant a womb, despite criticism that the unheard-of procedure was dangerous, medically unnecessary, and impossible.

Mats Brannstrom poses besides a photo showing the birth of a baby of a mother with a womb transplant at Stockholm IVF fertility clinic in Stockholm, Sweden, Sept. 19, 2016. (VOA)
Mats Brannstrom poses beside a photo showing the birth of a baby of a mother with a womb transplant at Stockholm IVF fertility clinic in Stockholm, Sweden, Sept. 19, 2016. (VOA)

Brannstrom went on to become the first doctor to deliver babies — five so far — from women with donated wombs. No other doctor in the world has succeeded, despite attempts in the U.S., Saudi Arabia and Turkey, and ongoing efforts in China, Britain, France, the Czech Republic and elsewhere.

The first of Brannstrom’s patients’ babies was born in 2014 and the fifth arrived in January; another is due in early 2017.

Brannstrom is working with doctors at Harvard Medical School and the Mayo Clinic to help women beyond Sweden get access to the procedure. Doctors at Baylor University in Texas, including two former members of Brannstrom’s team, announced this week they performed four womb transplants. One was successful, but not yet ready to attempt a pregnancy.

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And scientists, many of whom were both doubtful and critical before, now believe Brannstrom’s work could help them extend the use of organs for those who need transplants and learn how embryos implant in the uterus after conception, a poorly understood but critical stage in pregnancy.

Early studies, custom-made tools

To figure out if womb transplants were even feasible, Brannstrom first asked Rana Akouri, then one of his doctoral students, to start experimenting in rodents in 1999. He picked Akouri because of her delicate surgical skills — a mouse uterus is only less than an inch long (about 2 centimeters). The surgery was so complex, Akouri needed four custom-made tools to perform the microscopic operations.

FILE - Vincent, the first baby born to a woman who had a womb transplant, is cradled by his mother at an undisclosed location in Sweden, Oct. 6, 2014.(VOA)
FILE – Vincent, the first baby born to a woman who had a womb transplant, is cradled by his mother at an undisclosed location in Sweden, Oct. 6, 2014.(VOA)

After nearly two years, Akouri noticed in the belly of one of her mice a slight bulge. Too impatient to wait, she performed a cesarean section that evening — and found two tiny babies inside.

“I called Mats at 10pm and told him, ‘one of our mice is pregnant!’” she said.

That night, Brannstrom said, was the first time he thought that a womb transplant in humans might actually be possible.

“If it hadn’t worked in mice, we would have quit,” he said.

Transplants, tests, travel

Over the next decade, Brannstrom and his team performed hundreds of uterus transplants in rats, sheep, pigs and monkeys. Because Sweden forbids experiments in non-human primates, Brannstrom and 10 other doctors and nurses flew to Kenya nearly 20 times to perfect things like their surgical technique and the use of immune-suppressing drugs in baboons.

Brannstrom described the less-than-ideal conditions in Nairobi — no regular showers and power failures during surgery — as “team-building” experiences. Wooden carvings of African birds picked up during those trips now adorn several shelves at Brannstrom’s fertility clinic in Stockholm.

‘Into the unknown’

In 2012, it was time to try the surgery in humans. He obtained ethical permission to perform womb transplants in nine Swedish women. He then held an information session one evening in the southern city of Gothenburg, where the operations were to take place.

“We were quite frank in telling them, ‘This is not an infertility treatment, you’re participating in a scientific trial,’” he said. “We’re going into the unknown.”

Albin's mother Emelie Eriksson, left, poses for a photo with her son and her mother Marie, right, outside her home in Bergshamra, Sweden, Sept. 20, 2016. For Emelie Eriksson, the bond she shares with her son Albin is particularly unique: both Emelie and Albin were born from the same womb, after Emelie received her mother’s transplanted uterus in a revolutionary operation that links three generations of their family. (VOA)
Albin’s mother Emelie Eriksson, left, poses for a photo with her son and her mother Marie, right, outside her home in Bergshamra, Sweden, Sept. 20, 2016. For Emelie Eriksson, the bond she shares with her son Albin is particularly unique: both Emelie and Albin were born from the same womb, after Emelie received her mother’s transplanted uterus in a revolutionary operation that links three generations of their family. (VOA)

Of the nine women who had the transplants, two had their wombs removed when complications arose. Five women had healthy babies and the last two are trying to get pregnant.

At the time, many fertility experts considered it an outlandish pursuit.

“I thought this was crazy, a high-risk surgery for no reason,” said Dr. Tommaso Falcone of the Cleveland Clinic in the U.S. But a trip to Sweden to see Brannstrom’s clinic changed his mind. Falcone is now at the forefront of the Cleveland Clinic’s womb transplantation project. He and colleagues performed the first such operation in the U.S. in February, although the organ had to be removed after the patient developed an infection.

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Falcone predicts that Brannstrom’s work will lead to a better understanding of embryo implantation. And he marveled at the fact that babies have been born from organs once flushed with a cold solution — rendering them technically dead — before being placed into the recipient.

“Miscarriages are happening all over the place but here you have these dead uteruses that can carry a baby,” he said.

‘Rejuvenating’ older wombs

Other experts thought it was astonishing that wombs of some post-menopausal women were able to grow healthy babies after being transplanted. Doctors typically expect younger organs to work better, but in the case of womb transplantation, organs from older women appeared “rejuvenated” after being dosed with hormones.

“All of a sudden, you have this old organ doing things that you only expected a young uterus to do,” said Dr. Stefan Tullius, chair of transplant surgery at Harvard Medical School, who said that could lead to insights into extending the use of other organs.

Until now, Brannstrom has only used live donors, considered by some to be unethical because it means putting a healthy woman at risk for a procedure that isn’t life-saving. The wombs are intended to be kept for a maximum of two pregnancies and are then removed so that patients can stop taking anti-rejection medicines.

Brannstrom believes doctors in other countries will soon deliver more babies from women with transplanted wombs and predicts that the surgery will one day become routine.

Emelie Eriksson, who received a womb transplant and then had a baby boy in 2014, said she could never thank Brannstrom enough.

“I think I need to thank him a thousand times more,” she said. “He’s my hero. He made it possible for me to have a child.” (VOA)

  • Antara

    Medical marvels keep fascinating us! Amazing news!

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First Successful Case Of Womb Transplant in Brazil

In the Brazilian case, the recipient had been born without a uterus due to a condition called Mayer-Rokitansky-Küster-Hauser syndrome. The donor was 45 and died of a stroke.

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Womb Transplant
Medical team hold the first baby born via uterus transplant from a deceased donor at the hospital in Sao Paulo, Brazil. VOA

A woman in Brazil who received a womb transplanted from a deceased donor has given birth to a baby girl in the first successful case of its kind, doctors reported.

The case, published in The Lancet medical journal, involved connecting veins from the donor uterus with the recipient’s veins, as well as linking arteries, ligaments and vaginal canals.

It comes after 10 previously known cases of uterus transplants from deceased donors – in the United States, the Czech Republic and Turkey – failed to produce a live birth.

The girl born in the Brazilian case was delivered via caesarean section at 35 weeks and three days, and weighed 2,550 grams (nearly 6 lbs), the case study said.

Dani Ejzenberg, a doctor at Brazil’s Sao Paulo University hospital who led the research, said the transplant – carried out in September 2016 when the recipient was 32 – shows the technique is feasible and could offer women with uterine infertility access to a larger pool of potential donors.

Womb
. The woman’s previously fertilized and frozen eggs were implanted after seven months and 10 days later she was confirmed pregnant.. Pixabay

The current norm for receiving a womb transplant is that the organ would come from a live family member willing to donate it.

“The numbers of people willing and committed to donate organs upon their own deaths are far larger than those of live donors, offering a much wider potential donor population,” Ejzenberg said in a statement about the results.

She added, however, that the outcomes and effects of womb donations from live and deceased donors have yet to be compared, and said the technique could still be refined and optimised.

The first baby born after a live donor womb transplant was in Sweden in 2013. Scientists have so far reported a total of 39 procedures of this kind, resulting in 11 live births.

Experts estimate that infertility affects around 10 to 15 percent of couples of reproductive age worldwide. Of this group, around one in 500 women have uterine problems.

Before uterus transplants became possible, the only options to have a child were adoption or surrogacy.

Infants, baby, WOmb
The case, published in The Lancet medical journal, involved connecting veins from the donor uterus with the recipient’s veins. Pixabay

In the Brazilian case, the recipient had been born without a uterus due to a condition called Mayer-Rokitansky-Küster-Hauser syndrome. The donor was 45 and died of a stroke.

Also Read: Pregnancy is Possible For Survivors of Breast Cancer

Five months after the transplant, Ejzenberg’s team wrote, the uterus showed no signs of rejection, ultrasound scans were normal, and the recipient was having regular menstruation. The woman’s previously fertilized and frozen eggs were implanted after seven months and 10 days later she was confirmed pregnant.

At seven months and 20 days – when the case study report was submitted to The Lancet – the baby girl was continuing to breastfeed and weighed 7.2 kg (16 lb). (VOA)