The first UK womb transplants are expected to take place by the end of the year, using wombs from deceased donors as well as live donors related to recipients.
Researchers from the charity Womb Transplant UK have been raising funds to conduct the procedures in order to help women without wombs carry their biological children. The team now have enough money to provide three women with womb transplants in 2018.
Clinical lead Richard Smith said they plan to go ahead after evolutions in surgical techniques have reduced the surgery time to between three and five hours - previously operations took 12-13 hours and posed “significant risk of
potentially life-threatening blood clots” for women.
“As a result of this innovation, we will now be performing womb transplants using living donors, in addition to the deceased donor programme, and we hope to carry out the first operations before the end of 2018,” Smith said in a statement.
So, what do we know about the procedure so far and is it likely to become more widely available?
What is a womb transplant?
A womb transplant, sometimes called a uterine transplant, is when a healthy womb is surgically removed from a donor and then transplanted into a recipient. It’s a complex procedure and the surgeons at Womb Transplant UK estimate their upcoming donor operations will take between three and four hours, while the implantation of the donated womb will take approximately four-six hours.
If the recipient’s body successfully accepts the new womb, after six months the woman will be able to undergo embryo transplant. This involves surgeons inserting embryos into the womb that are usually the result of the recipient and her partner (or donor) undergoing IVF.
According to Womb Transplant UK, in the UK around 15,000 women of childbearing age have no womb; this may be because they have had a hysterectomy due to illnesses such as cervical cancer or endometriosis, or because they were born without a womb. In the UK, around one in every 5,000 girls is born without a womb, a condition known as Mayer Rokitansky Küster Hauser.
Womb transplant surgery is designed to give such women the chance to become mothers of their biological children without the need to use a surrogate.
How common are womb transplants in 2018?
In a recent review of the global womb transplant research to date, The Royal College of Obstetricians and Gynaecologists warned the treatment should still be considered “experimental”.
The latest statistics, which run until May 2017, show in total 42 women worldwide have received transplanted wombs and 11 babies has been born as a result. In 2014, the first baby born to a woman with a womb transplant was delivered by doctors from the University of Gothenburg, Sweden.
Lead author of the paper Dr Iori Kisu said far more research is needed before the treatment becomes mainstream. “The first successful birth after a uterus transplantation attracted widespread international attention and many countries have since begun to prepare for the clinical use – so far with limited success,” he said.
“As our review of the available evidence shows, establishment of womb transplantation as a new and successful therapy will require strict clinical study data, and thorough training and testing in animal experiments, as well as international collaboration and information sharing.”
Will the procedure be available to all women?
The team of doctors behind Womb Transplant UK will give their services for free to conduct the three initial planned transplants. They have already compiled a shortlist of potential recipients drawn from the hundreds of applications they received. All other treatment costs will be paid for using funds raised by the charity.
The group has applied to NHS England for support in the hope womb transplants could be routine in around four years time, but Professor Geeta Nargund, fertility expert and clinical director of Create fertility is doubtful this will happen. “I would like to see womb transplants become avaialble on the NHS for women who have had to have their wombs removed or women who were born without a womb, but I can’t see it happening any time soon,” she told HuffPost UK.
“The treatment requires a multidisciplinary team of highly skilled surgeons and it will be very expensive. Even basic things like IVF are not available on the NHS, so I don’t think womb transplants will become available for quite some time.”
Professor Nargund also raised concerns about “sourcing” of donor wombs until strict laws are in place around this new type of transplant. “If there is a member of the family that is willing to help with the womb, it will be a lot easier, but if you’re talking about ‘sourcing’ a womb, it’s going to become difficult,” she said. “I don’t want it to become commercial - I don’t want to get into a situation where women are going to other countries to try to find a womb that is available to buy.”