Baby born after uterus transplant is a first for France

A baby girl has become the first in France to be born from a transplanted uterus, two years after her mother received the transplant.

The baby girl was born safely at 33 weeks (seven and a half months) on February 12, weighing 1.845 kg, at the Foch hospital in Suresnes, Hauts-de-Seine, it was announced this week. There were no notable complications.

“Mother and baby are doing well,” Professor Jean-Marc Ayoubi, head of gynaecology-obstetrics and reproductive medicine at the hospital - whose team worked on the case - told the Agence France-Presse.

The mother, Deborah, 36, received a uterus transplant in March 2019, by the same team. It was the first uterine transplant in France.

The uterus used in the transplant was donated by Deborah’s own mother, who was then 57.

Professor Ayoubi said: “We usually wait a year to be sure that the transplant is not rejected.”

The process was then delayed by the first Covid-19 lockdown, as all assisted fertility activities stopped, but continued in summer.

The professor said: “The first transfer was done last July, and the patient became pregnant after this first transfer.”

A step forward for patients

The mother, Deborah, was born without a uterus, but with normal ovarian function. She has Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, which affects one in 4,500 women, and prevents the uterus and vagina from developing properly.

The successful transplant and birth have been hailed as a step forward for other patients born without a uterus, or women who have had the organ removed later in life.

In theory, it offers an alternative to surrogate pregnancy - which is banned in France - or adoption, for people who would otherwise not be able to have children.

It is possible because the immunosuppressant drug treatment - which means the body will not reject the new organ - is less intense than for other organs, and does not disrupt pregnancy. The same treatment is already used, for example, for pregnant women with kidney transplants.

First-ever cases

The case is the first-ever in France, but the world’s first-ever such case happened in Sweden, in 2014.

The birth happened one year after the uterine transplant; and was announced in the medical journal The Lancet, by Professor Mats Brannstrom and his team at the University of Gothenburg. The living donor was then aged 61.

A woman in Brazil also gave birth after a uterus transplant on December 15, 2017, announced Dr Dani Ejzenberg and the team at the Sao Paulo hospital. The patient’s uterus had been donated by a deceased woman.

Some uterus transplants are not intended to be permanent - and are only done to allow the woman to give birth - to avoid the need for continued anti-rejection treatment, Professor Ayoubi explained.

Some women may be able to keep the uterus to allow them to give birth a second time, but usually “we would wait a year” before starting the process again, he said.

In Sweden, several women with transplants have been able to give birth twice, he said, adding that “there have been around 20 births [from transplants] in the world”.

Several more uterus transplants are planned at the Foch hospital, for women who were born without the organ.

Professor Ayoubi and his team have now received authorisation from biomedicine agency l’Agence de biomédecine and national medicines and safety agency l’Agence nationale de sécurité du médicament et des produits de santé to begin a clinical trial with 10 uteri transplanted from living donors.

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