For the first time, a woman in the US has given birth following a uterus transplant. The baby boy entered the world last month at Baylor University Medical Center in Dallas, Texas. His parents have opted to stay anonymous, though the uterus donor has been identified as Dallas nurse Taylor Siler, a mother of two boys herself.
The birth gives hope to women unable to conceive or give birth due to uterus problems—whether they had it removed because of disease or complications, or were born without a uterus entirely. Some estimate thousands of American women could someday be eligible for the procedure.
Prelude to a breakthrough
Up until now, births resulting from uterus transplants have only occurred in Sweden; there have been eight babies delivered at Sahlgrenska University Hospital in Gothenburg since 2014. The first was a 3.9-pound baby born to a 36-year-old woman.
Uterus transplants weren't attempted in stateside until February 2016, when 26-year-old Texan Lindsey McFarland received a new organ. Due to an infection, it failed after two weeks.
The mother at Baylor was one of eight participants in a clinical trial that started in 2016. Though the surgery eventually failed for four of the other women, two more are attempting to conceive, and one is currently pregnant.
How a uterus transplant works
A uterus transplant begins long before the actual surgery. First, the patient takes fertility drugs, and her eggs are harvested, fertilized and frozen. Then, the donor's cervix and womb are implanted into the patient; the donor herself may be living or dead. It's a complex operation comparable to a liver transplant, says study principal investigator Giuliano Testa, MD, and takes about five hours to complete.
Following the transplant itself, the patient takes drugs to prevent organ rejection, and then waits a few months to assure the new uterus is functioning well. At that point, her eggs are implanted. If all goes well, it will result in a pregnancy. If the patient becomes pregnant and development progresses well, the baby will be delivered by C-section. Up to now, all births have occurred between 32 and 36 weeks.
There's one big difference between uterus transplants and heart, lung and other organ transplants: they're temporary. After the baby is born, the uterus is removed. This is so the mother can come off the medications necessary to prevent organ rejection; taken long-term, they can be harmful to her health.
The future of uterus transplants
What could this birth mean for women in the US? Since uterus transplants are still in the experimental stage, researchers will continue working to improve both the process and the procedure itself in the years to come. If a transplant does become a more mainstream operation, the cost—likely hundreds of thousands of dollars—will be prohibitive for most women, and it's unclear whether insurance will cover it.
Ultimately, however, the baby boy's appearance is a positive sign for those struggling with infertility. "This first live birth to a uterus transplant recipient in the United States was a milestone in our work to solve absolute uterine factor infertility," said Testa. "But, more importantly, a beautiful moment of love and hope for a mother who had been told she would never be able to carry her own child."
Photo credit: Baylor University Medical Center.
