Adelaide woman who died of cancer is the inspiration for radical womb transplant surgery
AN Adelaide woman who died of cancer, is the inspiration for a radical surgery that is giving fresh hope to infertile women all around the world.
Womb transplants, where live donors give their uterus to a recipient, are being successfully trialled in Sweden, including several cases where mothers have given their womb to their daughters.
The revolutionary treatment could be available in Australia as soon as 2016.
But it was an Adelaide woman, who died at aged only 26, who started the ball rolling with a request that doctors initially dismissed as”crazy’’.
The woman was fighting cervical cancer in the Royal Adelaide Hospital 16 years ago and facing the removal of her womb. But she asked young gynaecologist Mats Brannstrom if a transplant was possible.
Her mother was a volunteer, and so was her sister who already had a family.
“I told the patient before the operation that she would not be able to carry her own pregnancy, even if she had fully normal ovaries,” Professor Brannstrom said.
“She looked at me and asked about a womb transplant with her mother as a suitable donor. My immediate reaction was that it was a crazy suggestion. But I discussed it with one of my colleagues, Ash Hanafy, and we decided to explore the possibilities.’
On his return to Sweden in 1999, Prof Brannstrom pursued the concept and continued to collaborate with obstetrician and gynaecologist Associate Professor Hanafy, now Women’s Health Lead at Griffith University in Queensland.
The work moved from rats, to sheep, to pigs, to baboons and now to humans.
Nine women so far have had the transplants where a healthy uterus from a donor is implanted in the recipient.
In the Swedish trial, the women were either born without a womb or had womb problems preventing them from conceiving.
Most received wombs surgically removed from their own mothers, one from an older sister, another from an aunt, a mother-in-law and a friend
Embryo implantation via IVF has since been attempted with four women, creating a situation where a woman may give birth to a child from an womb that she herself was born from.
The transplants did not connect the uteruses to the fallopian tubes meaning they were unable to become pregnant naturally. However, each has ovaries, and egg cells from these were fertilised via IVF to create embryos for subsequent transfer.
The Swedish team has not yet released details of progress of the attempted pregnancies which owe their origin to the Adelaide lady.
Professor Brannstrom, head of Obstetrics and Gynaecology at the University of Gothenburg, will be a keynote speaker at the 5th Congress of the Asia Pacific Regional Initiative on Reproduction (ASPIRE) 2014 in Brisbane from April 4-6 where he will detail his research.
He said the Adelaide patient underwent surgery to remove her womb, but she later died from cervical cancer.
“So there is a direct Australian connection to this pioneering project,” he said.
“In that context, it is a patient driven research project. We would never have pursued it without the suggestion from the young patient at the Royal Adelaide Hospital.
“It has been an amazing journey and I consider the project to be a monument to the memory of this patient.”
Associate Professor Hanafy is the only Australian in the pioneering surgical team.
“I feel fortunate to be part of such a skilled team of physicians that started many years ago with just Mats Brannstrom and myself,” he said. “The success of this transplant procedure will be a healthy baby and once we achieve this objective the plan is to introduce the procedure in Australia by 2016.”
He noted the emergence of IVF in the 1970s had largely deferred uterus transplant research, and this work aimed to improve life rather than save lives.
The technique carries risks for the donor, while the recipient will need to take drugs to ensure the organ is not rejected.
Turkish doctors transplanted an uterus from a deceased donor to a woman in 2011 and achieved a pregnancy however it was terminated in its eighth week.
The ASPIRE conference will hear about a range of advances in fertility — Professor Robert Norman from the Robinson Institute in Adelaide is the first Australian president of ASPIRE.