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Thursday, 7 March, 2002, 05:00 GMT
Womb transplant breakthrough hope
surgeons performing an operation
The surgery was successful for a time
A 26-year-old woman has undergone what is believed to be the world's first womb transplant, scientists have revealed.

The breakthrough raises hopes that women who are currently unable to have children because their uterus has been damaged could eventually become mothers.

However, a leading UK expert has warned against fuelling expectation unjustifiably.

The woman underwent surgery six years after having a hysterectomy following a life-threatening haemorrhage.


There is a small group of women who are very keen to have children and who would be prepared to undergo that sort of surgery to achieve that end

Dr Richard Smith
The donor organ came from a 46-year-old woman.

The transplanted uterus eventually had to be removed after three months because blood clots had developed and started to cause tissue damage.

However, doctors, who performed the transplant operation in Saudi Arabia in April 2000, say the operation was not a failure because the uterus did respond well for a time.

It was kept viable by feeding it a supply of the female sex hormones oestrogen and progesterone.

Blood supply problems

Unlike other organs, which are supplied by large blood vessels, the uterus receives its blood supply from a network of tiny vessels.

This means that establishing a blood supply for the transplanted organ is extremely complex, and prone to problems.

In addition, the blood vessels supplying the uterus must be able to expand to three times their normal size during pregnancy if they are to support a developing foetus.

The team of four doctors, Wafa Fageeh, Hassan Raffa, Hussain Jabbad and Anass Marzouki describe the procedure in the International Journal of Gynaecology & Obstetrics.

They said: "Further clinical experience and additional development of the surgical techniques could make uterine transplantation useful in the treatment of infertility, especially in communities where the surrogate mother concept is unacceptable from a religious or ethical point of view."

Surrogacy


Putting a rotting piece of meat in the pelvis, which is what will happen with a womb transplant, will endanger the life of the recipient

Lord Winston
In a related editorial, US experts Dr Louis Keith and Dr Guiseppe Del Priore described transplantation of the reproductive organs as the "last frontier" in the field of organ transplantation.

They wrote: "To some individuals, childbearing is the greatest event of a lifetime.

"To such persons, transplantation of organs of reproduction would not be considered frivolous or unnecessary, even though these organs do not sustain life."

Their views were reflected by Dr Richard Smith, from the Chelsea and Westminster Hospital in London, who has been carrying out laboratory experiments to test the feasibility of a uterus transplant. He says that a similar operation should be possible in the UK in two years.

He said: "There is a small group of women who are very keen to have children and who would be prepared to undergo that sort of surgery to achieve that end."

It is estimated that 15,000 women in the UK are unable to have children by any fertility method currently available.

This is either because they have developed severe fibroids, have damage to the lining of the womb, or have undergone a hysterectomy operation.

Around 200 of these women each year opt for surrogacy.

Peter Bowen-Simpkins, from the Royal College of Obstetricians and Gynaecologists, said he believed the development would eventually lead to women without a uterus being able to give birth.

"This shows it is technically possible. The womb survived for more than two menstrual cycles, so the first crucial hurdles have been passed."

However, fertility expert Lord Robert Winston said he was very sceptical about the procedure, and warned against raising women's hopes unrealistically.

He said: "Putting a rotting piece of meat in the pelvis, which is what will happen with a womb transplant, will endanger the life of the recipient of the transplant and could cause a thrombosis.

"It would not be ethically justified in Britain or in the United States."

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 ON THIS STORY
The BBC's Sophie Hutchinson
"Those behind the report say it's an important breakthrough"
The BBC's Chris Hogg
"Some experts have been sceptical"
Lord Winston, fertility expert
"It was a complete failure"
See also:

27 Feb 02 | Health
Womb agony has family link
12 Feb 01 | Health
Many hysterectomies 'unnecessary'
24 Nov 99 | Health
Hysterectomy 'may improve sex'
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