Womb transplants 'a step closer'

The first successful human womb transplant could take place within two years, British scientists have said.  From a BBC News article, Thurs., Oct. 22, 2009.

London-based experts say they have worked out how to transplant a womb with a regular blood supply so it will last long enough to carry a pregnancy.  Research involving donor rabbits was presented at a US fertility conference.  The charity Uterine Transplant UK is seeking funding of £250,000 after being denied grants by several medical research bodies.  A breakthrough could offer an alternative to surrogacy or adoption for women whose own wombs have been damaged by diseases such as cervical cancer.  Up to 200 women in the UK are said to use surrogate mothers each year.  In the latest research conducted at the Royal Veterinary College in London, five rabbits were given a womb using a technique which connected major blood vessels, including the aorta.  Two of the rabbits lived to 10 months, with examinations after death indicating the transplants had been a success.

'Huge interest'  Richard Smith, consultant gynaecological surgeon at Hammersmith Hospital, told the American Society for Reproductive Medicine conference in Atlanta the team's next step would involve getting rabbits pregnant through IVF treatment.  The technique would then be used on larger animals.  Other research projects in the past have carried out similar experiments on pigs, goats, sheep and monkeys. A human transplant has also been tried once before - in Saudi Arabia in 2000 - but the womb came from a live donor, and was rejected after three months.  Mr Smith suggested it may have failed because surgeons had not worked out how to connect the blood vessels properly.  The UK study involved transplanting the womb with all its arteries, veins and bigger vessels.  "I think there are certain technical issues to be ironed out but I think the crux of how to carry out a successful graft that's properly vascularised - I think we have cracked that one."

A transplanted womb would only stay in place long enough for a woman to have the children she wanted.  And any baby would have to be delivered by Caesarean section as a transplanted human womb is unlikely to be able to withstand natural labour.  Conception would also need to be through IVF because women with a transplanted womb could be at higher risk of ectopic pregnancy.  Mr Smith acknowledged the procedures were seen as "a step too far in terms of fertility management" among the medical profession but said interest from patients was huge.  Tony Rutherford, chairman of the British Fertility Society, said: "I think there is a big difference between demonstrating effectiveness in a rabbit and being able to do this in a larger animal or a human..."

Clare Lewis-Jones, from Infertility Network UK, said "a great deal of thought and discussion" was needed on the issue including the ethical ramifications.