First live birth after uterus transplantation in the Middle East
- PDF / 621,831 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 79 Downloads / 217 Views
(2020) 25:30
Middle East Fertility Society Journal
RESEARCH
Open Access
First live birth after uterus transplantation in the Middle East Randa Akouri1* , Ghassan Maalouf2, Joseph Abboud2, Toufic Nakad2, Farid Bedran2, Pascal Hajj2, Chadia Beaini2, Laura Mihaela Cricu3, Georges Aftimos4, Chebly El Hajj2, Ghada Eid2, Abdo Waked2, Rabih Hallit2, Christian Gerges2, Eliane Abi Rached2, Matta Matta2, Mirvat El Khoury2, Angelique Barakat2, Niclas Kvarnström5, Pernilla Dahm-Kähler1 and Mats Brännström1,6
Abstract Background: The first live birth after uterus transplantation took place in Sweden in 2014. It was the first ever cure for absolute uterine factor infertility. We report the surgery, assisted reproduction, and pregnancy behind the first live birth after uterus transplantation in the Middle East, North Africa, and Turkey (MENAT) region. A 24-year old woman with congenital absence of the uterus underwent transplantation of the uterus donated by her 50-year-old multiparous mother. In vitro fertilization was performed to cryopreserve embryos. Both graft retrieval and transplantation were performed by laparotomy. Donor surgery included isolation of the uterus, together with major uterine arteries and veins on segments of the internal iliac vessels bilaterally, the round ligaments, and the sacrouterine ligaments, as well as with bladder peritoneum. Recipient surgery included preparation of the vaginal vault, end-to-side anastomosis to the external iliac arteries and veins on each side, and then fixation of the uterus. Results: One in vitro fertilization cycle prior to transplantation resulted in 11 cryopreserved embryos. Surgical time of the donor was 608 min, and blood loss was 900 mL. Cold ischemia time was 85 min. Recipient surgical time was 363 min, and blood loss was 700 mL. Anastomosis time was 105 min. Hospital stay was 7 days for both patients. Ten months after the transplantation, one previously cryopreserved blastocyst was transferred which resulted in viable pregnancy, which proceeded normally (except for one episode of minor vaginal bleeding in the 1st trimester) until cesarean section at 35 + 1 weeks due to premature contractions and shortened cervix. A healthy girl (Apgar 9-1010) weighing 2620 g was born in January 2020, and her development has been normal during the first 6 months. Conclusions: This is the first report of a healthy live birth after uterus transplantation in the MENAT region. We hope that this will motivate further progress and additional clinical trials in this area in the Middle East Region, where the first uterus transplantation attempt ever, however unsuccessful, was performed already three decades ago. Keywords: Human, Infertility, Transplantation, Uterus, Middle East
* Correspondence: [email protected] 1 Department of Obstetrics and Gynecology, Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SE-41345 Göteborg, Sweden Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a
Data Loading...
