Australia

Could uterine transplants become a reality in Australia?

It seems like it shouldn’t be possible – but at first Australian, Kirsty was able to carry a baby in the same womb as she grew up.
“That’s why this clinical trial will give us the opportunity,” says Kirsty. “She is OK. It’s amazing. “
Dr. Rebecca Deans is a gynecologist and fertility specialist in Sydney. Initially it was not sold on the idea of ​​a uterine transplant.
“So when I first asked about … transplantation in patients, I thought, well, do you really need this?” he said.

But his opinion changed when he saw the success of Swedish gynecologist Dr. Mats Brännström. Since she began these procedures, there have been 75 uterine transplants worldwide, resulting in more than 30 live births.

A picture of a doctor in scrubs.

Dr Rebecca Deans is expected to lead Australia’s first uterine transplant trial.

“And it really turned my mind on this topic … [because] There have been a number of pregnancies and it has formed many, many teams around the world, ”said Dr. Deans.

One in 4,500 to 5,000 unborn women – due to a condition known as MRKH Syndrome. But there are also women who have lost their uterus to conditions such as uterine cancer or emergency hysterectomy in childbirth.

Mother’s body, grandmother’s womb

Kirsty, 29, lost her uterus to a life-saving hysterectomy after complications during a c-section. He spent two days in an induced coma before he could meet his girl.
“So it probably wasn’t for … a good couple of weeks that I started to fully understand the consequences and how my life was going to look like without a womb,” she said.
Kirsty always planned to have a big family out loud; the football team is full. She never expected to lose her womb after carrying her daughter to safety for nine months.

She began researching her options and so she discovered a uterine transplant trial was set in Sydney.

A baby outside.

Kirsty hopes to bring a sibling to her daughter through a uterine transplant. Credit: Feed it

“I quickly rang my mother and said, ‘Hey mom …’ “And I think he thought I was kidding.”
It sounds impossible, but there are precedents. In 2014, a uterine transplant performed by Dr. Mats Brännström resulted in a Swedish baby being first born in her mother’s body but in her grandmother’s womb.
The upcoming Australian trial will take 12 candidates; six with dead donors and six with living donors like Kirsty’s mum. But it will not be an easy process.

“So it’s a big operation for the donor,” says Dr. Deans. “And in fact, the risk to the donor is greater than to the recipient.”

A diagram of a matrix with text.

The necessary extractions are more involved than a standard hysterectomy. Credit: Feed it

The extraction is not a standard hysterectomy, because it takes a lot of blood vessels around the uterus to be able to attach it to the recipient.

But Michelle, Kirsty’s mother, says she is willing to do what she asks.

“Kirsty is not just my daughter. She’s my best friend, ”Michelle said. “If I could help in any way, then I’m here … reserve me in.”

Reverse menopause

Kate, 32, was just 23 when she had a hysterectomy. She was diagnosed with a rare form of cervical cancer, and when her first round of chemotherapy and radiation was unsuccessful, the hysterectomy was performed as a life-saving procedure.
“You think … if that’s what you need to do, that’s what you need to do. So I was definitely not aware of the long – term implications, “he said.

So when Kate went to see what options she had with a fertility specialist, they told her she had no.

A woman sits on a rock in front of the ocean with her legs crossed.

Kate is another hopeful candidate for a uterine transplant in Australia. Credit: Feed it

“They just tell you at menopause,” Kate says. “You will never have a child.”
But when Kate heard about the uterine transplant trial, she couldn’t help wondering about the possibilities.
“Oh my God, what does that mean for me?” he asked. “Like, does that mean I can potentially carry my own baby?”

To be selected for uterine transplantation you need to successfully produce five embryos via IVF.

While Kate was technically menopausal, her medical team extracted some of her ovarian tissue before her chemo and radiation. They could implant that back in her pelvis, hoping it would trigger a hormonal response. It worked!
“Menopause was reversed,” Kate says. “Something that we thought would be impossible.”

Not only had her hormonal body returned to a pre-menopausal state – but her medical team was able to successfully harvest 11 of Kate’s eggs.

THE MOST

“This procedure is quite rare,” says fertility fellow Dr. Stephanie Sii, who was instrumental in Kate’s ovary extraction. “[But] it’s not considered experimental anymore because we’ve had, you know, a lot of pregnancies, all over the world. “

Not only does this mean that Kate has a chance to have her own biological child, but it also puts her one step closer to being selected for a uterine transplant.

To bring a child

While some candidates for trial are expected to be a living donor, some are expected to receive a womb from a deceased donor as well. Which raises some ethical questions.
“This is a unique example where transplantation is about creating new life rather than saving a life,” says Evie Kendal, bioethicist at Swinburne University of Technology.
“So we can’t prioritize medical necessities or emergencies … So that means we’re going to need to make some really tough decisions about allocating this scarce resource,” he said.
There are also concerns surrounding living donors.
Says Evie: “My main concern as an ethic is to avoid any form of exploitation or coercion. “You might feel pressured, due to these kinds of social norms about, particularly motherhood, but parents more generally.”

While Dr. Deans acknowledges some ethical considerations to be made, he also sees the potential of the life-changing transplant trial.

Two pregnant women pose with their bellies out.

There are just 12 seats available for what could be a first Australian. Credit: Feed it

“Not all women, but some women have a strong desire to have a baby and there is no doubt about that,” says Dr. Deans. “He could talk to … what this is for a woman.”

“So it has never been tested, but the brain sega in this might mean. I mean trans women may one day be able to have a baby and have a baby as a result of this procedure, ”she says.
For now, there are just 12 seats available for what could be an Australian debut. But Dr. Deans says it won’t be long before the procedure becomes more available.
“This could become the mainstay of our lives,” he said.
In the meantime, Kate and Kirsty are carefully optimistic about what is to come.
Kate says, “When I have a baby, I know I’m going to have a baby every day, and I’m really grateful for that.”
Kirsty says, “I have to give this a go.” I want to bring another child. And this is my only option. “

For more information on uterine transplant trials, you can contact the research team at uterustxaustralia.com.au.

Could uterine transplants become a reality in Australia? Source link Could uterine transplants become a reality in Australia?

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