An amazing event that could give hope to women who have been told they could never have a child because their uterus is nonfunctioning, unfolded recently in Dallas, Texas.
For the first time in the United States, a woman who was born without a uterus gave birth to a baby. The landmark birth took place at Baylor University Medical Center at Dallas, a part of Baylor Scott & White.
In an exclusive report by TIME, the details and background of this major undertaking are revealed.
The birth took place at Baylor — the first birth in the hospital’s ongoing uterus transplant clinical trial. Women who participate in the trial have what’s called absolute uterine factor infertility (AUI), which means their uterus is nonfunctioning or nonexistent. Most of the women in the trial have a condition called Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome — and have lived their entire lives under the assumption that they would never be able to be pregnant or give birth to a baby. The procedure could also work for women with other medical issues, such as certain cancers.
The women in the clinical trial are transplanted with a uterus from either a living or deceased donor. The woman who gave birth received her transplant from Taylor Siler, a registered nurse in the Dallas area, who was a so-called “altruistic” living donor: a stranger who volunteered to donate her uterus to a woman without one. So far, Baylor says they’ve had over 70 women express interest in donating their uterus.
Baylor will complete a total of 10 uterus transplants as part of its first trial. So far the hospital has completed eight. At least three have failed. The hospital has confirmed to TIME that there is another woman in the trial who is pregnant, using a living donor uterus.
Baylor’s uterus transplant program is one of a handful to launch in the United States in recent years, and it’s the first to use both living and deceased donors. Successful uterus transplants from live donors have taken place in Sweden — a medical team at Sahlgrenska University Hospital in Gothenburg pioneered the first uterus transplant trial that resulted in eight births. This birth at Baylor is the first to replicate that success.
“We do transplants all day long,” says Dr. Giuliano Testa, the leader of the uterus transplant clinical trial at Baylor, and surgical chief of abdominal transplant for Baylor Annette C. and Harold C. Simmons Transplant Institute. “This is not the same thing. I totally underestimated what this type of transplant does for these women. What I’ve learned emotionally, I do not have the words to describe.”
The recipients in the clinical trial are between the ages of 20 to 35, and the donors must be between ages 30 to 60. “When you donate a kidney, you do it to help someone live longer and get off dialysis,” says Dr. Testa. “For these women, they are donating an experience.”
Once the women in the trial are transplanted with the uterus, they wait to recover and achieve menstruation, usually about four weeks from transplant. Women whose transplant is successful can then attempt in vitro fertilization (IVF). (The women in the trial have functioning ovaries that are not attached to their wombs, which is why IVF is required to get pregnant.)
Although the successful transplant and birth may give hope to many women, it comes at a steep cost. Uterus transplants are expensive, with some estimates putting the cost at up to $500,000. Like other infertility treatments, it’s very rare that an insurance company would cover the procedure, which is largely viewed as elective. Baylor covered the cost of the first 10 transplants in the clinical trial, but the medical team is now seeking funding—largely through donations from institutions and private donors—in order to continue. The team says many more transplants need to be done before it could be provided as a standard treatment. “The reality is that it’s going to be very difficult for many women to afford this,” says Testa.
Baylor says they do not view uterus transplants as a replacement for other approaches like adoption or surrogacy, but as another option for women and their partners.
Baylor will continue to follow the health of the baby as part of the study. The goal is for the birth to mark the beginning of a new field of infertility treatment research, rather than be an outlier.
For the complete exclusive TIME story you can click on http://time.com/5044565/exclusive-first-u-s-baby-born-after-a-uterus-transplant/