The need for uterine transplantation
- As many as 50,000 women of childbearing age in the UK have no viable womb.
- MRKH alone (being born without a viable womb) affects 1 in 5000 women.
- Overall, absolute uterine factor infertility affects 1 in 500 women of childbearing age.
- In the UK 1650 women develop cervical cancer every year and most have a hysterectomy.
- Across Europe well over 200,000 women have no viable womb.
The Options for those with no viable womb
- In the UK adoption and surrogacy are the only options and the vast majority of children born to UK parents are born abroad. Surrogacy is only possible and legal in a few special cases in the UK.
- In 2013 167 children only were born in the UK to a surrogate, up from 47 in 2007.
Current demand for transplantation
- WombTransplantUK has been contacted by hundreds of women in recent years with increasing numbers since the Swedish operations began.
- Currently we have 104 potential patients who meet our criteria for a transplant.
- We have been researching womb transplantation for 17 years.
- We launched an appeal to raise funds to pay NHS costs estimated at £50,000 per operation.
- We have raised £40,000 so far and we need a total of £500,000 to complete our research programme of 10 operations.
- A team of 12 will be needed for each operation; 5 for the retrieval and 7 for the transplantation.
- Retrieval takes around 2 – 3 hours and the transplant around 6 hours.
The effect of Infertility on the individual – and partners
- Recent research shows 27% of relationships break down after failed fertility treatment.
- A couple are three times more likely to break up after failed IVF
- 13% of women consider suicide.
- Women are twice as likely to commit suicide after failed IVF.
- 50% of women describe infertility as the most upsetting experience of their lives.
- 17% suffer depressive illness.
- 71% of women feel ‘flawed’.
- 50% of men feel ‘inadequate.
- 43% of women feel ‘unattractive’.
- 36% of women and 42% of men feel tension in their relationship.
- 55% feel sex becomes physically and emotionally anxious.
Current Success Rates – Sweden and elsewhere
The World’s first womb transplant was carried out in the Middle East some 10 years ago. The transplanted womb was viable but had to be removed after three months. Several years ago a successful transplant was carried out in Turkey and the recipient became pregnant but miscarried after a few weeks.
In Sweden the team have not officially released all the details of their very successful programme and so from reports already in the public domain we can estimate that the current success rates exceed the average for IVF. In addition:
- Mats Branstrom and the Swedish team have undertaken nine womb transplants, with seven being successful (78% success rate). They officially reported the first live born child following uterine transplantation in September 2014. It has since been reported that a further three have delivered healthy babies whilst another has become pregnant resulting in a pregnancy rate of at least 71%, although official publication of these results is still awaited from the team.
- Current success rates for conventional IVF vary between 20 and 40%.
- Mats Branstrom has retrieved wombs from live donors.
NB: In the UK we will not be using live donation Organs. They will be sourced from ventilated donors who have no brain function. Donors might have suffered brain haemorrhage or trauma e.g. from a road accident.
Selection criteria for the UK research programme operations
- Patients should be aged between 24 and 38 years old (or 40 if eggs were frozen before 38)
- Patients must be eligible for NHS care.
- No significant medical problems.
- BMI <30kg/m2.
- Able to live in the UK as a resident for as long the grafted uterus is in-situ post operatively.
- Has a long-term partner.
- Has own ovaries and eggs (i.e no donor eggs).
- Fluent in the English language.
Women who cannot join the programme at the current time include those who:
- Have previously had children.
- Had previous major abdominal or pelvic surgery.
- Had previous severe endometriosis.
- Had cancer less than five years previously.
- Had a history of psychiatric illness involving hospital admission.
- Require donor eggs or sperm.
- Have insufficient embryo quality or quantity, <10 satisfactory embryos.
- Do not qualify for NHS care.
Once a patient has had a successful transplant
- Patient begins a course of immuno suppressants to prevent the donated womb being rejected
- Patient monitored for a year – general health and in particular health of the womb
- All being well after a year a single embryo is implanted and the foetus monitored closely.
- Baby delivered by Caesarean section at 35 – 37 weeks unless clinically required earlier.
- If all is well a second baby is possible.
- The donated womb will be removed six months after birth.
- Patient then ceases immunosuppression treatment and receives normal post hysterectomy monitoring.