A Rare Case Report of a Successful Womb Transplant

Grace was born with a rare condition, Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, where the womb is missing or underdeveloped, but with functioning ovaries. When the BBC first spoke to her in 2018, she was hoping her mother could donate her uterus to allow her to have children – but it proved to be unsuitable. When it eventually took place, in February 2023, it took a team of more than 30 medics around 17 hours to remove Amy’s womb and transplant it to Grace. Prof Richard Smith, a gynaecological surgeon at Imperial College Healthcare, who led the organ retrieval team, has been researching womb transplantation for more than two decades. He says his team is thrilled about the birth of baby Amy. Baby Amy was born by Caesarean section at Queen Charlotte’s hospital in west London on 27 February. “It was an incredible moment, full of joy,” says surgeon Isabel Quiroga. The donated womb will be removed after the birth of a second child. This will allow Grace to stop taking the daily immunosuppressants she is currently on to ensure her body does not reject her sister’s womb. Taking these drugs can increase the risks of developing some cancers, especially if taken over many years – but surgeon Isabel Quiroga says these risks should return to baseline once the womb is removed.

“I’m not often short of words but when the baby came out I was speechless – there were a lot of tears in the theatre that day.

“The whole thing is astonishing and incredibly moving,” Prof Smith adds.

He says Amy’s birth will give hope to many of the 15,000 women in the UK of childbearing age who do not have a functioning uterus, of whom around 5,000 were born without a womb. Mr Smith heads a charity called Womb Transplant UK, which paid the NHS costs for Grace’s transplant operation. All the medical staff gave their time for free.

In 2023, the undertakings of the first womb transplant in the UK:

The transplant was undertaken as part of the UK living donor programme, which is sponsored and funded by the charity Womb Transplant UK, following approval from the Human Tissue Authority. The surgical team was co-led by surgeons at Imperial College Healthcare NHS Trust and Oxford University Hospitals (OUH) NHS Foundation Trust. Both the donor operation and subsequent transplant took place at the Oxford Transplant Centre at OUH’s Churchill Hospital. The two procedures overlapped and together took almost 18 hours. The operations took place on a Sunday in early 2023 when NHS facilities were not being used by NHS patients. The whole surgical and anaesthetic team volunteered and took part in their own time.

**Pictured**: OUH Consultant Transplant Surgeon Isabel Quiroga and Professor Richard Smith, Consultant Gynaecological Surgeon at Imperial College Healthcare NHS Trust, who together performed the UK’s first womb transplant.

Initially, the donor and the recipient chose to remain anonymous…

After more than 25 years of research, a team has performed the first womb transplant in the UK, giving a woman who was born without a functioning womb the possibility of getting pregnant and carrying her own baby. As detailed in a case report published today by the BJOG, an international journal of obstetrics and gynaecology, both the woman and the donor, her sister, have recovered well. They wish to remain anonymous.

The transplant was undertaken as part of the UK living donor programme, which is sponsored and funded by the charity Womb Transplant UK, following approval from the Human Tissue Authority. The surgical team was co-led by surgeons at Imperial College Healthcare NHS Trust and Oxford University Hospitals (OUH) NHS Foundation Trust. Both the donor operation and subsequent transplant took place at the Oxford Transplant Centre at OUH’s Churchill Hospital. The two procedures overlapped and together took almost 18 hours. The operations took place on a Sunday in early 2023 when NHS facilities were not being used by NHS patients. The whole surgical and anaesthetic team volunteered and took part in their own time. All being well, the recipient will undergo embryo transfer later this year at the Lister Fertility Clinic in London, part of HCA Healthcare UK. Once pregnancy is confirmed the recipient will be closely monitored in a specialist antenatal clinic at Queen Charlotte’s and Chelsea Hospital, where the delivery would also take place.