Bringing a new life into the world is a magical experience for the vast majority of mothers. But for one female in Dallas, Texas, in late 2017, the miracle of birth was even more marvelous. Not only had the woman thought that pregnancy was an impossibility for her, but a groundbreaking procedure meant that her baby was the first of its kind in the U.S. And this medical advance has brought new hope to thousands of wannabe moms who thought carrying a child was beyond them.
In September 2016, a specialist team at the Baylor University Medical Center in Dallas conducted a series of cutting-edge operations as part of a clinical trial. Talented surgeons performed four living-donor uterus transplants. Although the technique had previously been pioneered in Turkey in 2011, the quartet of patients were the first to undergo such a procedure in the U.S.
All of the women who took part in the medical trial had absolute uterine factor infertility, where the uterus – or womb – is nonexistent or nonfunctioning. Some were suffering from Mayer-Rokitansky-Küster-Hauser syndrome. This rare condition means that, while the external genitalia and ovaries function normally, the uterus is undeveloped. As a result, these patients believed they would never be able to get pregnant and have naturally born children.
But thanks to the transplant surgery at Baylor, the four recipients now had hope of giving birth for the first time. And being able to give that gift to another woman was what persuaded 36-year-old Dallas resident Taylor Siler to donate her uterus. Siler, a nurse, had already had two children. As a result, she was keen that other women should have the experience of having and raising their own if they so desired.
Siler spoke to Time magazine about her altruistic action in December, 2017. She said that although she never thought she was cut out for motherhood, that had all changed when her first-born came along. Siler said, “Once they lay that baby in your arms, your life changes forever.” She added, “I have family members who struggled to have babies, and it’s not fair. I just think that if we can give more people that option, that’s an awesome thing.”
Unfortunately, not all of the transplants conducted in 2016 were successful for the women who cannot be named for reasons of patient confidentiality. Three of the four subjects had to have their donated uterus removed due to insufficient blood supply. Nevertheless, these women were determined to try again, and the team at Baylor was determined to learn from the experience. More happily, however, the woman who received Siler’s donated womb had better luck.
With the help of a powerful drug treatment to ward off the possibility of rejection, the woman’s body had taken to the new uterus well. The Baylor specialists were pleased to find that the organ was receiving a good flow of blood and showing no sign of infection. Consequently, the patient became the first woman in the U.S. to have a successful uterine transplant.
Now they knew that the transplanted organ was viable, the team at Baylor was hopeful that the uterus could perform its natural function. Could the woman in question conceive and carry a baby to term? The medical experts in Dallas already knew it was possible; the first baby delivered by a recipient of a uterus transplant had been born in Sweden in 2014. Specialists at Sahlgrenska University Hospital in Gothenburg had since supervised another four births from women with a transplanted womb.
Nevertheless, it was an exciting possibility for the medics at Baylor. Among their number was Dr. Liza Johannesson, an obstetrician and gynecologist who had previously been part of the team at Sahlgrenska University Hospital. “This is an incredibly important trial,” she told Time magazine. “We know firsthand that this can work, and it has the potential to help thousands of women worldwide born without a functioning uterus.”
So in the weeks that followed her uterine transplant, the Baylor experts monitored the womb recipient closely. The team were soon able to determine that the subject was ready to conceive, following menstruation. Although her ovaries functioned normally, they were not attached to her new uterus. Consequently, the wannabe mom underwent in-vitro fertilization – IVF – during which surgeons implanted an embryo into her womb.
It was shortly after this operation that Taylor Siler received a letter out of the blue. She had written to the recipient of her uterus around the time of both the women’s transplant surgery. Whether or not Siler had expected an extended correspondence, here was a message from the woman who now had her womb. And it was happy news; the note revealed that the woman was pregnant. And the nurse could not have been more delighted for the stranger who was partly her.
Presumably the woman’s pregnancy went to plan, because the next news that Siler received was that the womb recipient had given birth. The clinical team at Baylor told Siler that a healthy baby had been born in the last week of November 2017, but did not disclose its gender. The glad tidings were warmly welcomed by the donor, who found herself overwhelmed by the whole experience.
Siler told Time magazine that she considered having her babies as the best things she had ever done. So the fact that she had been able to help another woman experience the same thing felt wonderful, even though they had never met. “I’ve just been crying and getting teary thinking about it,” she said. “I think about her every day, and I probably will for the rest of my life.”
The woman in question gave birth via a planned cesarean section. She had been surrounded by various members of the Baylor team who had implanted her uterus and then helped her get pregnant. It was a proud moment for the new mom, but also the medical specialists who had made the first U.S. baby born via a uterus transplant a kicking-and-screaming reality.
Team member Dr. Johannesson had been one of the interested observers in the delivery room that day. She admitted to the reporter from Time that the baby’s birth had been an emotional event. “We’ve been preparing for this moment for a very long time,” she said. “I think everyone had tears in their eyes when the baby came out. I did for sure.”
Dr. Johannesson’s fellow obstetrician and gynecologist Dr. Robert T. Gunby Jr. was the one who actually delivered the history-making newborn. He told Time, “I’ve delivered a lot of babies, but this one was special.” He also put the groundbreaking event into perspective, adding, “When I started my career, we didn’t even have sonograms. Now we are putting in uteruses from someone else and getting a baby.”
The specialist team based at Baylor will continue to monitor mother and baby as part of its clinical study. The new mom’s donated uterus is not intended to be a permanent fixture. Since transplanted womb recipients have to take strong drugs to avoid their bodies rejecting the organ, medics are wary about the long-term implications of the treatment. Consequently, it has always been the plan for surgeons to remove the uterus after one or two pregnancies.
Following the initial four uterine transplants in September 2016, the specialists at Baylor have conducted another four such operations. They hope to complete ten of these surgeries during the first round of their clinical trial. Depending on the success of these further four transplants, the procedure could become a viable option for women with fertility issues due to nonexistent or dysfunctional uteri.
However, it should be borne in mind that uterine transplant surgery is hugely expensive. Experts estimate that the total cost surrounding such a transplant is in the region of $500,000. “The reality is that it’s going to be very difficult for many women to afford this [procedure],” the Baylor trial leader Dr. Giuliano Testa admitted to Time magazine.
But Dr. Testa went on to add, “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.” After all, whatever the procedure’s hefty price tag, it will surely be welcomed by women who fear that they will never be able to give birth. Dr. Testa’s colleague, uterine transplant nurse Kristin Posey Wallis, also spoke to Time. “For the girl who is getting the [infertility] diagnosis now, it’s not hopeless,” she said. “There’s hope.” And, for a wannabe mom, that is priceless.