The women were born without a uterus or had it removed because of cervical cancer. Most are in their 30s and are part of the first major experiment to test whether it is possible to transplant wombs into women so they can give birth to their own children.
Life-saving transplants of organs such as hearts, livers and kidneys have been done for decades and doctors are increasingly transplanting hands, faces and other body parts to improve patients’ quality of life.
Womb transplants — the first ones intended to be temporary, just to allow childbearing — push that frontier even further and raise some new concerns.
There have been two previous attempts to transplant a womb, in Turkey and Saudi Arabia, but both failed to produce babies. Scientists in Britain, Hungary and elsewhere are planning similar operations but the efforts in Sweden are the most advanced.
“This is a new kind of surgery,” said Mats Brannstrom in Gothenburg. “We have no textbook to look at.”
Dr Brannstrom, chair of the obstetrics and gynaecology department at the University of Gothenburg, is leading the initiative. Next month, he and colleagues will run the first-ever workshop on how to perform womb transplants and they plan to publish a scientific report on their efforts soon.
He said the nine womb recipients were doing well. Many already had their periods six weeks after the transplants, an early sign that the wombs are healthy and functioning. One woman had an infection in her newly received uterus and others had some minor rejection episodes, but none of the recipients or donors needed intensive care after the surgery, Dr Brannstrom said. All left the hospital within days.
None of the women who donated or received wombs have been identified. The transplants began in Sept 2012 and the donors include mothers and other female relatives of the recipients. The team had initially planned to do 10 transplants, but one woman could not proceed due to medical reasons, a spokesman said.
The transplant operations did not connect any of the women’s uteruses to their fallopian tubes, so they are unable to get pregnant naturally. But all who received a womb have their own ovaries and can make eggs. Before the operation, they had some removed to create embryos through in-vitro fertilisation. The embryos were then frozen and doctors plan to transfer them into the new wombs, allowing the women to carry their own biological children.
The transplants have ignited hope among women unable to have children because they lost a uterus to cancer or were born without one. About one in 4,500 girls are born with a syndrome, MRKH, where they do not have a womb.
Fertility experts have hailed the project as significant but stress it is not known whether the transplants will result in healthy babies.
Dr Brannstrom said using live donors allowed them to ensure the donated wombs were functional and did not have any problems like an HPV infection.
Doctors in Saudi Arabia performed the first womb transplant in 2000, using a live donor, but that uterus had to be removed after three months because of a blood clot.
Dr Brannstrom said he and his colleagues hope to start transferring embryos into some of their patients soon, possibly within months. The Swedish researchers and others have previously reported successful uterus transplants in animals including mice, sheep and baboons, but no offspring from the primates were produced.
After a maximum of two pregnancies, the wombs will be removed so the women can stop taking the anti-rejection drugs, which can cause high blood pressure, swelling and diabetes and may also raise the risk of some types of cancer.
Other experts said if the operations are successful, womb transplants could be an alternative for women who have few choices.