June 25, 2024

Whole Family

Trailblazing Family Excellence

The gift of life: Medical breakthrough as baby boy in Alabama becomes ‘first in the world’ to be born to a mom with a transplanted WOMB she received from organ

5 min read

A ‘miracle’ boy in Alabama has become the first baby in the world to be born from a transplanted womb outside of a clinical trial.

The child was born in May via C-section at the University of Alabama at Birmingham (UAB).

His mother, Mallory, who prefers to keep her full name anonymous, was born without a uterus, making her infertile and fully diminishing her chances of conceiving a child naturally.

She had her first child, a daughter, via surrogacy through her sister but admitted that not being able to carry her own felt like something in her life was ‘lacking.’ 

Mallory was accepted into the Uterus Transplant Program at UAB, where she underwent 18 months of IVF, transplantation, pregnancy, and finally birth. 

The procedure, which has only been done about 100 times worldwide in tightly-controlled clinical studies, has risks, including the chance of the fetus being rejected, the fetus being born at a low birth rate, or death of the mother.

Mallory, who prefers to keep her full name anonymous, gave birth to a healthy baby boy via transplanted uterus. Her son is the first baby born from this method outside of a clinical trial

Mallory, who prefers to keep her full name anonymous, gave birth to a healthy baby boy via transplanted uterus. Her son is the first baby born from this method outside of a clinical trial 

Mallory experienced a relatively normal pregnancy with typical symptoms, including fatigue and nausea. 'I just felt so grateful for every symptom because it was just a reminder that I was actually pregnant when I wasn't supposed to be. I'd never thought I would be,' she said

Mallory experienced a relatively normal pregnancy with typical symptoms, including fatigue and nausea. ‘I just felt so grateful for every symptom because it was just a reminder that I was actually pregnant when I wasn’t supposed to be. I’d never thought I would be,’ she said 

A uterus can be taken from a deceased donor who gave permission for their organ to be taken, or a living donor, such as someone who had a hysterectomy, a procedure that removes all female reproductive organs.

Before the transplant, Mallory had to undergo in vitro fertilization (IVF), which involves an egg being removed from a woman’s ovaries and fertilized with sperm in a lab. This creates embryos, which are frozen for later use.

Mallory does have ovaries, which allowed her to produce eggs for IVF, making the child biologically hers. 

The surgery, which can take about 10 hours, to implant the uterus involved placing the organ, shaped like an upside-down pear, in the pelvis and connecting blood vessels from the donor uterus to Mallory’s blood vessels

Once doctors implanted a donated uterus into her, Mallory had to take immunosuppressive medications so her body doesn’t reject the new organ. These medications are taken even throughout the pregnancy.

When the procedure is successful, the recipient will typically menstruate. For Mallory, this would have been the first time.  

One of the frozen embryos created through IVF was then placed directly into her transplanted uterus.

After she gave birth birth via C-section, the donated uterus was then removed.  

Mallory was diagnosed at age 17 with Mayer-Rokitansky-Küster-Hauser syndrome, a rare condition that causes the vagina and uterus to be either underdeveloped or completely absent, according to the National Institutes of Health (NIH). She was diagnosed when she failed to get first menstrual cycle. 

The condition causes uterine factor infertility, which means that a woman cannot carry a pregnancy to term since she doesn’t have a uterus. 

Mallory and her husband Nick relocated to Birmingham to enroll in UAB's Uterus Transplant Program. Their son is the program's first baby born

Mallory and her husband Nick relocated to Birmingham to enroll in UAB’s Uterus Transplant Program. Their son is the program’s first baby born

For Mallory, the entire process of receiving a uterus and giving birth took about 18 months. The program at the University of Alabama at Birmingham is only the fourth in the country

For Mallory, the entire process of receiving a uterus and giving birth took about 18 months. The program at the University of Alabama at Birmingham is only the fourth in the country

It affects up to 500 reproductive-age women worldwide.  

‘I had to come to terms with knowing that, OK, I won’t be able to carry my own children; but for me, it always felt like something that was lacking,’ Mallory said. 

From the moment her daughter could talk, Mallory said, her daughter asked for a sibling. 

‘We were very content and happy with her, but that was something we wanted to give her,’ she said. 

Rather than opt for surrogacy again, more than two decades after her diagnosis, Mallory, her husband Nick, and their daughter relocated to Birmingham after they were accepted into UAB Medicine’s uterus transplant program. 

‘Mallory was born without reproductive organs. The ability to take patients with that devastating condition and for them experience typical pregnancy I think is important. And that’s the huge success,’ said Dr Bryan Brocato, maternal-fetal medicine specialist at UAB. 

The technology for procedures like this is still fairly new, with the first successful uterus transplant taking place in Sweden in 2014. However, Mallory’s success is an important step in the field.

‘We are thrilled for Mallory and her husband, Nick, and humbled that they entrusted our UAB Medicine care team to guide them through this long, difficult — and exciting — journey of transplantation, pregnancy and childbirth,’ said Dr Anupam Agarwal, UAB’s senior vice president for medicine.

‘Our goal and dream for this program is to make this routine for women who want to experience pregnancy and childbirth but can’t for a variety of health reason.’

‘We have the expertise and the multidisciplinary teams in place here to help make this reality.’

‘Their work with Mallory and our other transplant recipients and pregnancies to date has just been phenomenal.’

Mallory’s son is the first to be born from a uterus transplant outside of a clinical trial. The difference between this and clinical trial cases is that clinical trials have much stricter oversight and involve multiple participants. Clinical trials also seek out participants with specific criteria to test experimental methods.

Mallory experienced a relatively normal pregnancy with typical symptoms, including fatigue and nausea. 

‘I just felt so grateful for every symptom because it was just a reminder that I was actually pregnant when I wasn’t supposed to be. I’d never thought I would be,’ she said.

‘I really enjoyed being pregnant.’

‘I knew it was going to be the only time I was going to be able to do it, and I knew how lucky I was to be able to experience that.’

The physicians now hope this success means more babies will be born through the uterus transplant, providing more options to families experiencing infertility. It may even open the door for transgender women to give birth in the future. 

‘Uterus transplantation is the only medical treatment for uterine factor infertility, and despite the safety and efficacy of this treatment, it is largely inaccessible to patients around the world,’ said Dr Paige Porrett, inaugural director for Vascularized Composite Allotransplantation in UAB’s Comprehensive Transplant Institute. 

‘UAB is committed to changing that reality, and this birth signifies that we are on our way.’

‘Babies being born is always a special event. I’m using some strong words here, but I think of these as our miracle babies.’

‘It’s really about restoring hope.’ 

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