Woman gives birth to baby boy after uterus transplant in Alabama

A woman born without a uterus welcomed a baby boy, becoming the first person outside of a clinical trial to give birth after receiving a uterus transplant.

The mom, identified by University of Alabama Birmingham Hospital only as Mallory, was 17 when she was diagnosed with Mayer-Rokitansky-Küster-Hauser syndrome, which affects approximately 1 in 4,500 female newborns. She was told she would never be able to biologically carry her own child. 

Years later, Mallory and her husband Nick had a daughter via a surrogate, Mallory's own sister, the hospital said in a Monday news release. They wanted another child, but asking Mallory's sister to undergo another pregnancy would have risked the sister's own health, so the couple began looking into uterine transplant. 

"There are all different ways to grow your family if you have uterine factor infertility, but this [uterus transplantation] is what I feel like I knew that I was supposed to do," Mallory said. 

Mallory was able to get the uterus from a deceased donor, according to the hospital. She, Nick and their daughter moved to Birmingham, Alabama, for the start of an 18-month process from transplant, to embryo implantation to birth. 

The process can take two to five years for many patients. An embryo is generated through in vitro fertilization before the transplant surgery. The mom-to-be is given immunosuppressive medications after the transplant and throughout the pregnancy to prevent transplant rejection. Several months after the transplant, doctors place one of the recipient's embryos directly into the uterus. The baby is delivered via a planned cesarean section. 

If the parents want another child, the uterus is left in place and the mom continues taking immunosuppressive drugs. The transplanted uterus is removed and immunosuppressive medications are stopped once the parents are done having children.

The first uterus transplant in the U.S. happened in 2016, but it failed and the organ had to be removed. The following year, a woman in Texas who had been born without a uterus became the first to gave birth to a baby in the U.S. after a uterus transplant. 

As of late 2020, there had been around 100 uterus transplants globally, according to University of Alabama Birmingham Hospital. 

For Mallory, who gave birth in May, more than two decades after her diagnosis, every moment of the pregnancy was special.

"Even through some of the tough stuff, I really embraced pregnancy as I knew it would 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 it," Mallory said. "Sharing that journey with our daughter was so special, too, with her being able to feel my belly. I just had so much gratitude to experience this."

Dr. Brian Brocato, Mallory's obstetrician, said he's still in awe of all the expertise and work that goes into uterine transplant programs. 

"One of the major successes was working with the other specialties that we don't typically work this closely with, and the ability to collectively take care of a patient with a single goal and offer our unique perspectives; to me, that was the real success — that we ended up with a healthy mom and baby," Brocato said.