Lying on a hospital bed in her laced violet nightgown, Derya Sert is the first woman in the world to receive a womb from a deceased donor, raising hopes for millions of women to bear a child.
Doctors at Akdeniz University Hospital in Turkey’s southern province of Antalya successfully transplanted a womb on August 9 to Sert, 21, who was born without a uterus, like one in every 5,000 women around the world.
“Happiness, excitement all the feelings are mixed,” said Sert, a housewife married to a car mechanic, who has been in hospital for around six months.
“If God allows, we will hold our baby in our arms,” she added in her hospital room, feeling some pain as she had just returned from her weekly check.
“I was never afraid of the surgery, I have never thought about the pain or suffering I would go through,” Sert said.
“The womb has already become one of my own organs ... We have been waiting for this day to come,” she said, adding that her family and relatives had supported her in finding a solution for her medical problem.
This was the second womb transplant to be performed in the world, the first being in Saudi Arabia in 2000 from a living donor, which failed after 99 days due to heavy clotting, media reports said. Doctors had to remove the organ.
“It was a handicap to have a living donor,” said micro-surgeon Omer Ozkan, part of the surgical team of eight doctors and seven medical staff at Akdeniz University.
“In that operation the vein was too short for the anastomosis and the uterus was not supported very well,” added gyneacologist Munire Erman Akar, from the same team.
The doctors are confident that they have overcome those problems. Taking advantage of working on a deceased donor, they were able to remove a wider tissue surrounding the womb to place it well inside the body of the recipient and longer vessels to support the organ.
Immunosuppressive drugs have also improved since that time, the doctors added.
However, they are still cautious in declaring a complete success.
“The surgery was a success ... (But) we will be successful when she has her baby,” Ozkan said. “For now we are happy that the tissue is living,” without any rejection, he added.
Ozkan gives at least six months before delivering the patient to the test-tube baby experts, who will implant the embryos belonging to Sert and her husband, produced before the surgery.
“I would say earliest six months, it can be up to seven or eight,” he said.
During pregnancy, “there are many risks like congenital anomalies because of the immunosuppressive (drugs), and intrauterine growth retardation, preterm labor,” Akar added.
Lowering the dose of the drugs is critical for Sert to carry a healthy baby through pregnancy.
Sert has already started to menstruate, which is an important sign that her womb is working. “We can see it from the ultrasound that the endometrium lining is perfect,” Akar added.
A woman can live without a womb, but the only chance for her to get pregnant is a transplant, doctors said.
“They are young patients. They have totally normal ovaries so they just deserve this chance to have a baby,” Akar said.
However the doctors want to remove the womb again after Sert has had her baby, to prevent any risks of rejection.
“Of course it is the patient’s choice but my preference would be to remove it,” Ozkan said, unless the family wants to have a second child, which would be possible with the same uterus.
Only three medical centers in the world work on womb transplants, the others being in Sweden and the United States.
“We would be so happy if I could be a hope for other women. I wish them to have have what they long for,” Sert said.
The womb has already become one of my own organs ... We have been waiting for this day to come