The ways we connect

A dull November morning when I left the children at the day care, I meet with one of the teachers. She has been on sick leave for a long time and the staff has been quite secretive about why she is absent. I had my suspicions though.

I see it in her eyes when she comes out of the personnel entrance. Somehow I just know. She starts to tell. About the bleeding from nowhere and the doctors who thought it could be cancer. About the scare. About the anxiety. The fear of perhaps having to leave her children. She was operated on and the doctors could thankfully say that it was a false alarm. There was no cancer.

Now she is without a womb. Puzzled. But incredibly grateful to be alive. Not having cancer. Shaken by the experience, she can continue to be a mother. I’m listening. Recognize so well what she tells me. The frighten. To no longer take anything for granted. The terrible in not having control over your life and your body. Much of what I have experienced, I have put behind me, of course thanks to the children. But also because I didn’t want to be someone who identifies herself with cancer. Surprisingly, however, much will come back when you have reason to be reminded of it.

It feels good to tell

She is only a few years older than I am. She could have been my sister, my friend. At this precise moment when we stand at the gate to the day care, it feels like I´m very close to her. There is so much I want to tell her. That I know what it is like to go from “deadly ill” to healthy again from one moment to another. What it does to you. That I know how it feels when something big within one has changed but everyone else live their lives as usual. How frustrating it sometimes is. And that I understand the need to talk, talk, talk. Let the world know what you have been through.

So I tell her. My story. That I also got my uterus removed. She is puzzled. How does that work? “I saw you when you were pregnant”. So I tell her that too. That I got my mother’s womb. She gets tears in her eyes. Obviously, I affect her. I try to convey her though that I am not telling her to overtake her story. But for her to know that I understand her. 

Because in fact she affects me. Although our stories are relatively similar, there is a big difference. She is a mom when all the terrible things happen. I have touched on the thought a couple of times. Now it becomes more difficult to defend myself against it. What if it had been the other way around? That the children came first and the cancer afterwards. What if it hadn’t been possible to remove it? I feel it in a completely different way now. The fear. The power of it is merciless.

She tells. I tell. It feels good.

Not a day too soon
First baby born to woman with uterus transplanted from deceased donor

Not a day too soon

The first time they transplant an organ successfully, it´s said to have have been in 1954. The first time they try to transplant a uterus is far later, in year 2000. Still, most people in the field say that the attempt is done way too early and without sufficient knowledge. This because the attempt fails. In 2007, the Sahlgrenska Academy in Sweden invites researchers and experts worldwide to “The First International Symposium on Uterine Transplantation”. I’m there. During the meeting, they discuss all possible aspects of uterine transplantation – rejection mechanisms, immunosuppression, surgical technique, pregnancy and everything there in between. It is clear that there is a lot of research that remains before a human transplant can be carried out.

After more than ten years of research, the Swedish team feels ready. In September 2012, they operate for the first time on a woman. Me. The unique thing in their research project is that the transplanted uterus comes from a living donor. My mom. The operation is followed by a further eight. In total, there are nine transplant cases in their study, all involving living donors. The majority of the world’s scientists would rather see that a uterine transplant is done using a deceased donor. The operation is simpler and does not need to take the donor into account. It also makes more wombs available to women who need them. The disadvantage is that it is impossible to get a complete overview and history of both the donor and uterus.

A race within the race

Sweden is the first to report on the first successful uterine transplant. However, it could have been Turkey. A Turkish plastic surgeon wants to try to make the historic breakthrough and operate a few years before Sweden. He uses a deceased donor. An American transplant surgeon who participates in the Swedish operations also decides to operate with a deceased donor. None of them has so far succeeded. For the thing with uterine transplant (and quite different from any other transplant), is that the surgery is not successful until the patient becomes pregnant and gives birth to a child.

At a medical congress in 2017, scientists gather again to share their worldwide experience of uterine transplants. This time they are significantly more. It’s a loaded and somewhat secretive atmosphere in the room. Several countries have made attempts with transplants and rumors say that some of the women may even be pregnant. It’s a lot of prestige. A race. Everyone wants to be the one who is first across the finish line and with results that impress the others. Nobody wants to be the one who makes a fool of himself. 

Another team in the United States has done operations. So even countries such as Mexico, Brazil, China, Germany, the Czech Republic and Serbia. In addition to Turkey, which only transplanted one woman, most seem to have followed on Sweden’s example and involved a series of women in the study. It is a little too much by chance that it would be successful in one single woman. Some have used live donors, some deceased. Some have even done both. In order to really compare. To the research group in the United States, Dr. Liza from Sweden have been handpicked to maximize their chances. They do not become the first in the world to succeed in having a child after a uterine transplant, but later on the first in the United States. That´s not too bad. They are very quick to announce the news.

> Learn more: First U.S baby born after a uterus transplant

Brazil and several others do their homework before their surgery and do a study visit at the Swedish doctors. They, in return, gladly share their experiences. It’s nice. In Serbia, they are even included in the operation. The donated uterus comes from the patient’s twin sister and the transplant is unique in that way that no rejection medicine is required, since the twins have completely identical tissue antigens. Serbia becomes the country reporting the world’s first child after a uterine transplant between identical twins.

It’s good that it is done

The 21st century seems undeniable be the century when uterine transplant is finally on the agenda. I wish the treatment had come earlier. Listening to the doctors’ successes, I can not help getting a little sad for all the women who have not got the chance. Where the dream of children died because there was no uterus. But I’m also glad. I am glad that in those cases where research has taken time, it has also been well done. I’m glad that uterine transplants are done today. Happy for the future and all women who will be able to get a completely different starting point when their own womb fails them.

And right… At the 2017 Congress, Brazil announced that they, in fact, have a pregnancy. They have succeeded with what three before them failed. They have done the first uterine transplant, with a deceased donor, where the woman has become pregnant. They have been so busy concentrating on their research that they have not communicated it to the world until now. It honors them.

> Learn more: First baby born to woman with uterus transplanted from deceased donor

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