First baby born in UK from deceased womb donor

The birth of a baby boy in the UK's first womb transplant involving a deceased donor offers hope to other couples wanting children.

Hugo Richard Norman Powell was born weighing 6lb 13oz (3.1kg) in December at Queen Charlotte's and Chelsea Hospital, part of Imperial College Healthcare NHS Trust.

The development represents a significant medical milestone, with only two previous births in Europe following womb transplants from deceased donors.

The deceased donor programme is a research programme combining expertise from Imperial College Healthcare NHS Trust, Oxford University Hospitals NHS Foundation Trust, NHS Blood and Transplant, Womb Transplant UK and The Lister Hospital.

It follows the UK's first womb transplant in 2023 involving a living donor.

Then, baby Amy was born to parents Grace and Angus Davidson after Mrs Davidson received a womb from her older sister.

Both Mrs Davidson and Hugo's mother, Grace, have Mayer-Rokitansky-Kuster-Hauser (MRKH), a rare condition affecting about one in every 5,000 women which results in an underdeveloped or missing womb.

However, the ovaries are intact and still function to produce eggs and female hormones, making conceiving via fertility treatment a possibility.

Isabel Quiroga, consultant transplant surgeon at Oxford University Hospitals who helped establish the programme, said the procedure is aimed at a specific group of women.

“This is only for women that have uterine infertility – either they have been born without a womb, or they lost it due to cancer or bleeding, or they have a womb that doesn’t work and cannot carry a child,” she said.

While this represents a small proportion of infertility overall, she added: “Infertility is a huge burden on families, on women. For this group of women, the only option to have a child is either to have a surrogate or to adopt.”

She also noted that surrogacy is not permitted in many countries and, for some women, it is against their religion: "For instance, Muslim women are not allowed to have a surrogate, so for them adoption is the only option. But now with the uterus transplant, maybe we are giving them a new opportunity.”

In the case of living donors, people undergo extensive counselling to ensure there is no coercion and that they understand the risks of donating an organ.

Each donation is considered by the Human Tissue Authority (HTA) and only happens once HTA approval is in place.

In the case of deceased donors, the womb is not covered by the normal consent for organ donation, nor by joining the organ donor register, and it is not covered by deemed consent (which presumes people want to donate unless they opt out).

If families have agreed to donate other organs, they may then be approached and told about the womb transplant research programme.

Only then are they asked specifically whether they wish to donate the womb, separate from other organs.

Women aged 18 to 51 who have been confirmed dead through brain stem death testing may be considered.

Womb Transplant UK is running two programmes, one involving living donors and another with organs from women who have died.

Ms Quiroga said using deceased donors could spare healthy volunteers from undergoing a major operation: “The important thing is we avoid the risks to the living donor – the risk of surgery, the risk of potential complications after the surgery.”

The living donor programme in the UK has so far focused on women with relatives who are willing to give their wombs.

However, the team believes that, in the future, the living donor programme will expand to include friends or altruistic donors.

Miss Quiroga said they hope the deceased donor programme will also widen access: “Many women would not have a potential donor – a sister or a mother that could donate to them,” she said. “If this becomes a viable option, hopefully we will be able to give the opportunity to many other women that otherwise might not be able to carry their own child.”

Each womb transplant costs about £30,000 and is fully funded by the charity Womb Transplant UK.

This includes payment to the NHS for theatre time and the patient's stay on a ward.

The operations are only carried out at times when the NHS is not using the operating theatre, so they do not have an impact on usual NHS waiting lists.

More than 30 staff are involved in looking after UK patients having a womb transplant and surgeons and medical staff involved have not been paid for their time.

Once a patient becomes pregnant through self-funded IVF, the NHS takes over the costs of managing pregnancy and the safe delivery of the baby, as with any other pregnancy.

Surgeons have carried out five womb transplants in the UK - two womb transplants involving a living donor and three using a deceased donor.

Two babies have been born - one using a womb from a live donor and the other from a deceased donor.

Experts believe a maximum of 20 to 30 womb transplants per year could be carried out in the UK in the future.

Estimates suggest there are 15,000 women in the UK of childbearing age who do not have a functioning womb.

To be eligible for the programme, women must live in the UK and be aged 24 to 40 (or 42 if embryos are frozen before the age of 38).

Womb Transplant UK has approved a live donor programme for five transplants.

The deceased donor research programme has approval for 10 transplants.

Miss Quiroga said that further transplants are already under way, with some recipients at different stages of IVF treatment: “We’re really hopeful to have some more babies and to be able to do more transplants in the coming years.”

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