title: One uterus bridging three generations: first live birth after mother-to-daughter uterus transplantation.
abstract: OBJECTIVE
  To determine whether a uterus from the mother of a woman with absolute uterine factor infertility can be transplanted to daughter and carry a pregnancy with delivery of a healthy child.
  
  
  METHODS
  Part of an observational study.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Twenty eight-year-old woman with uterine agenesis, her male partner, and her 50-year-old mother.
  
  
  METHODS
  In vitro fertilization with embryo cryopreservation before live donor uterus transplantation (UTx). Induction immunosuppression. Embryo transfer 12 months after UTx, pregnancy controls, delivery, and hysterectomy.
  
  
  METHODS
  Results of IVF-ET, parameters of pregnancy/birth, and surgical data of transplantation/cesarean section/hysterectomy.
  
  
  RESULTS
  Two IVF cycles before UTx resulted in 10 cryopreserved embryos. Donor surgery included hysterectomy with vascular pedicles of uterine vessels and proximal vessels up to and including parts of internal iliacs. Recipient surgery was by bilateral vascular connections to external iliacs, vaginal-vaginal anastomosis, and uterine fixation. Pregnancy occurred at the first single ET, and the pregnancy proceeded uneventfully until gestational week 34, when the patient developed cholestasis with intense pruritus. Cesarean section was performed at 34+6, with delivery of a healthy boy (weight 2,335 g). Hysterectomy was performed 3.5 months after delivery. The weight of the healthy child at 12 months was 9.3 kg. Grandmother (uterus donor) and mother are in good health 3 years after UTx.
  
  
  CONCLUSIONS
  This is the first report of a live birth after mother-to-daughter UTx, and it also represents the second birth ever after human UTx.
  
  
  BACKGROUND
  NCT01844362.
authors.affiliation: Department of Obstetrics and Gynecology, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden; Stockholm IVF, Stockholm, Sweden. Electronic address: mats.brannstrom@obgyn.gu.se.
authors.forename: Mats
authors.initials: M
authors.lastname: Brännström
authors.affiliation: Department of Obstetrics and Gynecology, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Bokström
authors.affiliation: Department of Obstetrics and Gynecology, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.
authors.forename: Pernilla
authors.initials: P
authors.lastname: Dahm-Kähler
authors.affiliation: Department of Obstetrics and Gynecology, La Fe Hospital, University of Valencia, Valencia, Spain.
authors.forename: Cesar
authors.initials: C
authors.lastname: Diaz-Garcia
authors.affiliation: Department of Transplantation, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.
authors.forename: Jana
authors.initials: J
authors.lastname: Ekberg
authors.affiliation: Department of Anesthesiology and Intensive Care, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Enskog
authors.affiliation: Department of Obstetrics and Gynecology, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden; Center for the Developing Brain, Division of Imagining Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
authors.forename: Henrik
authors.initials: H
authors.lastname: Hagberg
authors.affiliation: Department of Obstetrics and Gynecology, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.
authors.forename: Liza
authors.initials: L
authors.lastname: Johannesson
authors.affiliation: Department of Transplantation, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.
authors.forename: Niclas
authors.initials: N
authors.lastname: Kvarnström
authors.affiliation: Department of Clinical Pathology and Genetics, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Mölne
authors.affiliation: Department of Transplantation, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.
authors.forename: Michael
authors.initials: M
authors.lastname: Olausson
authors.affiliation: Reproductive Medicine, Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden; Division of Obstetrics and Gynecology, Department of Science, Intervention, and Technology, Karolinska Institute, Stockholm, Sweden.
authors.forename: Jan I
authors.initials: JI
authors.lastname: Olofsson
authors.affiliation: Reproductive Medicine, Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden; Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
authors.forename: Kenny
authors.initials: K
authors.lastname: Rodriguez-Wallberg
mesh_terms: D058489:46, XX Disorders of Sex Development / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D000328:Adult; D032721:Adult Children; D002585:Cesarean Section; D000013:Congenital Abnormalities / Q000175:diagnosis / Q000503:physiopathology; D015925:Cryopreservation; D004624:Embryo Transfer; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro; D006785:Hospitals, University; D006801:Humans; D007044:Hysterectomy; D007165:Immunosuppression Therapy; D007247:Infertility, Female / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D050498:Live Birth; D019520:Living Donors; D008875:Middle Aged; D009035:Mothers; D009095:Mullerian Ducts / Q000002:abnormalities* / Q000503:physiopathology; D011247:Pregnancy; D013548:Sweden; D016896:Treatment Outcome; D014599:Uterus / Q000503:physiopathology / Q000637:transplantation*
keywords: Human; infertility; pregnancy; transplantation; uterus