Yanhong Huang1, Xu Ding2, Biliang Chen2, Geng Zhang3, Aili Li2, Wei Hua2, Dongmei Zhou2, Xilin Wang2, Duoduo Liu2, Guoqing Yan4, Cuicui Zhang2, Junru Zhang2. 1. Department of Obstetrics and Gynecology, The First Affiliated Hospital of the Air Force Medical University (Xijing Hospital), Xi'an, People's Republic of China. Electronic address: huangyanhongphd@163.com. 2. Department of Obstetrics and Gynecology, The First Affiliated Hospital of the Air Force Medical University (Xijing Hospital), Xi'an, People's Republic of China. 3. Department of Urinary Surgery, The First Affiliated Hospital of the Air Force Medical University (Xijing Hospital), Xi'an, People's Republic of China. 4. Department of Pathology, The First Affiliated Hospital of the Air Force Medical University (Xijing Hospital), Xi'an, People's Republic of China.
Abstract
OBJECTIVE: To present the first live birth after uterine transplantation (UTx) in the People's Republic of China. DESIGN: Case study. SETTING: University hospital. PATIENT(S): A 22-year-old woman with Mayer-Rokitansky-Kuster-Hauser syndrome and previous surgery for vaginal reconstruction and UTx. INTERVENTION(S): Endometrial preparation, frozen embryo transfer, pregnancy follow-up, and cesarean section. MAIN OUTCOME MEASURE(S): Results of in vitro fertilization, frozen embryo transfer, ultrasound measurements during pregnancy, rejection diagnosis and treatment, delivery, live birth, and histology of uterus. RESULTS(S): Frozen embryo (cleavage stage) transfer started 1.5 years after UTx. The first embryo transfer (n = 2) resulted in a biochemical pregnancy. The second, third, and fourth embryo transfer (n = 2, 2, 3) did not result in pregnancy. The fifth embryo transfer (n = 3) resulted in pregnancy with two gestational sacs, but with spontaneous disappearance of one in early pregnancy. During early pregnancy three episodes of vaginal bleedings occurred (gestational weeks 6 + 2, 13 + 1, and 16 + 3), with a spontaneously resorbing subchorionic hematoma diagnosed at the last bleeding episode. Bleeding episodes were treated with corticosteroids and tacrolimus. During pregnancy, blood flow velocity waveforms and fetal growth parameters were normal. A subacute cesarean section was performed at gestational week 33 + 6 due to uterine contraction pattern suggesting imminent labor. A healthy boy (2,000 g) with Apgar scores of 10, 10, 10 was delivered. The uterus was kept for a possible second pregnancy. CONCLUSION(S): The first live birth after UTx in the People's Republic of China is reported and this occurred after a robotic-assisted laparoscopic uterus retrieval from the mother.
OBJECTIVE: To present the first live birth after uterine transplantation (UTx) in the People's Republic of China. DESIGN: Case study. SETTING: University hospital. PATIENT(S): A 22-year-old woman with Mayer-Rokitansky-Kuster-Hauser syndrome and previous surgery for vaginal reconstruction and UTx. INTERVENTION(S): Endometrial preparation, frozen embryo transfer, pregnancy follow-up, and cesarean section. MAIN OUTCOME MEASURE(S): Results of in vitro fertilization, frozen embryo transfer, ultrasound measurements during pregnancy, rejection diagnosis and treatment, delivery, live birth, and histology of uterus. RESULTS(S): Frozen embryo (cleavage stage) transfer started 1.5 years after UTx. The first embryo transfer (n = 2) resulted in a biochemical pregnancy. The second, third, and fourth embryo transfer (n = 2, 2, 3) did not result in pregnancy. The fifth embryo transfer (n = 3) resulted in pregnancy with two gestational sacs, but with spontaneous disappearance of one in early pregnancy. During early pregnancy three episodes of vaginal bleedings occurred (gestational weeks 6 + 2, 13 + 1, and 16 + 3), with a spontaneously resorbing subchorionic hematoma diagnosed at the last bleeding episode. Bleeding episodes were treated with corticosteroids and tacrolimus. During pregnancy, blood flow velocity waveforms and fetal growth parameters were normal. A subacute cesarean section was performed at gestational week 33 + 6 due to uterine contraction pattern suggesting imminent labor. A healthy boy (2,000 g) with Apgar scores of 10, 10, 10 was delivered. The uterus was kept for a possible second pregnancy. CONCLUSION(S): The first live birth after UTx in the People's Republic of China is reported and this occurred after a robotic-assisted laparoscopic uterus retrieval from the mother.