A woman in Nottingham has agreed to donate her womb to her infertile daughter if doctors gain permission to attempt the groundbreaking transplant operation.
Eva Ottosson, 56, the director of a lighting company, said she would offer her uterus to her 25-year-old daughter, Sara, who cannot have children because of a serious birth defect that left her without a womb.
If the operation goes ahead – at a hospital in Sweden – Sara could conceive and carry a child in the same womb she herself was born from, but serious technical hurdles must be cleared if the procedure is to succeed.The operation is experimental and still at a premature stage in animal studies. Only a handful of mice have been born from transplanted wombs and little work has been done in larger animals, such as pigs, rabbits and monkeys.
The deeply complex nature of the operation carries serious risks for the donor and recipient, leading some doctors to claim the procedure is not ready to be performed in humans. "As a mother you have all these questions: have you thought it through; do you know what you are doing; how do you feel about having the same womb that you have been developed in yourself," Eva Ottosson told the BBC.
"Of course it's major surgery and has its risks, but I trust them, I know they know what they're doing. I'm more concerned about my daughter and what the impact will be for her," she added.
Sara Ottosson, a biology teacher who lives and works in Stockholm, has a rare condition called Mayer Rokitansky Küster Hauser (MRKH) syndrome, also known as Müllerian agenesis, in which the reproductive system begins to grow but never fully develops. Women with the disorder are typically born without a womb and fallopian tubes, and have vaginal malformations.
Little is known about the cause of the condition, but like many of the one in 5,000 people born with the disorder, Sara only became aware of the problem when she failed to begin menstruating as a teenager.
While a small number of womb transplants have led to healthy births in experiments with mice, the procedure is almost completely untested in humans.
In 2000, doctors in Saudi Arabia transferred a womb from a dead donor into a 26-year-old woman, but had to remove the organ three months later when it developed a blood clot and began to die.
Sara Ottosson is one of seven patients who have undergone tests to assess their suitability for the operation under a programme run by Mats Brännström, a leader in the field of experimental womb transplants at Gothenburg University in Sweden. The operation could go ahead next year.
If the operation is approved, Sara would have surgery to transplant her mother's uterus before an IVF embryo created from her eggs and her partner's sperm was transferred.
A successful transplant would be temporary, with the uterus being removed two to three years later to avoid medical complications. Any birth would be via caesarean section.The operation is technically more demanding than a heart, kidney or liver transplant. Among the greatest risks are life-threatening haemorrhage and an insufficient blood supply to the womb.
Sara has said she will consider adoption if the transplant operation does not go ahead or fails to result in a baby. Some 15,000 women of childbearing age in Britain were born without a uterus or had the organ damaged or removed by illness, such as cancer.
In 2009, a team of surgeons and vets led by Richard Smith at Hammersmith Hospital in London reported several womb transplant operations in rabbits, though none of the animals became pregnant and carried young. The research has stalled in Britain through a lack of funding and scepticism from some in the medical community. The work is due to resume this year with support from an independent charity, Uterine Transplant UK.