Tamara Franco, a 34-year-old young woman from Murcia who was born without a uterus, has just presented her son Jesus, the result of a uterus donation from her sister Bárbara, slightly younger than her, and who is already a mother. The transplant was carried out at the Hospital Clínic de Barcelona, which announced the process on Monday, in which a hundred specialists have participated, with a happy ending. Tamara has become the first woman with a uterus transplant to give birth to a healthy baby. There is another woman, a Canary Islander named Mayra, who also underwent a uterus transplant in July of last year.
Both Mayra and Tamara have Rokitansky syndrome, a congenital disorder of the female reproductive system that affects one in 5,000 women worldwide. These women are already born without a uterus and without fallopian tubes, (therefore, they cannot get pregnant) they have ovaries and sexual desire, but they do not have their period.
Jesus came into the world on March 10 at the Maternity Hospital of the Clínic Barcelona hospital at seven months of gestation, fulfilling the dream of Tamara, who had previously undergone various assisted reproduction processes. “It has been a very hard process, but at the same time very beautiful,” said the emotional mother this Monday when presenting her son together with her husband, Jesús, and the Clinic’s medical team. The baby who was born as a result of a cesarean section and weighed 1,125 kilos, has spent 74 days admitted to the Maternity Unit, 43 days in the ICU and 31 in the Intermediate Care Unit of the Neonatology Service.
The uterus transplant intervention was carried out on October 5, 2020 at the Clínic under the direction of Francisco Carmona, head of the Gynecology Service, and Antonio Alcaraz, head of the Urology and Kidney Transplant Service.
A pioneering case
“I have always wanted to be a mother. She was one of those who asked the Kings for a cart with a doll », recalls Tamara. At the age of 15, she knew that she could not be a mother and that moment “was a very hard blow” that made her cry “a lot”. That’s why when she gave birth and they showed her the child she couldn’t believe it. »For so long chasing him, it was fulfilling a dream«.
Tamara says that in 2014 she learned on television that a woman without a uterus had given birth in Sweden. Searching the Internet, she found out that the Clínic de Barcelona was preparing to perform a uterus transplant and sent an email to Dr. Carmona. The next day she already got the first answer and a whole journey of tests began for her and her sister (who ended up donating her uterus). On October 5, 2020, the transplant was performed. The surgery lasted 20 hours and was successful. Tamara became the first woman in Spain to undergo a uterus transplant. She and she is now the first woman to give birth after that intervention.
First rule with the transplanted uterus
Two months after surgery, the patient had her period for the first time and her recovery was normal and, like any person with an organ transplant, she was treated with immunosuppressants. However, she had to wait 6 months, from the first period, to be able to carry out the first transfer of embryos (which had already been collected previously). Tamara became pregnant, but she miscarried at week 8 of pregnancy. “I got discouraged, but it also gave me a lot of strength to keep going,” she says.
“I wanted to be a mother. It was my great illusion and I have fulfilled a dream»
After a few months, and after the patient had recovered, she was infected with covid and had to wait a few months before making another attempt with new embryos. Finally, a new fertilization could be carried out and Tamara became pregnant with Jesus.
Tamara’s pregnancy was followed by a multidisciplinary team of gynecology and maternal-fetal medicine. Tamara had a complication of endothelial dysfunction. “One of the main functions of the endothelium is to regulate blood flow and perfusion through changes in vascular diameter and tone. This dysfunction during pregnancy can lead to fetal growth below expectations and an increase in blood pressure,” says Dr. Figueras, head of the Maternal-Fetal Medicine Service. The medical team decided to schedule a conventional caesarean section at week 30 of gestation. The caesarean section was performed without any complications and Jesus was born weighing 1,125 grams. «During the pregnancy I had a lot of fear, a lot of anxiety in case something went wrong, that’s why seeing Jesus was like, my God, is this mine? It was a dream!” says Tamara. And her husband, who is named after the baby, clinches: “You see that little creature the fruit of such great love and you cannot believe it.”
a day of celebration
For Josep Maria Campisol, general director of the Clínic Barcelona hospital, “today is a day of celebration that values our Health and our hospital, which tries to be pioneering and innovative and promotes the vision and ability of professionals to achieve new challenges.”
The birth of Jesus has been possible thanks to an interdisciplinary team made up of more than one hundred people who have been involved in both the transplant and the monitoring of the pregnancy and birth. “And it has also been thanks to Tamara’s determination and trust in our hospital and in our team”, adds Campisol, for whom the birth of Jesus goes a step further “because here you are giving life”.
Without permission from the ONT
The uterus transplant to Tamara has not been without some controversy. It was done without the final authorization of the National Transplant Organization (ONT). ONT sources explain that there is an advisory commission in that body, whose agreements are not binding, which asked the Clinic for some modifications in the process. These modifications, relating above all to the person donating the organ, were not carried out. Yes, they were carried out in the case of the Canary Island Mayra, the second woman to receive a uterus transplant, who also underwent the intervention at the Barcelona hospital. This commission of the ONT, in which all the autonomous communities are represented, objected at the time to the transplants of hands, feet and face carried out by the well-known doctor Cavadas.
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