Mumbai to get its first uterus transplant programme

Mumbai: In a ray of hope for women with uterine abnormalities, the city is set to welcome its first uterus transplant programme after Maharashtra’s directorate of health services (DHS) issued a licence to H N Reliance Hospital last week. Confirming the news, Pune-based Dr Shailesh Puntambekar, who carried out India’s first uterus transplant in May 2017, said that the inspection by the State Organ and Tissue Transplant Organisation and district transplant committee took place in his presence followed by DHS granting the license.

“My team and I have signed a deal with H N Reliance Hospital to lead their uterus transplant program. We will perform the transplants there and train the team at the hospital too,” said Dr Puntambekar.

The surgeon, who is the director of Pune’s Galaxy Care Multispeciality Hospital, is the country’s sole practitioner of this procedure, having conducted 11 successful uterus transplants so far. He is slated to perform two uterus transplants next month in Pune, one of them on a 29-year-old married woman from Mumbai. “The H N Reliance Hospital team too is preparing its list,” he said. “If there is a patient, we will perform the first uterus transplant in Mumbai next month.”

The demand for uterus transplants is high, with over 600 women currently on the waiting list, of which 60 percent are from Maharashtra. “We have 287 married and 330 unmarried women on the list,” said Dr Puntambekar. “Ninety percent of them have uterine factor infertility—a condition in which the uterus is either absent or non-functioning. It is said that one in 5,000 baby girls in India is born with a uterus problem—it is either absent, small, absent or there could be two uteruses.” Apart from this, there could also be uterus damage due to infections like tuberculosis, multiple fibroids or multiple surgeries.

While uterus transplants can be done with cadaver uterus donations, all the 11 uterus transplants performed by Dr Puntambekar and his team were from live donors. “Ten donors were the patients’ mothers,” he said. “In one case, the donor was the sister. We have seen that a mother’s uterus is easily accepted by the donee’s body.”

While the city awaits the first uterus transplant, gynaecologists have welcomed the news with caution. Dr Hrishikesh Pai, president of the Federation of Obstetric and Gynaecological Societies of India said, “It is welcome news that a woman gets one more option to explore apart from surrogacy. However, the patient should be counselled on the risk involved in the procedure.”

Another senior gynaecologist from the city said though uterus transplants were a big step from a medical science perspective, gynaecologists still did not recommend them because of the risk factors. “There are too many surgeries involved,” he pointed out. “Women who undergo a transplant have to take immunosuppressant drugs to avoid organ rejection. There is no study available on the effect of these drugs on a developing foetus. The immunosuppressant drugs have side-effects and can increase the risk of pre-term delivery. Post-delivery, the recipient has to undergo another major operation to remove the uterus in order to stop taking immunosuppressant drugs.”

Dr Nikhil Datar, the gynaecologist who got policymakers to raise the upper limit for abortions from 20 weeks to 24 weeks, said it was an individual preference of a woman whether she wanted to experience motherhood via surrogacy, adoption or through uterus transplant. “Once upon a time, a woman with no uterus meant one could not become a mother,” he said. “But now, with the advancement of medical technology, she has alternatives and opportunities.”

BOX

A uterus transplant is a surgical procedure by which a healthy uterus is transplanted in a woman whose uterus is absent or diseased

The first uterus transplant in the world was done in 2002

The first uterus transplant in India was done in May 2017

While the first two womb transplants were completed in approximately nine hours, others have taken around six hours.

Pune’s Galaxy Care Hospital runs the country’s only uterus transplant OPD

There are 617 women on the waiting list for uterus transplants, in which ten women are from Mumbai, two from Pakistan, four from Bangladesh and one each from US and Dubai

60% of the women in the waiting list are from Maharashtra

30% from West Bengal, Gujarat, Rajasthan and Madhya Pradesh