Four women born without a uterus were given the chance to give birth to their own children through the first transplants of the living organ to take place in the U.S.
The surgeries, first reported by TIME, were performed at Baylor University last month. Living uterus transplants have been successful in Sweden, where five of nine organ recipients have given birth to healthy babies. One of the women is pregnant with her second child.
Three of the four women who had the operation at Baylor had their transplants removed after tests determined blood was not flowing properly to the new organ. The last woman’s body appears to be accepting the womb.
All of the organs were donated by women who aren’t related to or acquainted with the women receiving them. The recipients, aged 20 to 35, have Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, which caused them to be born without a uterus. The donors, aged 35 to 60, are four of 50 who volunteered to donate.
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“I am totally amazed by that,” Dr. Guiliano Testa, Baylor’s lead surgeon and chief of abdominal transplantation, told TIME. “They told us, ‘We had our chance to become mothers, and now we have this uterus and it’s not doing anything for us. We can put this uterus to use for people who really need it.’ That struck me as a physician. These women are phenomenal.”
Testa’s team was assisted by two Swedish doctors who helped perform the first successful womb transplants in that country. It takes about five hours to remove the uterus from the donor and an additional five hours to transplant it. The operation, which is not generally covered by insurance, costs from $150,000 to more than $500,000.
It should take the women about three months to recover enough to participate in daily activity, with it taking six to 12 months before in vitro fertilization can be attempted. The women must get pregnant through IFV because the transplant does not connect the new uterus to a woman’s ovaries.
Earlier this year, the Cleveland Clinic attempted a womb transplant from a deceased donor. The organ had to be removed less than two weeks later when the recipient got an infection.
The Swedish team will continue working with Baylor as it attempts further surgeries, with the university hoping to complete 10 by the end of the year.
“I am not ashamed of being the one who will be remembered as the guy who did four [transplants] in the beginning and three failed,” Testa said. “I am going to make this work. I believe from an ethical and clinical and research point of view, we have our heart in the right place.”