First live birth after uterine transplantation

The world's first live birth following uterine transplantation has been announced by Mats Brännström at the Sahlgrenska University Hospital, Gothenburg.(1) The report, published online by The Lancet on 5 October, describes how a 35-year-old woman with congenital absence of the uterus (Rokitansky syndrome) received the donor uterus from a 61-year-old, two-parous woman in 2013. The recipient and her partner had IVF before the transplantation, from which 11 embryos were cryopreserved and one transferred.

Brännström had described the background to the transplantation at this year's 'Best Of' joint meeting of ESHRE and ASRM in Italy, with the details published almost simultaneously in Fertility and Sterility.(2) The investigators now report their results as 'a proof of concept for this treatment of absolute uterine factor infertility', adding that the efficiency of the technique 'is unclear and remains to be established'.

The present series of patients comprises nine women with an absent or dysfunctional uterus. Two earlier cases of uterine transplantation have been reported, one from Saudi Arabia and another from Turkey, both of which were criticised ethically. The Gothenburg series, as Brännström explained in Italy, allowed no risk of such accusations, with a painstaking research approach progressing from mice to non-human primates.

Kersti Lundin, Chairman Elect of ESHRE and Laboratory Director at Reproductive Medicine at Sahlgrenska University Hospital, said: 'This is a fantastic achievement by Professor Brännström and his team, a milestone that has been reached after more than ten years of research and very careful preparations.'

According to press reports, further pregnancies from the series are ongoing; back in March Brännström said that seven of the nine recipients began menstruating from the second month. In this first successful case, the recipient’s first menstruation occurred 43 days after transplantation, and her first embryo transfer, which resulted in pregnancy, one year after.

1. Brännström M, Johanneson L, Bokström N, et al. Livebirth after uterus transplantation. Lancet 2014; http://dx.doi.org/10.1016/S0140-6736(14)61728-1.
2. Brannstrom M, Johannesson L, Dahm-Kahler P, et al. First clinical uterus transplantation trial: a six-month report. Fertil Steril 2014; 101: 1228–1236.

European Commission rejects pro-life campaign proposals which threatened EU research funding 

The European Commission has concluded that no further legislative action is necessary following the million-signature pro-life campaign known as 'One of Us'. The campaign succeeded in gathering the one million signatures necessary for a European Citizens Initiative, a public citizen scheme inviting the European Commission to propose legislation on matters in which the EU has legislative power.

The campaign had sought "a concrete ban of life-destroying policies in the EU budget" based on an argument of protection of the right to life "of every human being from conception".

The European Commission, following a public meeting on the Initiative in March, delivered its response on 28 May, stating that it "does not see a need to propose changes to the financial regulation".(1) In particular, the Commission notes that "Horizon 2020 provisions on human embryonic stem cell research . . . involve a carefully calibrated set of exclusions and conditionalities, rigorous ex-ante checks, case-by-case decision-making involving the Member States, contractual obligations, reporting requirements, and ex-post audits". They add that these provisions already exclude from EU funding the destruction of blastocysts for research purposes, and fully respect national legislation on human embryonic stem cell research.

ESHRE, along with other health organisations, had opposed the One of Us campaign, arguing that a ban on the funding of embryonic stem cell research would jeopardise progress in regenerative medicine, reproductive health and the treatment of genetic disease.

Commenting on the European Commission's statement, ESHRE Chairman Juha Tapanainen said he welcomed the decision as a reflection of common sense and public opinion. "The arguments of the One of Us campaign were misguided," he said, "and it is reassuring that the EU remains committed to supporting embryo research in reproductive medicine and degenerative diseases."

1. See http://ec.europa.eu/transparency/regdoc/rep/1/2014/EN/1-2014-355-EN-F1-1.Pdf

Arguments applied in the 'One of Us' citizens initiative are 'misguided' and not representative of European citizens
ESHRE calls on the European Parliament to reject ill-founded claims

Brussels, 9 April 2014: ESHRE, the European Society of Human Reproduction and Embryology, believes the arguments of the "One of Us" campaign are misguided and not representative of the scientific community or indeed of most European citizens.(1)

The proposals set out in the "One of Us" European Citizens Initiative will be the subject of a public hearing on 10 April 2014 at the European Parliament. The "One of Us" organisers have stated that the desired outcome of the initiative is "a concrete ban of life-destroying policies in the EU budget".

ESHRE, as the leading society in Europe in the field of reproductive medicine, has always based its ethical judgments on responsible science and a duty of care to infertile patients and the health and wellbeing of the future child. It is thus a matter of grave concern to ESHRE that the opinions expressed in such campaigns as “One of Us” will jeopardise EU funding for research in reproduction and regenerative medicine. For the “One of Us” campaign to describe such research solely as "embryo-destructive" misrepresents the advances already achieved in stem cell research, or indeed in the world's more than five million babies conceived by reproductive technologies. Infertility affects as many as one in six couples of reproductive age, and progress in its treatment over the past 35 years has only been possible because of research on embryos.

Similarly, stem cell research currently holds the greatest promise in the treatment of chronic life-threatening diseases such as diabetes, Alzheimer's and cancers. Despite the progress made in the derivation of pluripotent adult stem cells, embryonic stem cells remain the gold standard for research in regenerative medicine.

Non-communicable diseases, such as heart disease, stroke, diabetes, common cancers and chronic diseases of the liver, kidney and respiratory system together cause 86% of all deaths in Europe, and up to 40% of European adults suffer some long-standing health problem related to them.

ESHRE's position has always been that human embryos should be treated with respect and should not be used for any purposes other than those of moral worth. Such morally worthwhile aims include the treatment of infertile couples, a better understanding of infertility and its treatments, and the development of stem cell therapies to treat life-threatening and disabling diseases.

ESHRE calls on the European Parliament to reject the ill-founded proposals of the “One of Us” campaign and recognise the value of embryonic stem cell research to current and future citizens of Europe.

1. See http://ec.europa.eu/public_opinion/archives/ebs/ebs_341_winds_en.pdf, page 55

* ESHRE is an international non-profit organisation whose main objective is to promote the study of reproductive science and medicine and the treatment of infertility. The Society, which was founded in 1984, has more than 6200 members.

For further information on the details of this press release, contact:
Christine Bauquis at ESHRE
Mobile: +32 (0)499 25 80 46
Email: christine@eshre.eu