For some infertile women a uterus transplant is the only way to get pregnant, but donors are so far limited to willing volunteers, which has made the procedure possible in only a handful of cases. Now, scientists at the University of São Paulo have reported the first successful birth of a child after the mother received a uterus transplant from a deceased organ donor. The milestone may expand the options for more women with fertility issues.

Donating your uterus is a big ask for a live patient, and so far the procedure has been performed less than 40 times, resulting in just 11 live births since 2013. Using the organ from deceased donors could expand the availability, but although this has been attempted 10 other times in recent years, no live births have been reported until now.

The recipient of the organ was a 32-year-old woman born without a uterus, while the donor was a 45-year-old woman who had died of a stroke. Four months before the transplant the recipient underwent an IVF procedure, and eight fertilized eggs were frozen.

The 10.5-hour transplant operation took place in September 2016, and everything went smoothly. Five months after the procedure, there were no signs of anomalies or rejection, and the patient was experiencing regular menstruation. Seven months after the surgery, the fertilized eggs were implanted, resulting in a healthy pregnancy.

The baby was born at 35 weeks and three days, weighing 2.5 kg (5.5 lb). A caesarian section was performed, and the transplanted uterus was removed at the same time. Both mother and child were healthy during the following months that they were observed.

"The use of deceased donors could greatly broaden access to this treatment, and our results provide proof-of-concept for a new option for women with uterine infertility." says Dr. Dani Ejzenberg, lead researcher on the study. "The need for a live donor is a major limitation as donors are rare, typically being willing and eligible family members or close friends. The numbers of people willing and committed to donate organs upon their own deaths are far larger than those of live donors, offering a much wider potential donor population."

As promising as the development is, it's still early days and there are a few things to iron out. The team says there's still room for optimization in the surgical procedures and immunosuppression techniques, which reduce the chances of the body rejecting the transplanted organ. There's also a need to compare the outcomes and effects between uteri from live and deceased donors.

The research was published in the journal The Lancet.