Jennifer and Drew Gobrecht are barely exaggerating when they call their son “a perfect miracle.”
Benjamin Thomas Gobrecht was conceived using in vitro fertilization and grew inside a womb that was transplanted into his mother more than a year ago at the Hospital of the University of Pennsylvania.
On Thursday, the 2-month-old infant and his parents were the stars of a news conference held on Penn Medicine’s campus in West Philadelphia. Benjamin is the first baby born as part of Penn’s two-year-old uterus transplant study, led by obstetrician-gynecologist Kathleen O’Neill and transplant surgeon Paige Porrett. The plan is to do five transplants to see whether the experimental procedure — with its high costs and vocal critics — is practical for some of the estimated 500,000 U.S. women who are infertile because of a missing or nonfunctioning uterus.
“Uterine transplantation is about hope,” Porrett said during the media event.
During his turn at the microphone, Drew Gobrecht told the Penn team: “We’ve been given the greatest gift of our lives. We can’t begin to thank you for what you’ve done for our family.”
The first live birth from a uterus transplant occurred just six years ago in Sweden. In all, there have been about 70 uterus transplants worldwide, most with organs from living donors. Penn is part of a scientific consortium with the other U.S. pioneers — Baylor University Medical Center in Dallas and Cleveland Clinic. With the arrival of Benjamin, the eighth uterine transplant birth in the U.S., all three institutions can boast the crowning achievement.
Jennifer Gobrecht, now 33, was 17 years old when her lack of menstrual periods led to the diagnosis of a congenital disorder called Mayer-Rokitansky-Kuster-Hauser syndrome. She was told, on what she calls “one of the hardest days of my life,” that she had healthy ovaries but an underdeveloped uterus that could not carry a pregnancy.
Jennifer, an event planner, and Drew, a restaurant supply marketer, met in college, married five years ago, and settled in Ridley Park. They began exploring the possibility of having a biological child using in vitro fertilization — combining her eggs and his sperm in a lab dish to create embryos — and having another woman carry the embryo to term. By the time they learned of Penn’s study two years ago, they had frozen embryos that could be transferred into Jennifer if a uterus transplant was successful.
The couple went through an intensive evaluation by Penn specialists in obstetrics, gynecology, transplant, infectious disease, psychology, bioethics, social work, and more. Besides Jennifer’s undergoing a 10-hour transplant surgery, the protocol meant she would have weekly visits for at least two years, take anti-rejection drugs that would suppress her immune defenses, and undergo several dozen cervical biopsies — the only way to monitor for rejection of the uterus.
OB-GYN O’Neill, a mother of three who has personally experienced the anguish of IVF and miscarriages, said during an interview: “Jen and Drew really understood what they were getting into. They were very open and honest and had great communication between them.”
The transplanted uterus came from a deceased donor because Penn initially excluded living donors. It now accepts them because data from other programs have shown smaller risks for living donors than expected.
The first embryo transferred into Jennifer’s donated uterus produced a pregnancy — one that she thoroughly enjoyed.
“I loved being pregnant,” she said during an interview. “I had no nausea. I had that pregnant ‘glow.’ I thought, ‘My stretch marks are so cool.’ ”
Because uterus transplant patients can’t give birth vaginally, Benjamin was delivered by cesarean section surgery a few weeks before his December due date. He weighed just under 5 pounds.
Although Penn’s study allows transplant recipients to keep the uterus long enough to have a second birth, the Gobrechts opted for a hysterectomy immediately after their son’s delivery.
“That was our choice,” Jennifer said. “So I’m not on drugs” for immune suppression.
While the Gobrechts’ parenthood quest was personal, there was an element of altruism.
“When I signed up for this trial, I hoped it would help my husband and me start a family, but I also strongly believed in helping others,” Jennifer said. “My hope is that through this research, others with similar struggles will have the same opportunity.”
During an interview, O’Neill and Porrett said they see even broader implications. Their clinical trial — which has announced one successful transplant besides Jennifer’s — is yielding clues to some of the cruelest mysteries of the female reproductive system. That includes endometriosis, placental abnormalities, and pregnancy-induced high blood pressure. The physicians are also investigating the use of DNA fragments in the bloodstream to detect transplant rejection, an advance that would avoid invasive cervical biopsies.
A huge barrier, however, is the $200,000-to-$300,000 cost of uterine transplantation, which has so far been absorbed by the hospitals researching the option. Health insurers have not been receptive to covering a type of transplant that, unlike vital organs, is not lifesaving. There are also other ways to have a child — through adoption or a gestational carrier.
“The recognition that infertility is a disease is an evolving concept and not universally accepted,” Porrett said. “For both Kate and myself, it’s very frustrating to recognize that, despite the potential and success of uterine transplantation, we may not be able to offer it.”