Woman born without a vagina reveals her hopes for a large family after being transplanted with one grown in a laboratory

Unnamed Mexican woman has condition called MRKH

This is rare condition in which the vagina is underdeveloped or absent

Organ is engineered using muscle and c ells from the genital region

Woman says the transplant has finally made her feel normal

A woman given a vagina grown in a laboratory has spoken of her hope to have a family one day.

She is one of four women born without a vagina who have been given the new treatment, revealed last week.

Scientists at Wake Forest Baptist Medical Center's Institute for Regenerative Medicine engineered the organs using the women's own cells.

The unnamed woman, from Mexico, is one of four women born without a vagina who have been given the new treatment, revealed last week.The organ is engineered using a woman's own cells

The new organs have been given to women born with MRKH - Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, a rare genetic condition in which the vagina and uterus are underdeveloped or absent

One of the women, interviewed by New Scientist, credits the procedure with giving her a normal life.

She said: 'At the beginning it wasn't easy, thinking that a part of your body was going to be made in a laboratory. It was difficult to understand.



'But as the years pass and with the good results, you find a way of life which is different but not too far from normality.

'You start from a point where you are scared of everything, of trying anything – you feel you aren't normal.

The new organs have been given to women born with MRKH - Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, a rare genetic condition in which the vagina and uterus are underdeveloped or absent

Eight years on, the woman says the organ works 'as if it weren't made in the lab' and her body has accepted it incredibly well

The lab-grown vagina developed from a woman's own cells

'But with time, the support of friends and my partner, and the unconditional support of my mother who gave her all to understand me, I feel I am a very lucky person, fully satisfied.'

The unnamed woman, who lives in Mexico, was 18 when she was diagnosed with MRKH.

She said she had experienced 'moments of desperation' - especially when she was told she wouldn't have children - and the process had been difficult and painful.



But it was worth it - eight years on she says the organ works 'as if it weren't made in the lab' and her body has accepted it incredibly well.

HOW THEY DID IT The organ structures were engineered using muscle and epithelial cells (the cells that line the body’s cavities) from a small biopsy of each patient’s external genitals. The cells were extracted from the tissues, expanded and then placed on a biodegradable material that was hand-sewn into a vagina-like shape.

These scaffolds (pictued below) were tailor-made to fit each patient.

About five to six weeks after the biopsy, surgeons created a canal in the patient’s pelvis and attached the scaffold to reproductive structures.

At the same time the scaffolding material is being absorbed by the body, the cells lay down materials to form a permanent support structure – gradually replacing the engineered scaffold with a new organ.

She now hopes to have children, despite her options being limited - and dreams of the day she is interviewed surrounded by a large family,



The researchers also hope the treatment could be used to help women with vaginal cancer or injuries.

Writing in The Lancet, programme leader Dr Anthony Atala, said: 'This pilot study is the first to demonstrate that vaginal organs can be constructed in the lab and used successfully in humans.

'This may represent a new option for patients who require vaginal reconstructive surgeries. In addition, this study is one more example of how regenerative medicine strategies can be applied to a variety of tissues and organs.'

The girls were between 13 and 18 years old at the time of the surgeries, which were performed between June 2005 and October 2008.



Data from annual follow-up visits show that even up to eight years after the surgeries, the organs had normal function.

The vaginas were engineered using muscle and epithelial cells (the cells that line the body's cavities) from a small biopsy of each patient's external genitals.

The cells were then extracted from the tissues, expanded and then placed on a biodegradable material that was hand-sewn into a vagina-like shape.



These scaffolds were tailor-made to fit each patient.

Yuanyuan Zhang demonstrates the process where four young women born with abnormal or missing vaginas were implanted with lab-grown versions made from their own cells

About five to six weeks after the biopsy, surgeons created a canal in the patient's pelvis and sutured the scaffold to reproductive structures.

WHAT IS MRKH SYNDROME?

MRKH (Mayer Rokitansky Küster Hauser) is a congenital abnormality which affects one in 5,000 women in the UK. It is characterised by the absence of the vagina, womb and cervix.

Women suffering from the condition will have normally functioning ovaries and so will experience the normal signs of puberty but will not have periods or be able to conceive.

The external genatalia are completely normal which is why MRKH isn’t usually discovered until women are in their teenage years.

It’s usually discovered when the woman tries to has sex or fails to get her period.

Many women are able to create a vaginal canal using dilation treatment, which uses cylinder shaped dilators of different sizes to stretch the muscles.

However, if this is unsuccessful then surgery will be used to stretch the vaginal canal.

Following treatment women are able to have intercourse and can have their eggs removed and fertilised to be used in surrogacy.

Previous research in Dr Atala's lab has shown that once cell-seeded scaffolds are implanted in the body, nerves and blood vessels form and the cells expand and form tissue.



At the same time the scaffolding material is being absorbed by the body, the cells lay down materials to form a permanent support structure – gradually replacing the engineered scaffold with a new organ.

Follow-up testing on the lab-engineered vaginas showed the margin between native tissue and the engineered segments was indistinguishable.

In addition, the patients' responses to a Female Sexual Function Index questionnaire showed they had normal sexual function after the treatment, including desire and pain-free intercourse.



"Tissue biopsies, MRI scans and internal exams using magnification all showed that the engineered vaginas were similar in makeup and function to native tissue, said Atlantida-Raya Rivera, lead author and director of the HIMFG Tissue Engineering Laboratory in Mexico City, where the surgeries were performed.

Current treatments for MRHK syndrome include dilation of existing tissue or reconstructive surgery to create new vaginal tissue.



A variety of materials can be used to surgically construct a new vagina – from skin grafts to tissue that lines the abdominal cavity. However, these substitutes often lack a normal muscle layer and some patients can develop a narrowing or contracting of the vagina.

The researchers say that with conventional treatments, the overall complication rate is as high as 75 percent in paediatric patients, with the need for vaginal dilation due to narrowing being the most common complication.





