In what doctors Tuesday said was a medical first, an Argentine woman with a transplanted heart gave birth to a baby girl following an in vitro fertilization.
Pregnancy after an organ transplant is always a high risk proposition because the drugs needed to ensure the transplanted organ is not rejected make pregnancy difficult, and their effects on the fetus were not clear.
“There is no record in the world of a transplant patient who has achieved pregnancy through in vitro fertilization,” said Gustavo Leguizamon, head of the high risk pregnancy center in Buenos Aires, where the treatment was performed.
The risks are even greater in heart patients because women have 40 percent more blood during pregnancy, putting extra strain on the heart.
“This could lead to not enough blood getting to the uterus, causing the baby to grow less” and a possibly premature birth, Leguizamon said.
The medications needed to perform in vitro fertilization added yet another layer of complication, said Ricardo James, a reproductive specialist at the high risk center.
But the risks did not stop Juliana Finondo, 39, who was determined to chase her dream of motherhood.
“I was never afraid. Maybe I’m too optimistic,” she said.
The graphic designer from eastern Argentina, who now lives in Buenos Aires, had a heart transplant in 1999. At the time, doctors told her she could not risk getting pregnant after the surgery.
A decade later, she decided to try — but two years passed without getting pregnant naturally.
Infertility can be a side effect of the immunosuppressant drugs used to prevent organ rejection, said Sergio Papier, a doctor who heads a research center focusing on gynecology and reproduction.
Transplant patients “can see their ovarian reserve affected and their fertility diminish,” said Papier, who did not work with Finondo.
The immunosuppressants work by preventing the development of new fast-growing cells, including those that are necessary for pregnancy, he said.
So after Finondo was carefully examined to ensure she didn’t show any signs of rejecting her heart, her doctors designed a special medication plan to wean her from the drugs, adding to her difficulties conceiving and to add in the fertility drugs needed for in vitro fertilization.
Luckily, Finondo got pregnant on her first round of IVF. And after nine months of strict monitoring her healthy daughter Emilia was born on January 15.
Finondo’s cardiologist Sergio Perrone said the case shatters prejudices of the limitations of a life post-transplant.
“Today a transplant patient has an excellent quality of life, much better than people realize,” Perrone said.
He said he also hoped the story would encourage people to consider organ donation, “because it saves one life, which can be multiplied by so many more.” The infant Emilia “will become a mother in her time,” he said.
In Argentina, in 2012, 630 donors contributed organs to 1,458 patients, a record rate of 15.7 donors per million people.
But there are 7,290 patients on the waiting list, according to government figures.