Side by side in the bright yellow seats of a backyard swing are Jen Dingle’s wildest dreams.
Dingle was 14 when she was first told this seemingly ordinary moment — two children of hers, Jia, 4, and Jade, 2, playing outside on a sunny spring day in Arlington — would never be possible.
“It catches me off guard even now,” Dingle said. “They are, by far, my accomplishments of which I am most proud.”
There are also two Baylor University Medical Centers.
In February 2020, Dingle became the first woman in the United States to deliver two babies from a transplanted uterus. This Mother’s Day, Dingle celebrates the obstacles she overcame to create and define family – alongside some of the only other women in the world to have shared such a journey – and the Dallas Hospital defying the odds of bring them together.
Baylor University Medical Center in Dallas, part of the nonprofit Baylor Scott & White Health System, has delivered 15 babies via womb transplant since 2016, making it the largest and most successful uterus transplant program around the world.
At least three other hospitals in the United States – the Cleveland Clinic, the University of Alabama at Birmingham and the University of Pennsylvania Hospital – have uterus transplant programs, as well as hospitals in countries such as Belgium, Germany, Sweden and the United Kingdom.
The procedure is for women who do not have a uterus or whose uterus cannot support a pregnancy.
For Dingle, it was Mayer-Rokitansky-Küster-Hauser syndrome, a disorder that affects about 1 in 5,000 women. She was born with ovaries but no uterus or cervix, and we told her she could never bear a child.
“I really wanted my own biological children to experience the bond that comes with pregnancy, so I was a bit depressed,” Dingle said. “I knew I was ready to start a family, but where do I start?”
A life-changing call
While living abroad with her husband, Jason, in 2015, Dingle heard of clinical trials for a womb transplant program beginning in the UK, the second country to attempt the procedure after it has been successfully carried out in Sweden.
Dingle reached out to see if she could join, only to learn that they weren’t accepting patients yet.
“I was starting to feel hopeless,” she said. “You can only put so many options on the back burner.”
In 2016, Dingle learned that Baylor was start your own clinical trial. Knowing that there were only 10 places, she became one of the first patients to register in July. Dingle was accepted two months later and soon moved to Texas to start the process.
“It all started falling into place so quickly,” she said. “I went from thinking this would never happen for me, to changing our whole life in a matter of months to making it a reality.”
Her husband said they didn’t really know what they were getting into.
“But at the same time, we knew what our goal was and we were willing to try every opportunity that came our way to try and get there,” Jason Dingle said.
In November, the clinic found a living donor, and a month after the nine-hour transplant surgery Dingle had her first period, aged 27, proved that the first step in the process was a success.
Thanks to in vitro fertilization, Dingle underwent an embryo transfer six months after the transplant – and ended up getting pregnant on the first try.
“It was super exciting, but really scary because of all the unknowns,” she said. “If I had a question or a strange pain, I would tell the doctors about it, and I didn’t always get an answer, because it was so new for them too. We had to take everything day by day.
After an uncomplicated pregnancy, Dingle gave birth to Jia in February 2018.
“It felt like I had taken a big step,” she said. “We were missing something, and doctors telling me that they had heard of a womb transplant before but should never count on it because it seems too risky, and then prove to them that they were wrong? It’s stimulating.
It wasn’t until months after she was born that doctors asked Dingle if she wanted to try something no other woman in the trials had done – trying to have a second child.
With only four embryos remaining, the first three attempts failed. In July 2019, the fourth and final transfer made history and Jade was born in February 2020.
To save women who receive a uterus transplant from having to take anti-rejection drugs for the rest of their lives, doctors remove the uterus after one or two deliveries. Dingle underwent a hysterectomy minutes after Jade was born.
“We knew from the start that we wanted to try to have as many children as possible because the truth from the start was that the transplant would never be a permanent solution for me,” she said.
Donors, doctors who change lives
The identity of Dingle’s donor remained anonymous throughout the clinical trial. But on Tuesday, she met Cassie Dunn for the very first time.
“Finally meeting her was the icing on the cake,” Dingle said. “The girls are here, I’ve had the hysterectomy, I’m done with the meds – but it was meeting her that felt like I ended the whole trip.”
Dunn, a mother of four, joined the Dingles again, along with other donors, recipients and children who have been part of the program, Saturday at the Dallas Arboretum and botanical garden for a private event to celebrate Mother’s Day.
“The road to motherhood is no longer linear,” said Liza Johannesson, a gynecological surgeon at Baylor who specializes in uterine transplantation. “When we started this program six years ago, we could only dream of having you all here.”
In the center of the banquet hall, the children played together, building with plastic bricks and wooden blocks, while their parents finally put faces to names they had previously only seen in articles, letters or Facebook support groups.
Dunn was among the women who said Baylor’s program not only fulfilled lifelong dreams of motherhood, but created a “sisterhood like no other.”
“I wanted to do something for someone else, to give someone else the gift of having children,” Dunn said, “but I couldn’t have imagined then how [the Dingles] would become my extended family. I can’t see my life without her.
Going forward, Johannesson said the goal is to make the option of receiving a transplant available to as many applicants as possible.
“Everyone gathered today rewrote the treatment guide for what was once called the last hurdle in infertility for a long, long time,” Johannesson said. “But it’s not just the people in this room who have benefited, it’s the whole world.”
Johannesson, along with physicians like Giuliano Testa, head of abdominal transplantation at Baylor and president of the Annette C. and Harold C. Simmons Institute of Transplantation, works with countries around the world – Spain, Italy, Chile and England among them – to create additional programs.
“We can reach out to others and tell them not to make the mistakes we made and start from where we’ve been successful and move on,” Testa said.
“It’s the story of the hospitals, the leaders and the women who had the courage to imagine the unimaginable.”