When Kirsty Bryant became the first woman in Australia to receive a uterus transplant, she did not expect to fall pregnant just months afterwards.
The 30-year-old mother from Coffs Harbour on the NSW Mid North Coast, underwent the landmark 16-hour surgery in January after receiving a uterus donated by her mother, 54-year-old Michelle Hayton.
Ms Bryant is now seven weeks' pregnant after an embryo was transferred into the same womb in which she was formed.
"It's very surreal. It's a wonderful feeling," she said.
"I was just super excited when I found out. It almost feels like it's meant to be, but it's still sinking in that I am going to have another baby at the end of the year.
"It's so wonderful that my body can do this and that my mum has given me this gift.
"Mum is very excited. She can't wait to welcome another grandchild into the family … she is over the moon."
Ms Bryant underwent the uterus transplant as part of a research trial at The Royal Hospital for Women in Sydney.
She applied for the clinical trial after she lost her uterus in a life-saving hysterectomy performed immediately after delivering her daughter, Violet.
"A few years ago, after my hysterectomy, I didn't think I would be able to carry a baby again. I was just overjoyed to find out I was pregnant," she said.
Offering women hope
Since the successful uterus transplant, another two procedures have been performed in Australia.
So far, Ms Bryant's successful embryo transfer after the transplant remains a first in the country.
The gynaecologist leading The Royal Hospital for Women trial, Rebecca Deans, said it was very encouraging news.
"It's come earlier than we expected. It's Kirsty's first embryo transfer so we are surprised and thrilled," she said.
"We are all keeping fingers and toes crossed … with every week that things progress, your chance of miscarriage starts to fall away.
"We had to monitor her really closely for rejection of the uterus and she's had absolutely no signs of rejection, so she's been really fortunate in that regard."
Uterus transplants are temporary measures and are expected to last about five years, enough time for a woman to have her children.
Currently, there is funding for a total of six uterus transplants as part of the Royal Hospital for Women trial, with plans to expand it further.
"There's been about 80 uterus transplants done around the world and there have been about 40 live births as a result of the transplant," Dr Deans said.
"After our research we will review our findings and then hopefully offer [uterus transplant] as a treatment in Australia for women who are either born without a uterus or who have lost their uterus and want to be a parent.
"You are offering hope to women. It gives women choice and hope."
High-risk pregnancy
Ms Bryant will be closely monitored during her pregnancy, which is considered high risk.
Her immune suppression medication, which helps stop her body from rejecting the foreign uterus, has been reduced to a safe level for pregnancy.
"I had an ultrasound a week ago and got to hear our baby's heartbeat, so that was really super exciting … slow and steady until we get to the 12-week mark," Ms Bryant said.
The baby is due in late December.
"I don't have the nerves connected to my uterus, so I won't be able to feel any contractions," Ms Bryant said.
"So from 18 weeks I will be monitored every two weeks with an ultrasound to make sure my cervix isn't thinning and I won't go into early labour."
Ms Bryant is expected to have a caesarean section at 37 weeks' gestation.
Her family is sharing in the excitement.
"Violet is very excited to have a brother or a sister. She hasn't decided which she'd prefer. She just keeps asking for a baby," Ms Bryant said.
"My husband is stoked. I think it's still a bit surreal for him, too.
"People keep saying it's a miracle, but I try to remind them, 'No it's science. Science has got me here'."