Uterine Transplants

Hope for Women With Uterine Factor Infertility (UFI)

Surgeon talking to patient before surgery
Surgeon talking to patient before surgery. Getty Images/Medic Image/Universal Images Grou

Uterine transplants, a highly experimental procedure, may offer new hope for women who are infertile. Women, with uterine factor infertility (UFI), are of a reproductive age but are unable to carry a pregnancy. It has been estimated that UFI affects thousands of women worldwide. Some women have been born without a uterus, others have developed UFI because their uterus no longer functions or it was removed for medical reasons, such as a serious pelvic infection or cervical cancer.

Uterine transplants have been successfully performed in Sweden and resulted in five pregnancies and four live births.

Women selected to receive a transplanted uterus will need to follow a specific protocol. In addition, they will need to begin an in vitro fertilization (IVF) process in order to produce eggs. The eggs are then retrieved, fertilized with sperm, and frozen for use after the transplant.

After a donor is found, their uterus is transplanted into the patient’s pelvis within six to eight hours of being matched. The uterus, complete with two major arteries and four veins, is removed from the donor in a surgery that can take up to three hours. It is then implanted into the patient recipient during a six-hour operation. The recipient patient will then be placed on immunosuppressant drugs to prevent the transplanted uterus from being rejected.

After the transplant, the transplanted uterus will need time to heal.

The healing process should take about a year. During this time, the patient will continue to take anti-rejection drugs and may require additional surgeries. After the healing has taken place, the embryos that had been frozen are thawed and implanted into the uterus, until pregnancy is confirmed. The anti-rejection drugs will continue to be taken during the pregnancy to prevent rejection of the transplanted organ.

To prevent complications, delivery of the baby will need to be by cesarean section (C-section). This procedure provides infertile women the ability to bear a child that is genetically their own and the experience of carrying a pregnancy for the first time.

Are Uterine Transplants Ethical?

There is an ongoing debate in the medical community about whether uterine transplants are ethical or not. Why risk the life of woman and her unborn child when infertility is not a life threatening condition? Other transplants like heart and kidney transplants are life-saving -- not elective procedures, like uterine transplants. We have successful, proven alternatives for women who are infertile, like surrogacy and adoption. Do the benefits of uterus transplant exceed the risks?

For the woman who undergoes the first successful transplant and pregnancy, the answer is yes. But for the many women before her who may have lost their lives, suffered late miscarriages, or did not become pregnant at all, the answer will likely be no. Unfortunately, it takes sacrifices like these to perfect a medical procedure. To have a child of their own, this is a risk many women are willing to take.

Another ethical concern being raised is if successful uterine transplant could lead to men carrying children. Of course, this is far into the future, but could it be possible? Medically speaking, with adequate hormone therapy and successful uterine transplant, it may very well be possible.

Sources:

Anjana Nair, Jeanetta Stega, J. Richard Smith, Giuseppe Del Priore. Uterus Transplant. Annals of the New York Academy of Sciences. 2008 Apr. Vol 1127, 83-91.

Fageeh W, Raffa H, Jabbad H, Marzouki A. Transplantation of the human uterus. International Journal of Gynecology and Obstetrics. 2002 Mar. Vol 76(3):245-51.

Continue Reading