by:
Lisa Kaplan Gordon
Uterus Transplant Surgery Now A Reality in U.S. (Stocksy)
The
reproductive world is buzzing today with news that the Cleveland Clinic
will soon perform groundbreaking surgery to transplant donor uteri into
10 women suffering from uterine factor infertility (UFI).
“Although
there appears to be potential for treating UFI with uterine
transplantation, it is still considered highly experimental,” says Dr.
Tommaso Falcone, chair of Cleveland Clinic’s Ob/Gyn & Women’s Health
Institute.
Actually,
they’ll be loaner uteri, because after a woman becomes pregnant and
delivers a child or two, she’ll have to give the transplanted uterus
back either through hysterectomy or by letting it wither away.
Unlike
other life saving organ transplants, uterus transplant is considered
“life enhancing,” says Andreas Tzakis, the Cleveland Clinic lead
investigator in the research study of uterus transplant in the U.S.
Doctors in Sweden already have successfully transplanted the organ
achieving five pregnancies and four live births.
“Unlike
any other transplants, they are ‘ephemeral,’” Tzakis says in a
Cleveland Clinic statement. “They are not intended to last for the
duration of the recipient’s life, but will be maintained for only as
long as is necessary to produce one or two children.”
So far, no date for the first U.S. uterus transplant has been set.
“We do not know when a transplant will happen, there are a lot of
variables, including finding a donor and we can’t predict a timeline,”
Tora Vinci, a spokeswoman for the Cleveland Clinic told Yahoo Health in
an email.
Here’s How It Works
In
September, the Cleveland clinic began screening transplant candidates,
21-to-39-year-old women with UFI who underwent extensive rounds of
medical and psychological evaluations. Ten were selected to undergo the
transplant following ovary stimulation, in vitro fertilization and embryo harvest and freezing.
Eventually,
a donor uterus will be identified, transplanted and allowed to heal for
12 months before the frozen embryos are thawed and implanted one at a
time until pregnancy is achieved. During pregnancy, the mother-to-be
will take anti-rejection drugs and will be checked monthly for organ
rejection.
The
baby will be delivered by cesarean section. And after one or two
babies, the mother will have a hysterectomy to remove the transplanted
uterus, and anti-rejection drugs will be stopped.
It’s a Game Changer
Infertility
is a heartbreaking condition for women who yearn to give birth. In the
U.S. 6.7 million women ages 15 to 44 have fertility problems, according
to the Centers for Disease Control and Prevention. Although the exact
incidence of UFI is unknown, experts say it affects thousands of women
worldwide who were either born without a uterus or whose uterus was
damaged by disease or removed by hysterectomy.
“Women
who are coping with UFI have few existing options,” says Dr. Falcone.
“Although adoption and surrogacy provide opportunities for parenthood,
both pose logistical challenges and may not be acceptable due to
personal, cultural or legal reasons.”
After
two failed attempts at uterus transplantation internationally, a
University of Gothenberg team achieved its first birth in September 2014
from a live donor. Cleveland Clinic doctors will use uteri from
deceased donors.
Dr.
Tristi W. Muir, chair of the Department of Obstetrics and Gynecology at
Houston Methodist Hospital, told Yahoo Health that she still marvels
“at the miracle of birth” and that new surgical and medical technologies
“have now made it possible for women without a uterus to experience
this miracle.”
However, Muir cautions that “this dream does not always have a happy ending.”
“Less
than 50 percent of the women who have undergone uterine transplantation
have had a baby,” she says. “There are risks to the woman undergoing a
transplant including surgical risks and medical risks of rejection and
suppression of the immune system to tolerate the transplant. “
Also, Muir says, the handful of babies that have been born via transplantation have been born prematurely.
“The
financial impact on a family and our healthcare system of the cost of
transplantation, immunosuppression and prematurity should not be lost in
chasing this dream,” she says. “There are other options available to
women who desire the miracle of having a family, including adoption and
surrogacy.”
Could Uterus Transplants Allow Men to Have Babies?
OK,
it’s a little science fictiony. But science is moving so quickly that
we wondered if this new transplantation surgery is the gateway
technology that would allow men to someday carry a baby.
Theoretically,
yes, says Dr. Sandra Carson, vice president of the American College of
American College of Obstetricians and Gynecologists.
“There
would have to be some anatomical and hormonal rearrangements,” Carson
told Yahoo Health. “But theoretically it could happen.”
