Uterus Transplants May Soon Help Infertile Women Have Children

 
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.”