Uterus Transplant Trial to Begin in US

Uterus transplants to be performed in uterine factor infertility patients at Cleveland Clinic

(RxWiki News) Science has accomplished miraculous feats to help women unable to get pregnant achieve their dreams of motherhood. Now, doctors are hoping to help even those women who lack an essential element of every pregnancy — a uterus.

In a groundbreaking new trial, a team of surgeons from the Cleveland Clinic will attempt uterus transplants in 10 women with uterine factor infertility (UFI). Women with UFI cannot become pregnant because they were either born without a uterus, had their uterus removed or have a uterus that no longer functions. The hope is that these women will be able to carry a pregnancy to term and give birth to one or two healthy babies.

Although this trial is a first in the US, similar ones have already led to live births in Sweden. To date, surgeons from the University of Gothenberg have performed nine uterus transplants — achieving a total of five pregnancies and four live births.

"The exciting work from the investigators in Sweden demonstrated that uterine transplantation can result in the successful delivery of healthy infants," said Cleveland Clinic lead surgeon Andreas Tzakis, MD, in a press release.

While the Swedish team used live donors for their transplants, Dr. Tzakis and team have opted to avoid complications by using deceased donors. In other words, the women will have to wait for a donor with matching blood and tissue type to die — as is the case with vital organ transplants.

The transplants will be temporary. The transplanted uterus will be removed after one or two babies are born so that the woman can stop taking drugs that prevent her body from rejecting the transplant (anti-rejection drugs).

Because the fallopian tubes will not be connected to the transplanted uterus, a natural pregnancy will be impossible. Instead, the women will need to go through in vitro fertilization (a procedure in which eggs are collected from the ovaries and fertilized by sperm in a lab) to become pregnant. Babies will then be delivered by cesarean section (c-section) before the due date to protect the transplanted uterus from the strain of labor.

In September, the Cleveland Clinic began screening women ages 21 to 39 with UFI for transplants. Each candidate will face extensive rounds of medical and psychological evaluation and must be unanimously approved by the team.

One candidate, a 26-year-old with two adopted children, told The New York Times she wants the chance to give birth.

"I crave that experience," she said. "I want the morning sickness, the backaches, the feet swelling. I want to feel the baby move. That is something I’ve wanted for as long as I can remember."

If the procedure is successful, an estimated 50,000 US women could be candidates for future transplants, the Times reports. But there are some potential dangers. Any pregnancies that occur will be considered high-risk, as babies will be exposed to anti-rejection drugs throughout.

Review Date: 
November 17, 2015