Many women don’t really think about their uterus until they are ready to have children. In fact, most women probably take their uterus for granted, but for many women who were born without one or who had them removed due to medical issues, a uterus would be a treasured organ. A groundbreaking surgery may soon be available to offer these women a chance at giving birth with a uterus transplant. And for some, carrying a child is worth a complicated non-life-saving medical procedure.
According to a recent story in the New York Times, doctors at the Cleveland Clinic hope to be the first to perform a uterus transplant in the U.S. They are currently practicing the procedure and vetting potential transplant recipients. This procedure has been performed nine times in Sweden, resulting in 4 healthy births with one more expected in January. Several patients have not yet conceived and two had to have their transplant removed due to medical concerns. Two other countries have performed the procedure without success.
For the procedures in the U.S., the donor uterus will come from a deceased woman who is a match for the healthy recipient, which differs from the live donors that were used in Sweden. The donor’s uterus, cervix, part of her vagina and uterine blood vessels will be removed and transplanted into the recipient. These reproductive parts will not be linked to the recipient’s fallopian tubes and therefore she cannot release an egg naturally to produce a baby. Rather, she will wait a year after the trasnplant and then have in vitro fertilization in hopes of becoming pregnant.
Like other transplant recipients, women who undergo a uterus transplant will take anti-rejection drugs while the uterus is in their bodies. However, this transplant is only temporary. After the woman has had one or two babies, the uterus will be removed and she will stop taking the drugs. During pregnancy she will have to continue to take the anti-rejection medication, which doctors say is not necessarily detrimental to a baby’s health. Women who have undergone other organ transplants have healthy babies on anti-rejection medication on a regular basis. Babies born to mothers with a uterus transplant do tend to be born premature and small and mothers are considered high risk with an increased likelihood of preeclampsia. The reason for these complications is unknown and could be attributed to the drugs or the foreign uterus itself. The babies will be delivered via c-section in hopes to avoid any complications during childbirth.
Unlike heart, liver, kidney and lung transplants, a uterus transplant is not a life-saving measure. This raises ethical questions for some, however the Cleveland Clinic and others around the world believe that modern medicine should not only save lives, but also improve lives. For women who want nothing more than to carry their own baby, this would be the opportunity of a lifetime.
The team at Cleveland Clinic is studying under the Swedish doctors who originally performed the transplants in order to perfect the procedure. They will proceed if they feel it is completely safe for their patients. Other hospitals are also working towards the goal of offering uterus transplants but none are as close to their first operation as Cleveland Clinic.
This is exciting stuff in two of the most innovative areas of medicine, reproduction and transplant. It could significantly change the lives of thousands of women in the U.S. who don’t have a uterus, giving them hope to one day carry and deliver their own babies.
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