Cleveland Clinic plans first U.S. uterus transplants
For some American women unable to have children, there may be a new option available soon to help them become pregnant.
Doctors at the Cleveland Clinic have announced plans to transplant healthy uteruses into 10 women with uterine factor infertility (UFI). These women cannot carry a pregnancy because they were either born without a uterus, had their uterus removed for medical reasons, or have a uterus that no longer functions.
This is the first time uterus transplants will be performed in the United States.
"Women who are coping with UFI have few existing options," Dr. Tommaso Falcone, Chair of the Women's Health Institute at the Cleveland Clinic, said in a post on the clinic's website. "Although adoption and surrogacy provide opportunities for parenthood, both pose logistical challenges and may not be acceptable due to personal, cultural or legal reasons."
The number of women living with UFI is unknown, but experts estimate it affects thousands of women of childbearing age, according to the Cleveland Clinic.
Surgery to transplant a uterus has been performed successfully nine times in Sweden and has so far resulted in five pregnancies and four live births. In September of 2014, a baby boy named Vincent became the first child born to a mother with a transplanted uterus.
Still, Falcone calls the operation "highly experimental." Unlike the Swedish team -- who used live donors -- the Cleveland Clinic study will use organs from deceased women to avoid putting healthy donors at risk of complications of surgery, the New York Times reports.
Women selected to receive the transplant surgery must follow a complex protocol. First, they begin the in vitro fertilization process by having their eggs fertilized with sperm at a laboratory and then frozen.
Then, once a donor is found -- with the consent of the donor's next of kin -- the uterus will be transplanted into the patient's pelvis. The surgery needs to take place within six to eight hours of finding a matching donor. Following surgery, the transplanted uterus heals over the course of a year. After this time, the frozen embryos are thawed and implanted, one at a time, until the woman becomes pregnant. The baby will have to be delivered by C-section.
The procedure is not without risk. The women will have to take anti-rejection drugs -- including during pregnancy -- and may need further surgeries. But for those seeking the procedure, the risks are worth it for the hope of having their own babies.
"These women know exactly what this is about," Dr. Andreas G. Tzakis, the study's lead investigator at the Cleveland Clinic, told the Times. "They're informed of the risks and benefits. They have a lot of time to think about it, and think about it again. Our job is to make it as safe and successful as possible."
However, doctors say it's critical to try to minimize the risks for uterus transplants, which are not life-saving but rather life-enhancing.
Unlike other organ transplants -- which patients keep for life -- after having one or two babies, the transplanted uterus is removed and the recipient can stop taking the anti-rejection drugs.
The Cleveland Clinic is currently screening women 21 to 39 years old with UFI for the transplant study.
