By: Beth Walsh for Uterus1
A uterus transplant is a possible treatment for assisted reproduction, according to findings published in Obstetrics & Gynecology. Giuseppe Del Priore, MD, of New York Downtown Hospital and his colleagues took part in an organ donor network retrieval team for more than six months and successfully retrieved the uterus in eight of nine cases.
|The Pain of Infertility|
About 10 percent of Americans, or 6.1 million people, are affected by infertility. A cause of infertility is found in about 90 percent of couples. About 60 percent are able to achieve a pregnancy through the use of fertility drugs or corrective surgery.
For women, the most common cause of infertility factor is an ovulation disorder. Other causes include blocked fallopian tubes as a result of pelvic inflammatory disease or endometriosis. Congenital anomalies involving the structure of the uterus or uterine fibroids may cause repeated miscarriages.
“Our hope is to eventually restore reproductive function through transplantation of a human uterus,” Dr. Del Priore said.
For the study, about 1,800 eligible organ donors were identified and multi-organ procurement surgery was performed on about 150 patients. There was specific consent from the families to retrieve the uterus in nine cases. The causes of death included stroke, cardiac arrest during electro-physiologic testing, and traumatic brain injury. All donors had previously given birth, with between one and three deliveries of healthy children, and were 30 to 45 years old. The organs appeared to remain viable when they were kept for 12 hours in cold conditions without a blood supply.
“When controlled for other factors, pregnancy outcomes appear acceptable,” according to the study. “Fortunately, long-term safety data are available because generations have now become pregnant after organ transplants.”
Del Priore said there are likely to be many women interested in a uterus transplant. He and his colleagues have more than 100 candidates in the preparation process. Once a woman has a donated uterus implanted, doctors make sure the organ is functioning and stable for at least three months via the use of anti-rejection drugs. An embryo created through in vitro fertilization is then placed in the womb. If the pregnancy goes well, the baby is delivered by Caesarean section to minimize risks from labor and to allow doctors to simultaneously remove the uterus, so the woman can discontinue the anti-rejection drugs.
If that works, in subsequent cases women with functioning ovaries who got a uterine transplant might eventually be able to get pregnant without IVF. Critics say more testing on animals is needed before research in humans can proceed. They also say that since a uterus is not a life-sustaining organ, women should not be allowed to face the risks of major surgery and anti-rejection drugs.
Del Priore acknowledged the possible risks, but he and others said women should have the choice. "For many women, it is an essential part of their life to be able to carry their own child. They are willing to do many brave things to do it. Natural childbirth can be very risky, but women choose that in many parts of the world. I do not think this is in any sense reckless when you compare this to that," Del Priore said.