Friday, November 13, 2015

Uterus Transplants May Soon Help Some Infertile Women in the U.S. Become Pregnant

The doctors leading the uterus transplant team at the Cleveland Clinic, from left: Andreas G. Tzakis, Uma Perni, Rebecca Flyckt and Tommaso Falcone. Credit Michael F. McElroy for The New York Times
CLEVELAND — Six doctors swarmed around the body of the deceased organ donor and quickly started to operate.The kidneys came out first. Then the team began another delicate dissection, to remove an organ that is rarely, if ever, taken from a donor. Ninety minutes later they had it, resting in the palm of a surgeon’s hand: the uterus.

The operation was a practice run. Within the next few months, surgeons at the Cleveland Clinic expect to become the first in the United States to transplant a uterus into a woman who lacks one, so that she can become pregnant and give birth. The recipients will be women who were born without a uterus, had it removed or have uterine damage. The transplants will be temporary: The uterus would be removed after the recipient has had one or two babies, so she can stop taking transplant anti-rejection drugs.

Uterine transplantation is a new frontier, one that pairs specialists from two fields known for innovation and for pushing limits, medically and ethically — reproductive medicine and transplant surgery. If the procedure works, many women could benefit: An estimated 50,000 women in the United States might be candidates. But there are potential dangers.

The recipients, healthy women, will face the risks of surgery and anti-rejection drugs for a transplant that they, unlike someone with heart or liver failure, do not need to save their lives. Their pregnancies will be considered high-risk, with fetuses exposed to anti-rejection drugs and developing inside a womb taken from a dead woman.

Eight women from around the country have begun the screening process at the Cleveland Clinic, hoping to be selected for transplants. One, a 26-year-old with two adopted children, said she still wanted a chance to become pregnant and 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.”
She traveled more than 1,000 miles to the clinic, paying her own way. She asked that her name and hometown be withheld to protect her family’s privacy.

A Temporary Transplant