In the Near Future: Uterus Transplants

The New York Times November 13 print edition ran an article by Denise Grady that announced "Uterus Transplants May Soon Help Some Infertile Women in the U.S. Become Pregnant." The Times considered the news so big that a press release came to my in-box. It's all going down at The Cleveland Clinic, where doctors expect to become the first in the US  to transplant a uterus into a woman who lacks one—whether due to congenital factors, injury, or illness. The procedure would eliminate the need for a gestational surrogate.After giving birth to one or two children—by C-section—the woman receiving the transplanted uterus would have it removed so she can quit taking anti-rejection meds. An estimated 50,000 women in the United States might be candidates. Currently, eight have begun the screening process.The transplant team would remove the uterus, cervix, and part of the vagina from a recently deceased organ donor. (The uterus, if kept cold, can survive outside of the human body for six to eight hours.) The recipient's ovaries and fallopian tubes would be left in place, and after one year of healing, she would undergo an IVF/embryo transfer procedure.Sweden is the only place where doctors have already successfully completed uterine transplants. Nine recipients have delivered four babies. Another is due January 2016. Two failed and had to be removed—one, due to a blood clot; the other, due to infection. The Cleveland doctors plan to use deceased donors, so they won't put healthy women at risk. For a live donor, the operation takes seven to eleven hours and requires working near vital organs.Recipients must have ovaries. But because the fallopian tubes won't be connected to the transplanted uterus, a natural pregnancy will be impossible.