Cleveland Clinic will embark on a groundbreaking clinical trial where 10 women with uterine factor infertility (UFI) will be given a uterus transplant in hopes of a successful pregnancy.
Approximately 50,000 women in the United States cannot get pregnant due to UFI. Some women were born without a uterus while some women lost their uterus after hysterectomy. There are also women who have a uterus that no longer functions due to medical conditions.
A new medical field called uterine transplantation combines transplant surgery and reproductive medicine, and offers hope to women who wish to carry their own pregnancies but were previously unsuccessful.
The birth of the world's first womb transplant baby in Sweden in September 2014 paved the way for many women in the United Kingdom to be given the same chance. For the first time, women in the United States will be given the same opportunity.
"Although there appears to be potential for treating UFI with uterine transplantation, it is still considered highly experimental. Cleveland Clinic has a history of innovation in transplant and reproductive surgery and will explore the feasibility of this approach for women in the United States," said OB/GYN and Women's Health Institute Chair Dr. Tommaso Falcone.
Upon receiving the green light from the Institutional Review Board, the screening process kicked off last September. Eight healthy women with UFI aged 21 to 39 years old have undergone an extensive series of psychological and medical assessments by experts in various fields. The Cleveland Clinic will perform 10 uterus transplant surgeries.
Unlike the womb transplant in Sweden which used a living donor organ, the transplants in the United States will use deceased donor organs to minimize injuries and time in the operating room. However, this needs time, patience and perseverance. The process starts by retrieving the patient's eggs and fertilizing these with her partner's sperm in a lab. Upon acquisition of the donor organ, the actual uterus transplant surgery begins. It requires an entire year for the patient to heal.
After the 12-month healing period, the thawed embryos are then implanted into the transplanted uterus until a successful pregnancy is achieved.
Apart from the surgeries and withstanding the effects of anti-rejection or transplant drugs, any potential pregnancy will be considered high-risk, as the fetus will start its development inside the womb of a deceased donor and will be exposed to anti-rejection drugs that the mother will be taking.
Should the pregnancy be successful and the patient gives birth to her child, the transplanted uterus can be maintained until she gives birth to a second child. Unlike other transplant organs like the liver, heart and kidneys, the uterus is not meant to remain for the entire duration of a woman's life. The transplanted uterus will then be removed to reduce the woman's dependency on anti-rejection drugs.