In spite of major advancements in fertility treatments, such as the development of IVF in the 1970s and intracytoplasmic sperm injection in the 90s, there hasn't been a viable option for women who suffer from a dysfunctional or absent uterus.
These women have a condition called absolute uterine factor infertility. About 1 in 500 women have this condition that prevents pregnancy, but recent developments show promise that a uterus transplant surgery combined with infertility treatment could be the solution.
The Uterus Transplant Procedure
A uterus transplant is a procedure in which a donor's uterus is removed and transplanted into the recipient. It allows a woman who suffers from absolute uterine factor infertility to experience carrying a baby throughout gestation and give birth to a healthy infant.
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Uterus transplants can come from either living or deceased donors. It all begins with a thorough vetting process, designed to ensure the recipient is healthy enough to undergo the transplant surgery and pregnancy, and to make sure a suitable donor is available.
The actual surgical transplant procedure is complex and lengthy. Both the donor and recipient undergo surgeries that last about five hours each to remove and transplant the uterus.
With other transplant surgeries, surgeons can see right away whether or not a transplant is successful. A patient's new kidney begins to function or their new heart starts beating, while the patient is still on the surgery table.
Doctors and patients of a uterine transplant don't have it that easy. The first sign of a healthy, functioning uterus is menstrual bleeding - and as many women understand, this can take some time and is often unpredictable. If all goes well, the transplant recipient maintains close contact with her doctors throughout the functional phase of the transplant.
The process is really just getting started. Once a transplanted uterus is deemed viable, the patient then has to undergo IVF treatments to attempt pregnancy. In a recent study of women partaking in IVF, patients on average need three cycles of treatments with vastly varying degrees of success depending on age.
And the surgeries don't end there. To prevent the risk of long-term complications and avoid the need for a uterus recipient to take life-long immunosuppressive drugs, the recipient is only allowed to keep the transplanted uterus for five years. This means the patient must undergo a final, five-hour-long surgery to remove the uterus.
A Priceless Experience Shared Among Women
With both the physical and emotional intensity of the womb transplant process, involving a number of surgeries over a short period of time, it's normal to assume that women would be disinclined. However, infertility is a very personal struggle, and everyone experiences it differently.
For many women, the opportunity to not only have children, but to experience pregnancy and give birth, are priceless. As it turns out, hundreds of women are signing up for uterus transplant surgeries and just as many are expressing an interest in becoming donors, in spite of the significant commitment it requires.
For 1 in 500 women with absolute uterine factor infertility, a transplant would makes dreams of bonding with their child in the womb a reality.
One donor named Taylor Siler donated her uterus in 2016. She has two children of her own and says she began bonding with them as soon as she started to feel them moving in her womb. Siler says she couldn't understand why a woman wouldn't want to help another woman have the same experience of bonding with her child in the womb.
Are Uterine Transplants Available for Everyone?
Today, only about 17 babies have been born via a uterine transplant, according to Dr. Liza Johanesson. Dr. Johanesson is one in a handful of doctors around the world who perform uterus transplant surgeries.
In the future, the hope is that more successful clinical trials will be completed and uterine transplant surgery will become a mainstream treatment for women suffering from absolute uterine factor infertility.
Doctors around the world are just beginning clinical trials, with the hope that this will become a more mainstream treatment.
Additionally, some have posited the potential for a transgender uterus transplant surgery in the future. However, the medical research community is currently focused on restoring a function that is naturally present in a female body, rather than creating a new function in a person born as a male.
The additional challenge of finding space within the male anatomy for female functions would require surgeons to, in essence, reinvent human anatomy. It is, however, a possibility that the research trend could shift, if great enough demand for a transgender procedure exists, once the science around uterus transplant surgery gains more ground.
Making Dreams a Reality
When it comes to fertility treatments, effectively addressing absolute uterine factor infertility is one of the last frontiers. Uterine transplant surgery is one of the first real solutions for women suffering from this type of infertility.
In the past, women living with this condition had to accept the fact that they would never be able to be pregnant and carry a healthy baby to term. The only options they had were adoption or gestational surrogacy.
These are still great options for any woman who wants to have a family, but many women have a real desire to feel their child grow inside them and to give birth. For these women, the possibility of a uterine transplant offers the potential opportunity to live out their dreams.