Cleveland Clinic announced Thursday the launch of a
“groundbreaking” research study that will perform uterus transplants in 10
women. The first operation is expected to take place within the next few months,
the New York Times reports.
Since the 1970s a number of teams around the world have been
researching the possibility of developing a womb transplant procedure.
Transplant research, as a whole, has also tended to focus on
life-saving transplantation (heart, kidney, liver) with womb transplant
research being rather limited especially following advances in IVF techniques.
We have come a long way since 1905 which saw the first successful
corneal transplant.
In 2000 the world’s first womb transplant was performed on a
26 year old woman in Saudi
Arabia. But, the transplanted womb only
lasted for 99 days.
In December 2010, our colleagues in Sweden were able to report a
pregnancy as a result of a womb transplant on a rat.
In September 2014, Mats Brännström and colleagues report the
first successful birth of a child following uterus transplantation. The
recipient, a 35-year-old woman lacking a uterus (Rokitansky syndrome), received
a cryopreserved embryo 1 year after transplantation, leading to a livebirth by
caesarean section.
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| The first uterine transplant baby being delivered by Cesarean Section . | | | | | | | | | | |
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The donated uterus came from the woman’s own mother, so the
baby is also the first born to a woman using the same womb from which she
emerged herself.
This team has since performed a total of nine uterus
transplants that have resulted in five pregnancies and four live births.
This report marks an important development that will give
women with congenital or surgical absence of the uterus an opportunity to give
birth to a child.
The first clinical trial of uterus transplantation in the United States has begun at Cleveland Clinic in Ohio, where the process
of selecting women to participate in the study is now under way.
The ground-breaking study will include 10 women with uterine
factor infertility (UFI), a condition in which a woman was born without a
uterus, has lost her uterus, or has a uterus that no longer functions.
It's thought that as many as 50,000 U.S. women
might be potential candidates for the procedure.
Complex Protocol of the study
After being approved for the trial, the woman follows a complicated
protocol:
- Clinicians begin the in vitro fertilization
process by stimulating the woman's ovaries to produce multiple eggs.
- After retrieval of the woman's eggs, they are
fertilized with sperm in a laboratory and frozen.
- After 10 embryos have been frozen, Lifebanc, an
organ procurement agency, starts searching for a donor.
- When a uterus donor has been found, that
person's next-of-kin signs an informed consent for the organ donation.
- The donor uterus is transplanted into the
patient's pelvis within 6 to 8 hours after harve
- The transplanted uterus is allowed to fully heal
over 12 months.
- After 1 year, the woman's frozen embryos are
thawed and implanted, one at a time, into the woman until she becomes pregnant.
- The woman takes Immunosuppressant drugs during
her pregnancy.( tacrolimus, azathioprine, and corticosteroids).
- A high-risk obstetrics team monitors the woman
throughout pregnancy and childbirth.
- The woman undergoes a cervical biopsy each month
to monitor for organ rejection
- An obstetrician delivers the baby by cesarean
section.
- After the woman has one to two babies, she
undergoes a hysterectomy and stops taking Immunosuppressant drugs to reduce her
long-term exposure to the medications.
Uterine Transplants are Unique in the sense that unlike any other
transplants, they are ‘ephemeral,'” Cleveland Clinic lead researcher Andreas
Tzakis said in the release. “They are not intended to last for the duration of
the recipient’s life.”
After 1-2 healthy pregnancies the transplanted uterus is either removed or
allowed to disintegrate.
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| Vincent, One year now |
Now, Vincent the first Baby born after uterus transplant is healthy one year old and the team of Dr. Mats Brännström, the Swedish professor in obstetrics and gynecology of
the University of Gothenburg and Sahlgrenska University Hospital, are looking forward to improve the technique and reduce the surgical procedure time.
References:
All Photos courtesy by Martin
Valigursky/iStock/Getty Images
