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Uterus Transplant in Women With Absolute Uterine-Factor Infertility
Giuliano Testa1, Greg J McKenna1, Anji Wall1
1Department of Surgery, Baylor Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, Dallas, Texas.
JAMA
|August 15, 2024
Summary
Uterus transplantation is a feasible procedure for women with uterine-factor infertility, enabling successful pregnancies and live births. While complications can occur in recipients and donors, the infants born have shown no congenital abnormalities to date.
Area of Science:
- Reproductive medicine
- Transplant surgery
- Obstetrics and gynecology
Background:
- Absolute uterine-factor infertility prevents women from carrying a pregnancy.
- Uterus transplantation offers a potential solution for uterine-factor infertility.
Purpose of the Study:
- To assess the feasibility and safety of uterus transplantation.
- To evaluate the live birth rate of healthy infants following uterus transplantation.
Main Methods:
- A case series of 20 women with uterine-factor infertility who underwent uterus transplantation.
- Transplantation involved orthotopic placement with vascular anastomoses.
- Immunosuppression was administered until uterus removal.
Main Results:
- 14 of 20 recipients (70%) achieved successful uterus allografts.
- All 14 recipients with successful grafts gave birth to at least one live infant.
- Complications occurred in 11 recipients; 50% of pregnancies had maternal/obstetrical complications. No congenital malformations were observed in 16 live-born infants.
Conclusions:
- Uterus transplantation is technically feasible with a high live birth rate.
- Adverse events are common in recipients and donors.
- Current data show no congenital abnormalities or developmental delays in children born after uterus transplantation.
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