What Is a Uterine Transplant, and Who Can It Benefit?

Beauty

In November 2019, a woman in Pennsylvania became the second American to give birth after receiving a uterus transplant from a deceased donor. Uterine transplantation, a procedure for a person who doesn’t have a uterus but wants to get pregnant, is relatively new to medicine. So far, there have been around 80 uterine transplants resulting in births around the world.

The most recent transplant birth is unique because the uterus came from a deceased donor — most of the research on uterine transplants focuses on living donors. The first known delivery from a uterine transplant from a deceased donor took place in Brazil in 2017. The Cleveland Clinic led the way for the first patient in North America to give birth after receiving a uterus transplant from a deceased donor in July 2019.

To learn more about the growing field of uterine transplants — and how it could benefit people in the future — Allure spoke with some of the doctors and at the forefront of the research.

How do uterine transplants work?

Tommaso Falcone, an OB-GYN at Cleveland Clinic, says uterine transplants can be an extensive process. First, doctors need to make sure a candidate will be able to get pregnant. Before the uterine transplant takes place, doctors will remove eggs from the candidate’s ovaries to freeze embryos. If there are enough embryos to ensure the possibility of a pregnancy, a patient will move forward to receive a uterus from a deceased or living donor. “Then we do in vitro fertilization to make sure they get pregnant,” he says.

Liza Johannesson, medical director of uterus transplant at Baylor University Medical Center (BUMC) in Dallas, says doctors usually wait anywhere from three to six months to impregnate a patient with the embryos they froze before pregnancy. Because transplant patients have to take immunosuppressant drugs that, if taken long-term, can come with health risks, doctors usually remove the uterus when the patient is done having children. Johannesson says the hysterectomy can take place anywhere from a year to five years after the initial transplant.

Who can benefit from this procedure?

Anyone without a uterus can benefit from a uterine transplant. Falcone says the one in 5,000 cisgender women who are born without a uterus make up the majority of uterine transplant cases. Others may have lost their uterus due to a medical condition like cancer, and in some cases, a uterus might not be functional.

“The basic idea is to give [those who are] born without a uterus or have had a hysterectomy early on in their life to have a chance to have a biologically delivered child,” says Falcone.

In the future, the procedure could also benefit transgender women or nonbinary people who want to give birth. But Falcone says most of the research on uterine transplants has been done on cisgender women. “We’re in a research phase that requires fewer variables,” he says. “Theoretically, I am very confident it will happen.”

What are the risks of uterine transplants?

As with any transplant or surgery, there are some risks to a uterine transplant. Giuliano Testa, Division Chief of Abdominal Transplant at BUMC and principal investigator of the Uterine Transplant Clinical Trial, says some of the most common risks are infection, bleeding, an allergic reaction to medication, and blood clots that could lead to a pulmonary embolism.

But since those who receive uteruses are usually otherwise healthy, it’s rarer for them to experience major complications like someone who received an organ for medical reasons. ”The only issue is the absence of the uterus,” he says. “There’s usually no underlying chronic condition that will affect other organs or systems in the body.” So far, Testa says none of his successful uterine transplant patients have had significant issues beyond a urinary tract infection.