Concepts in Conception: Uterine Transplants
With increasing numbers of people seeking infertility treatment, it is not surprising that the medical community has begun investigating new and more effective ways to help these couples get pregnant.
Within this context is an up-and-coming procedure designed specifically for women unable to achieve pregnancy due to uterine abnormalities, such as an enlarged or prolapsed uterus, or lack of a uterus altogether. The procedure is called a uterine transplant, and although it is not yet being offered, researchers are predicting it could become available within the next five years. The surgery, however, is not without it's share of controversy, as ethicists debate its moral rationale.
What is a Uterine Transplant?
A uterine, or uterus, transplant would function in much the same way as a kidney, heart, or liver transplant; a donor would offer her uterus to be transplanted into a woman who is looking to conceive. However, the procedure would be considerably more invasive, and would involve a lengthy, and potentially risky (not to mention costly), surgery.
The first step for any patient being considered for the surgery would be to undergo in vitro fertilization (IVF), so that doctors would have a ready supply of frozen embryos available for implantation after the transplant. This is done because intercourse is generally prohibited after surgery; it is also a way for doctors to confirm that there are no other fertility problems inhibiting the woman from getting pregnant.
The surgery itself involves a vertical incision in the abdomen of the recipient. The donated uterus would be attached to the recipient's vagina by the cervix, and the uterus would be connected to four blood vessels-- two on each side. As is the case for every transplant surgery, immunosuppressive medication (typically steroids) would be offered afterwards to prevent organ rejection. Women would be encouraged to use donor sources from immediate family members (i.e. mother or sister) to avoid the risk of rejection.
The frozen embryos would then be implanted, once the woman is in stable condition. It is important to note, however, that this does not always result in pregnancy. If pregnancy is achieved, delivery would have to take place via cesarean section. Afterwards, a hysterectomy would be performed to prevent any additional complications.