American doctors are one step closer to performing historic uterus transplant
Surgeons in Cleveland are quickly on their way to reaching a major breakthrough in medical history.
In the coming months, Cleveland Clinic surgeons anticipate to become the first doctors in the United States to transplant a uterus into a woman who doesn't have one, so that she can get pregnant and give birth.
While this "new frontier" of reproductive medicine and transplant surgery could help the estimated 50,000 United States women who do not have a uterus, it would be running several risks. Not only will the transplant create the possibility for blood clots and infection, but women would also have to be consistently taking anti-rejection drugs throughout the duration of carrying the donated uterus. This also exposes the growing fetus to such drugs, which could potentially harm its development.
Healthy women who lack a uterus, have had one removed or have uterine damage would be eligible to become recipients for this groundbreaking procedure. Eight women from the United States are already being considered.
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One 26-year-old woman, who found out at age 16 that she was born without a uterus, traveled over 1,000 miles to Cleveland in order to be considered for the process. She told the New York Times that although she has two adopted children, she still wants the opportunity to become pregnant and give birth. This procedure would give her, who asked to remain anonymous, this otherwise impossible opportunity.
The women are well-informed of both the risks and benefits of such a procedure, says Dr. Andreas G. Tzakis, the "driving force behind the project." "They have a lot of time to think about it, and think about it again," he says. "Our job is to make it as safe and successful as possible."
Tzakis, 65, has extensive experience with the transplantation of abdominal organs. He also spent time with the surgical team in Sweden, meticulously preparing to successfully spearhead his own team.
In order to avoid putting healthy women at risk, the Cleveland team plans to use uteri from deceased donors, although the Swedish doctors' donors are alive.
In five cases, the donor was the recipient's mother, which raised the dizzying possibility of a woman giving birth from the same womb that produced her.
The New York Times
Physical health is not the only requirement for becoming a uterus recipient. Women also have to be involved in a "stable relationship".
"The initial phase includes screening for psychological disorders or relationship problems that could interfere with a candidate's ability to cope with a transplant and be part of a study," reads The New York Times. "Doctors use similar criteria for people receiving other types of organ transplants because the process is arduous, and patients with a strong social support system seem to fare better."
Women will also need to be able to pay for their own room and board in Cleveland, considering parts of the study require their presence onsite.
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Once a woman receives the transplant, she will go through in vitro fertilization, as a natural pregnancy will be impossible with the transplanted uterus.
The woman will wait one year to heal from the surgery and adjust the doses of anti-rejection medicine before trying to become pregnant.
The New York Times
Once a transplant is done successfully, doctors will then implant an embryo into the uterus. If and when the recipient becomes pregnant and carries the baby to term, she will deliver the child by cesarean section before going into natural labor, in order to protect the uterus from the intensity of giving birth.
After a successful childbirth, the recipient will have the option to have the uterus removed or stop taking anti-rejection drugs, or try for one more baby. For precautionary reasons, the limit is two babies for a transplanted uterus.
This medical step is groundbreaking for not only medical reasons, but also ethical.
"I think our initial impression was, 'Wow. This is really pushing the envelope,'" said Dr. Alan Lichtin, chairman of the Cleveland Clinic's ethics board.
"I know the risks," says the 26-year-old woman being screened for the process. "But I think we're in the best of hands. I think we can handle anything that comes our way."
Check out this inspiring video about a woman who donated her uterus to her daughter:
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