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Last week, The New York Times reported that within a few months, doctors are planning to conduct the first uterus transplants in the US.
For women who are born without a uterus, have one that is damaged, or have had it removed, implanting a healthy uterus from a dead or living donor offers the tantalizing possibility of getting pregnant and giving birth to their own child. Although theoretically this would be possible, it would be a huge surgical and endocrinologic undertaking and involve not just the creation of a vagina but also surgical reconstruction of the whole pelvis by someone skilled in transgender surgery. After this procedure and the grafting of a donor uterus, a complex hormone regimen would be required to support a pregnancy prior to and after embryo transfer (although this could be done, as we provide similar hormone regimens to menopausal women to support a pregnancy). Instead of using the patient's eggs, doctors would use his sperm and a eggs from his partner or a donor, Flyckt continued.
For now, added Flyckt, the procedureA will be limited to women without a functioning uterus.
Of course, even though the procedure is medically possible, there are a number ethical issues to consider.
First, there's the issue of whether the donor is living or dead, Art Caplan, head of medical ethics at NYU Langone Medical Center, told Business Insider. If the donor is dead, she might not have consented to donating her uterus when she became a donor.


Then there's the issue that this is an elective surgery, not a life-saving procedure such as a liver or kidney transplant. The surgeons remove the uterus and part of the vagina from the donor a€” preferably one who is deceased, since it is a risky surgery that involves separating uterine blood vessels that are tightly wrapped around the tubes from the bladder. After the surgery, the woman will have to take drugs to prevent her immune system from rejecting the new organ.
The baby will be born by cesarean section, since the transplanted uterus might be too fragile to undergo labor. Besides the typical risks of an infection, there's the risk that the anti-rejection drugs the mother would have to take could harm a growing fetus. The first birth from a transplanted uterus took place in September 2014, to a 36-year-old woman who was born without a uterus. Five of the donors were the recipient's mother, which means any babies would be born from the same womb as their own mom! Within a few months, Ohio's Cleveland Clinic aims to become the first US clinic to complete such a tranplant. And if she is a living donor who is related to the recipient, she might feel pressured to donate out of family obligation.


Surgeons connect an artery and a vein on either side of the uterus to connect it to the recipient's blood supply. She must wait a year before trying to get pregnant by in vitro fertilization, where an egg is fertilized in a test tube and then implanted in the womb.
The mother will be able to keep the uterus for one or two pregnancies, and then doctors will need to remove it so she can stop taking anti-rejection drugs. However, many women taking these drugs for other organ transplants have had healthy babies. This is often caused by Mayer-Rokitansky-KA?ster-Hauser syndrome, a disorder that affects 1 in 4,500 newborn girls.
A piece of the donor's vaginal tissue is attached to the recipient's vagina, and supporting tissue is attached to the pelvis to secure the organ in place. But these women have a higher risk of preeclampsia, a condition involving high blood pressure, and their babies tend to be smaller than average.



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