First live birth after uterus transplantation in the United States

Abstract

Uterus transplantation has proven to be a successful treatment for women with absolute uterine infertility, caused either by the absence of a uterus or the presence of a nonfunctioning uterus. We report the first birth of a healthy child following uterus transplantation in the United States, from a recipient of a uterus allograft procured from an altruistic living donor. Two major modifications from the previously reported live births characterized this uterus transplant. First, the transplanted uterus relied upon and sustained the pregnancy while having only the utero-ovarian vein as venous outflow. The implication is a significantly simplified living donor surgery that paves the way for minimally invasive laparoscopic or robot-assisted techniques for the donor hysterectomy. Second, the time from transplantation to embryo transfer was significantly shortened from prior protocols, allowing for an overall shorter exposure to immunosuppression by the recipient and lowering the risk for potential adverse effects from these medications.

Revaluation and lessons learned from the first 9 cases of a Czech uterus transplantation trial: Four deceased donor and 5 living donor uterus transplantations

“…2,6 The technique of DD uterus procurement was published previously by our team in detail. 2,6 The technique of DD uterus procurement was published previously by our team in detail.…”

“…10.7 days(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). The mean surgical time for the UTx was 245 minutes (210-300 minutes).…”

“…The mean postoperative hospital stay was 8 days(6)(7)(8)(9)(10)(11), and the mean surgical time for graft procurement was 356 minutes (320-430). The mean postoperative hospital stay was 8 days(6)(7)(8)(9)(10)(11), and the mean surgical time for graft procurement was 356 minutes (320-430).…”

Clinical applications of uterus transplantation in China: Issues to take into consideration

“…However, surrogacy is legally prohibited in China as per the 'Administrative Measures for Assisted Human Reproductive Technology' (2001). Moreover, even in the countries where surrogacy is permitted, UTx trials are also underway and have achieved live birth already in these countries . What is more, as for the surrogacy, the following problems regarding medical, ethical, legal and financial issues exist: the risk of communicable diseases from the surrogate mother to the child; the lifestyle of the surrogate; the risk of undermining the value of women's reproductive autonomy; psychological and physical risks for the surrogate mother and the child, potential custody battles and dispute in financial compensation for the surrogate mother .…”

Uterine transplantation in transgender women

“…An alternative donor pool may be female to male (F2M) transgender men undergoing hysterectomy and vaginectomy, although the increased radicality of the hysterectomy may not be acceptable. However, recent evolution of the surgical technique, following cases in China and Dallas, has potentially significantly reduced donor risk. The modified technique utilises venous drainage of the graft via the ovarian or utero‐ovarian veins, as opposed to the unpredictable and tortuous uterine venous plexus which leads to the internal iliac veins.…”