Livebirth After Uterus Transplantation From a Deceased Donor in a Recipient With Uterine Infertility

Abstract

(Abstracted from Lancet 2018;392:2697–2704) Infertility is common and affects about 10% to 15% of couples. In such couples, 1 in 500 women has infertility due to uterine causes, with uterine agenesis (Mayer-Rokitansky-Küster-Hauser [MRKH] syndrome), or due to hysterectomy, malformation, or the sequelae of infection or surgery.

Contemporary Issues in Women's Health

“…Ejzenberg et al. recently reported a healthy live birth, demonstrating that a uterus procured from a deceased donor can be functional . In this case, the donor—a 45‐year‐old woman who died from a subarachnoid hemorrhage—was deemed a good candidate because she had had three vaginal deliveries during her life and her blood type (O‐positive) matched that of the recipient.…”

“…Ezjenberg et al. have also shown that the human uterus can remain functional after cold ischemia for four times longer than the average time after live donation (7 hours, 50 minutes vs 1 hour, 18 minutes) …”

“…The recipient was a 32‐year‐old woman who experienced Mayer‐Rokitansky‐Küster‐Hauser syndrome, with an agenesia of the distal vagina but without any kidney or musculoskeletal malformations. According to the investigators, the ovarian reserve of the recipient was normal, as shown by the generation of eight good‐quality embryos in one in vitro fertilization cycle …”

“…The researchers followed the Swedish protocol for immunosuppression therapy . The patient stayed in an intensive care unit for 2 days and then on a specialized transplant ward for 6 days.…”

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 .…”