By: Leah Howard
The Cleveland Clinic is one of three medical centers in the U.S. approved by the United Network for Organ Sharing to have the ability to perform these procedures. Baylor University Medical Center will open a clinical trial for 10 women who suffer from uterine factor infertility and Boston’s Brigham and Women’s Hospital currently has one patient waiting for a uterine transplant. Despite the initial setback, the Cleveland Clinic is also currently undergoing a study for 10 women also suffering from uterine factor infertility (UFI).
The procedure begins with the patient receiving in vitro fertilization so that they can store a handful of embryos. After the procedure, doctors will wait about a year until they transfer one of the embryos into the uterus. Due to the inability to transfer the Fallopian tubes, the women are unable to become pregnant naturally. During the year before the transfer, doctors reduce the dosage of anti-rejection medication the patient is taking. The Cleveland Clinic study only allows for each patient to have one to two children delivered via cesarean section. Afterwards, the uterus is removed in order to ensure that the patient no longer has to take anti-rejection drugs, which can cause infections and possibly cancer. The Cleveland Clinic opted to use only deceased donors in order to minimize risks, but could use living donors in the future.
When asked about the risks of the procedure, Dr. Wolpe expanded upon the fact that the transplant recipient would “need to take anti-rejection drugs during pregnancy, without clear knowledge of its effect on the fetus. In addition, the source of the donation is also relevant, some uterine transplants have been from live donors, other cadaveric, and there are different ethical challenges with each.”
Dr. Wolpe’s opinion on the procedure demonstrates the conflict, but promise. “I believe it still must be considered an experimental procedure, though at some point in the future, with very good informed consent and improved surgical and maintenance methods, I think women should be allowed to choose it.”