CLEVELAND, Nov. 13 (UPI) — Women with uterine factor infertility, or UFI, cannot get pregnant because they were born without a uterus, lost their uterus, or have one that does not function. While there have been options for these women to have children, none of them involve getting pregnant and carrying their own children.
In the first clinical trial of its kind in the United States, doctors at the Cleveland Clinic announced they will accept 10 women into a program to test the success of uterine implants for women with UFI with the goal of successful pregnancies resulting in live births.
While the first two transplant attempts, performed in Saudi Arabia and Turkey, failed, doctors at the University of Gothenburg in Sweden have performed nine transplants, five of which have resulted in pregnancy and four in live births. The fifth is due in January.
“It gives us scientific evidence that the concept of uterus transplantation can be used to treat uterine factor infertility, which up to now has remained the last untreatable form of female infertility,” Dr. Mats Brännström, a professor at the University of Gothenburg, said in a press release last year after the first live birth.
Doctors started screening patients in October for the study, with the expectation that about 150 UFI patients will go through the intense screening process in order to find 10 women for the transplants.
Women with UFI applying for the trial must be between the ages of 18 and 45, be willing to undergo psychiatric and social work evaluation, undergo all associated medical procedures and exposure to potential complications, in addition to meeting a wide range of lifestyle and health requirements. Eight women have already started the screening process for the trial, which is scheduled to run through 2021.
Once accepted, doctors stimulate a patient’s ovaries to produce multiple eggs, starting the in vitro fertilization process. The eggs are then frozen and doctors locate a donor. Uterine transplants take about 12 months to heal, after which doctors thaw and implant the woman’s eggs one at a time until the patient becomes pregnant.
Women start taking anti-rejection drugs after receiving a uterus, taking them throughout pregnancy. Doctors expect women to have one or two children before having a hysterectomy to remove the transplanted uterus, after which anti-rejection drugs can be stopped.
“Women who are coping with UFI have few existing options,” said Dr. Tommaso Falcone, Women’s Health Institute Chair at Cleveland Clinic, in a press release. “Although adoption and surrogacy provide opportunities for parenthood, both pose logistical challenges and may not be acceptable due to personal, cultural or legal reasons.”
Dr. Andreas Tzakis, lead investigator in the trial, said the surgery is ephemeral, in that it is not lifesaving and the transplants are not intended to last for a patient’s entire life. Comparing the surgery to face and extremity transplants, he called it “life-enhancing.”
The surgery has the potential to deem surrogacy, women who become pregnant with babies for those who cannot have them, as an unnecessary ethical and legal consideration.
“You create a class of people who rent their uterus, rent their body, for reproduction. It has some gravity. It possibly exploits poor women,” Tzakis told The New York Times.
Uterine transplant also offers women the potential to experience pregnancy and birth their own children, considered by some to be a cherished life experience — which doctors said is the point of exploring the procedure to help women with UFI.
One 26-year-old with two adopted children traveled more than 1,000 miles hoping to be included in the trial put it simply when explaining why she would put so much effort out for a chance that may not work out.
“I crave that experience,” she told the Times. “I want the morning sickness, the backaches, the feet swelling. I want to feel the baby move. That is something I’ve wanted for as long as I can remember.”
