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A uterine transplant is a chance to fulfill the dreams of motherhood for women who were born without a uterus or who lost it as a result of a cancer. Scientists are still carrying out research on uterine transplantation so that it can function as well as possible and allow the birth of a he althy baby. Is uterine transplantation a new method of fertility treatment? What are the chances of a woman having a uterine transplant to become a mother?

Uterine transplantis a surgical procedure performed on women who were born without a uterus or lost it as a result of a cancer, such as cervical cancer, so that they could do so in the future give birth to your own he althy baby. In the latter case, transplantation may take place when there is no indication that the disease has recurred.

First successful uterine transplant

The world's first successful uterine transplant, that is, acceptance of the transplant, was conducted by a team of doctors from Akdeniz University Hospital in Antalya (southern Turkey) on August 9, 2011. The recipient was 21-year-old Derya Sert, who was born without a uterus, and the donor was a deceased person who was not unrelated to the woman. In 2013, doctors at Akdeniz University announced that the patient had become pregnant as a result of artificial insemination. Unfortunately, the woman lost her baby in the 8th week of pregnancy.

The first transplant procedure, during which the mother's uterus was transplanted to a daughter, was carried out by Swedish doctors from the Sahlgrenska clinic in Gothenburg in 2012. A similar procedure was performed in 2000 but was unsuccessful.

Who can't get a uterine transplant? Contraindications to the treatment

Contraindication to the procedure is an active neoplastic disease and disorders in the field of metabolic diseases, such as diabetes, but also immunosuppression and diseases that lead to permanent damage to the vascular system. In patients with this type of disease, the risk that the transplanted uterus will be rejected increases several times.

What are the preparations for the treatment like?

In patients, prior to transplantation, in vitro fertilization is performed and the resulting embryos are frozen. They will be used if it turns out that the transplanted uterus is in working condition within a year of the operationdeliver the baby. Therefore, the patient should have well-functioning ovaries that produce eggs.

It is worth knowing that the entire process involves not only a surgeon and gynecologist, but also an immunologist, a person dealing with molecular medicine and many other specialists (in Sweden, where the most advanced research in this field is carried out, the research group consists of with over 20 doctors of various speci alties).

What determines the success of a uterine transplant?

The uterus is a highly supplied organ with blood, which increases many times during pregnancy. Accordingly, the blood movement also increases. After 2000, when the uterine transplant failed due to a clot in a blood vessel feeding the organ, specialists concluded that maintaining adequate circulation is crucial to this technique and is more responsible for the success of the procedure.

What are the chances of women after a uterine transplant to get pregnant and give birth to a he althy child?

Women with a transplanted uterus have a good chance of having a baby, provided that the uterus is adequately supplied with blood. However, the biggest problem is getting pregnant naturally. According to doctors, it is more advisable to collect the egg, fertilize it in vitro and then introduce it into the uterus.

If a patient with a transplanted uterus succeeds in delivering a pregnancy, delivery is performed by caesarean section. After the baby is born, the uterus is removed to avoid the risk of rejection.

Doctors can talk about their success when transplant patients give birth to a he althy child.

Does the transplanted uterus always have to be removed?

Some specialists argue that if pathological changes do not develop in the transplanted uterus after the birth of a he althy child, there is no need to deprive the woman of this organ. At the same time, they emphasize that the observations are too short to say whether the transplanted uterus ceases to function after some time.

Uterine transplant - complications after the procedure

Transplant is dangerous for both the mother and the baby developing into a transplanted uterus. The patient may miscarry, but other complications are possible as well. Doctors emphasize that after the transplant, immunosuppressive treatment is used, which may adversely affect the fetus. It's unclear whether the anti-rejection medications a woman is taking will have side effects.

Is uterine transplant possible in Poland?

In Poland, such treatments are not carried out yet. Doctors have no experience with thisscope, there are also no established technological and formal and legal standards (e.g. from whom this organ can be harvested for transplant: from the deceased or only from relatives?). For this reason, the procedure is treated in Poland as an experimental developmental study.

Currently, research into uterine transplantation is conducted by the British. Scientists have already managed to improve the work of blood vessels and allow the free flow of blood in rabbits. The next stage of their research is in vitro fertilization in rabbits and the observation of blood flow.

Worth knowing

So far, several he althy babies have been born thanks to a uterine transplant

The first woman in the world to give birth to a child after a uterine transplant was a 36-year-old Swedish woman. The boy was born in September 2014 and weighed almost 1.8 kg. According to the Lancet, the mother left the hospital three days after giving birth, and her son left the neonatal unit seven days later. It is worth knowing that reproductive organ transplants are the speci alty of Swedish surgeons from the University of Gothenburg.

In turn, the first child (also a boy), born in the United States thanks to a uterine transplant, had to wait until November 2022. The delivery took place at Baylor University Medical Center in Dallas. The donor was a nurse who already had children of her own and did not plan any more.

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