For many women with uterine factor infertility (UFI), the dream of pregnancy would never be fulfilled. Because they were born without a uterus, have had the uterus surgically removed, or have a uterus that does not function properly, these women have been unable to conceive a baby.
That could all change with uterine transplantation.
A uterine transplant, or “womb” transplant, places a healthy uterus from a donor into a woman whose uterus is absent or unhealthy, allowing her to carry a child, and possibly multiple children, to term.
The procedure is complex, and we’re proud to be the first health system in the northeast to offer this groundbreaking clinical trial. Penn Medicine’s in vitro fertilization program was one of the first in the nation, and now we continue to push the boundaries of what’s possible in the fields of fertility and transplant.
How does a uterine transplant work?
A uterine transplant is very similar to any other type of transplant, with one exception: after the woman gives birth, doctors surgically remove the transplanted uterus.
The transplanted uterus is completely temporary, serving the sole purpose of allowing a woman to carry a baby. Patients who undergo uterine transplants will need to take antirejection medication (deemed completely safe during pregnancy) until the uterus is removed.
On top of these two surgeries – one to implant the uterus and one to remove it – in vitro fertilization (IVF) treatment is involved to create the embryo.
Before the transplant, participants in the trial will have eggs harvested and fertilized through the standard in vitro fertilization process. Fertility specialists will preserve the resulting embryos, so they can be transferred later to the transplanted uterus.
Like other transplants, the uterus will come from a deceased donor, age 18 to 45, who has had a history of successfully delivering healthy babies.
Once the uterus has healed, about a year after transplant, doctors will place a single embryo in the new uterus. Women with a transplanted uterus can have up to two babies. The birth will be a scheduled Caesarean section since the women likely do not have a ‘normal’ vaginal canal.
According to transplant surgeon, Paige M. Porrett, MD, PhD, “Assuming that a woman becomes pregnant upon her first embryo transfer, the entire process may take 16 to 24 months.”
Who is a candidate for uterine transplantation?
If a woman with UFI is interested in transplantation, she will undergo testing at Penn Medicine to ensure that she is a good candidate for the procedure. We’ll look at her medical and surgical history, as well as conduct a physical examination and lab work.
Women participating in the clinical trial must be:
- Diagnosed with UFI
- Of good health (as determined by testing)
- Between ages 21 and 40 (child-bearing age)
Both heterosexual and same-sex couples are eligible, but participants need to be in a stable relationship that has lasted at least three years.
"Stable relationships are important because transplant recipients need to have a lot of support,” explained Kathleen E. O’Neill, MD, MYR, obstetrician and gynecologist at the Hospital of the University of Pennsylvania.
Although it is a long and challenging journey, for many couples struggling with infertility, it may be worth it. And for those who are just now getting diagnosed with UFI: There’s more hope than ever before.
Interested in the uterine transplant clinical trial? Learn more and complete the screening questionnaire.
Ready to help? The best way to support organ and tissue donation, including uterus donation, is to register to be a donor and discuss the decision with your family.