On Friday February 26, the Cleveland Clinic, in Cleveland, Ohio performed the first uterus transplant in the United States. According to National Public Radio (NPR), the procedure took nine hours, and the 26 year old patient was reported to be in stable condition. The organ, like many other organs used in transplants, came from a deceased donor.
The woman was one of ten selected for the clinical trial of the operation. All ten women selected were either born with a condition called Mayer-Rokitansky-Küster-Hauser syndrome (a condition in which one is born with an underdeveloped or absent uterus), had to have their uterus removed, or lack a functioning uterus. Uterine factor infertility (UFI), however, while similar is also different. UFI is the inability to carry a pregnancy due to a lack of uterus, whether one was born without one, theirs doesn’t function properly, or they’ve had their uterus removed. According to CNN the condition is irreversible and affects 3-5% of women in the world. According to the New York times, there are thought to be 50,000 women in the United States alone that would qualify as candidates for a transplant because of UFI. However, the ethics panel at the Cleveland hospital gave permission for the clinic to perform the procedure only ten times, as an experiment.
While the options of using a surrogate or adoption have also been available for these women, Dr. Andreas G. Tzakis, the leader of the surgery team that conducted the transplant said, “for reasons that are personal, cultural, or religions” women may choose not to go through with these options. An unnamed woman being screened as a candidate for the transplant, however, was quoted in a New York Times article as having a different reason for wanting to pursue the operation rather than hiring a surrogate or adopting. “I crave that experience,” she said. “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.”
Before the clinic’s success the only other country that had successfully performed a uterus transplant was Sweden. So far, doctors at the University of Gothenburg have performed nine successful transplants. CNN reported that of the nine women to get transplants, five women have gotten pregnant resulting in four live births. However, all the women in Sweden received transplants from live donors. According to the New York Times Tzakis, who has performed 4,000-5,000 organ transplants, traveled to the University of Gothenburg to work with doctors who have been successful with their transplants.
While the transplant is a significant part of the process to an alternative route to pregnancy, it is only a small part of the process these women will go through before giving birth. The process begins before the transplant when the patient’s eggs are harvested and frozen. After a year post-transplant, allowing for healing and the adjustment of anti-rejection medication, the patient’s eggs will be artificially inseminated and implanted until the patient becomes pregnant. After heavy observation and one or two babies are delivered through cesarean section, the uterus will be removed to avoid prolonged exposure to medication.
While the temporary transplant is an impressive advancement in the medical field, some feel as though it is not as necessary as others may think. Dr. Michael Green of Massachusetts General Hospital views uterine transplants as a quality-of-life issue and has been quoted as stating, “Nobody needs a uterus to live, OK?” A NPR article also reports Green as wondering “whether health care dollars should be spent on uterine transplants when a woman who lacks a uterus can turn to a surrogate mother to provide her with a child — if she can afford it, that is.” The Cleveland clinic, however, argued that surrogacy isn’t always an option, “In the U.S., the surrogacy process can be legally complicated. In many other countries, surrogacy is highly restricted or even banned.”