In a nutshell
This study examined clinical outcomes of uterus transplantation in 7 women with absolute uterine factor infertility (AUFI). Researchers reported continued menstruation and blood flow to the uterus 1 year after uterus transplantation. Any rejection episodes were detectable early on and treated successfully.
Absolute uterine factor infertility (AUFI) is a type of female infertility caused by abnormalities of the uterus (womb). AUFI is considered to be the only major cause of female infertility that remains untreatable. Uterus transplantation has been proposed as a possible treatment for AUFI. The procedure involves surgically removing the uterus from a live or deceased donor, which is then transplanted into the recipient. Transplantation surgery is often combined with immunosuppression (induced suppression of the immune system) to prevent the body from rejecting the transplant. The long-term safety of uterus transplantation is still being investigated.
Methods & findings
The aim of this study was to report clinical outcomes during the first year after uterus transplantation.
This study followed 7 out of 9 women with AUFI who have kept their transplanted uterus during the first year after the procedure. (1 transplanted uterus had to be removed due to blood clotting and 1 due to infection.) All women underwent uterus transplantation from a live donor. Immunosuppression with tacrolimus (Prograf) and mycophenolate mofetil (CellCept) was administered.
All women had a normal menstrual cycle within 2 months after uterus transplantation. Ultrasound examinations showed normal blood flow to the uterus during the first year after the procedure.
Rejection episodes (based on tissue samples from the cervix) were observed in 5 of the 7 women. However, most episodes were considered mild, were not associated with any symptoms, and treated with steroid drugs. On all occasions of detected rejection, cervical cells returned to normal 2 weeks after rejection treatment.
Withdrawal of mycophenolate mofetil after 6 months was well-tolerated. Some mild inflammation was noted in 4 women. This was successfully treated with additional immunosuppression and steroid drugs.
The bottom line
Researchers concluded that uterus transplantation is feasible in some women with AUFI. Rejection episodes were detectable early on and treatable.
The fine print
Because this is a new surgical procedure, large clinical trials are needed to confirm the safety and effectiveness of uterus transplantation.
Published By :
Fertility and Sterility
Jan 01, 2015