Uterus transplantation: where do we stand today and where should we go?

Abstract

If transplantation of the uterus is developed into a safe method with a reasonable chance for the patient to carry an uneventful pregnancy, this procedure could become a feasible fertility treatment for women with absolute uterus factor infertility. The activity in this research field is growing and during the past 5 years several reports have been published. In this brief review the authors summarize the state of research in this field and also speculate on what might lie ahead.

Uterus Cryopreservation: Maintenance of Uterine Contractility by the Use of Different Cryoprotocols

“…The group of Brannstron in Gothenburg has already achieved pregnancies in mice uterus transplants (Racho El‐Akouri et al. 2003) and sheep (Brannstrom and Wranning 2007) and Ramirez in goats (Ramirez et al. 2007).…”

“…For patients with no functional uterus, there is still no assisted reproductive technology possibility that will help these patients. In the last years, there have been many reports (Pearson 2007) on uterus transplantation attempts, so that many predict that uterus transplantation may reach a clinical stage within 2-3 years, in the event of a continuous high research activity within this field (Brannstrom and Wranning 2007). In an uterus transplant, the organ would be removed from a living or recently deceased donor and transferred to a recipient.…”

“…Regarding the uterus, there has been a recent report that cold ischaemia allows the perfusion of the organ up to 12 h (Del Priore et al 2007). The group of Brannstrom showed in a mouse uterine transplantation model and on human uterine tissue that the tolerance for cold ischaemia from the time the uterus is taken out from the donor until placed in the recipient is around 24 h (Brannstrom and Wranning 2007). The uterus has an additional advantage regarding its possible cryopreservation, that although it is a big hollow muscular organ, it has not the dense and highly organized structure of a heart or kidney, which could not be cryopreserved (Fahy et al 2006).…”

“…The desire to conceive a child can cause such an anguish in these women, that they would be ready to undergo an uterus transplantation, a totally experimental, risky and expensive procedure, which is not considered universally justifiable, since it is not a life or death situation. Of course, the transplanted uterus should be removed from the recipient after successful pregnancies, so that the patient would not be subjected to lifelong antirejection medications (Altchek 2003; Brannstrom and Wranning 2007).…”

“…There has been one attempt to transplant a human uterus, which however failed. Since then, several uterine transplantation animal models have been developed to examine various aspects of the uterus transplantation procedure and to optimize it for human use (Altchek 2003; Brannstrom and Wranning 2007).…”