A Second Chance: What Uterus Transplants Mean For Couples Struggling With Fertility

Parenthood is hailed as a major turning point in life. But, what of those who are unable to experience the infinite joys and hurdles of raising their own child? In the wake of India’s first successful uterine surgery, scores of women with congenital or acquired uterine damage now stand a chance to have children. In fact, the surgery is being hailed as the most ground-breaking event infertility treatment since the development of in-vitro fertilization (IVF) in 1978.

However, as with any news being covered by pop-culture sites, misinformation about the implications of the medical procedure is rampant, and so we at Health Library decided to clear the air; are womb transplants for everyone? Read on for everything you need to know and see what it means for you and your loved ones:

Do You Qualify For A Uterus Transplant?

If you were born without a uterus, have undergone a hysterectomy or have a non-functioning uterus, you could qualify for the surgery. Other eligibility factors include child-bearing age (you must be under 40) and donor availability.

Where Can You Get It Done?

Currently, the procedure is still experimental and a Pune-based group of experts is the only surgical team in India to have successfully attempted it.

Stage 1 – Creating The Embryos

First, the patient’s eggs are harvested from her ovaries. The eggs are then fertilized in a lab, before being cryogenically preserved for later implantation. This process, by itself, is a common step in several birth and fertility-related procedures.

Stage 2 – The Womb Transplant Procedure

Here’s a simple breakdown of the surgical process:

1. First, the patient is placed on a course of immunosuppressive drugs that prevent the body from immediately rejecting the new uterus.
2. The donor uterus is then removed, along with the organ’s blood supply, in a 3-5 hour operation.
3. After transplanting the uterus into the patient, the surgeon then connects the organ’s blood vessels to the patient’s system.   

The entire process takes about 8-12 hours, depending on individual bodies and their issues, and the complications encountered during surgery.

Stage 3 – Recovery & Motherhood

Once a few months have passed, the patient will begin getting her period.

But when will she be able to give birth? Read on.

After being placed under observation and immunosuppressants for a year, the patient will be reviewed for embryo implantation via IVF. This review includes a series of cervical biopsies to check for organ health and potential rejection.

If all goes to plan, the embryos are implanted while the mother is placed on a reduced dosage of immunosuppressants. And once it reaches term, the baby will be delivered by Caesarean section to minimize trauma to the donor uterus.

NOTE: Uterine transplants don’t last forever. Ideally, after one or two babies have been successfully birthed, doctors will remove the uterus via a standard hysterectomy.

What Are The Risks? How Experimental Is ‘Experimental’?

The surgery has only been tried about 25 times and has a 78% success rate. Prior to the domestic breakthrough, the procedure had only been attempted in Sweden and the USA.

Organ Rejection: Even on a regimen of immunosuppressants, it’s quite possible that the body will still reject the donor uterus.

Immunotherapy: Doctors are still largely in the dark about the effects of anti-rejection drugs on the unborn fetus, but potential problems include infection and premature birth.  

Surgery: All invasive medical procedures carry their own risks, but transplant surgeries are notorious for their complications and the high level of skill required to perform them successfully.

Uterine transplants take upwards of 8 hours and sometimes required multiple operations, dramatically increasing the risk to both donor and receiver.  

Should You Get A Uterine Transplant?

Infertility of various kinds affects over 5 million women in India alone. Uterine conditions like Asherman’s syndrome, malformations and fibroids, and the comparatively rarer, MRKH syndrome (where a woman is born without a uterus), affect a significant percentage of this segment.

While current child-bearing options for incurable infertility include adoption and surrogacy, some women feel a deep-seated need to physically carry, nurture and birth their own offspring. In fact, many would argue that the need to bring a child to term is intricately tied to their sense of identity. For them, uterine transplants are a splash of life and color in the gray melancholia of infertility.

Since it does not alleviate any dire physical complication, this sort of transplant is classified as a life-enhancing surgery, rather than a life-saving one.

But remember. As with all experimental procedures, many of the complications and dangers of uterine transplants are still being figured out. And it may take as long as a decade before the surgery becomes safe enough to become a ‘routine’ procedure.  

If you have fertility issues that are unrelated to the uterus, however, you might want to check out this incredible list of tips for women trying to conceive.

And if you found this article helpful please go ahead and let us know in the comments section below. Or you could head over to our discussion pages and start a conversation around women’s fertility.