A uterus transplant is a promising new procedure that helps some women overcome uterine factor infertility (UFI) and carry a baby. UFI is a condition in which a woman cannot get pregnant because she was born without a uterus, had it surgically removed during a hysterectomy, or has a uterus that does not function properly. UFI is estimated to affect as many as 5% of childbearing-aged women worldwide and once was an irreversible form of female infertility. The first successful uterus transplant was performed in Sweden in 2014. As of late 2020, roughly 100 uterus transplants have been performed in the world, including about 30 in the United States.
If the woman is approved for the procedure, the process starts with creating an embryo using in vitro fertilization (IVF), in which the woman’s eggs are retrieved and fertilized with sperm. Next, a healthy uterus is transplanted into the patient. About six months after a successful uterus transplant, a single embryo is implanted into the uterus. If it leads to a successful pregnancy, the pregnancy is treated as high risk, and the baby will be delivered via Cesarean section, because women with UFI cannot delivery vaginally. Babies born from uterus transplant recipients tend to be born early, at about 35 weeks of gestation. Caring for these premature infants often requires a stay in a neonatal intensive care unit for several weeks. The entire process can take 2-5 years.
As with other types of organ transplants, the woman must take immunosuppressive medications to prevent the body from rejecting the transplanted uterus. After the baby is born and if the woman does not want more children, the transplanted uterus is removed with a hysterectomy procedure, and the woman no longer needs to take anti-rejection medications.
UAB Medicine’s uterus transplant program is the first of its kind in the southeast and only the fourth in the United States. Women interested in uterus transplantation will undergo significant physical and psychological evaluation to ensure that they understand the risks of the procedure and have considered alternatives for family building. The program is led by the organ transplant surgeon and immunologist who started the third uterus transplant program in the United States. The transplant team works closely with the UAB Department of Obstetrics and Gynecology to help ensure that uterus transplant patients and their babies have a healthy and positive experience. To speak to a member of the uterus transplant team, please call 833-UAB-CTI1.