Uterine Transplantation

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Penn Medicine is currently recruiting patients for the Uterine Transplantation for Uterine Factor Infertility (UNTIL) Trial.  Uterine transplantation is a major breakthrough in the field of fertility.  A uterine transplant is not for everyone and your physician may recommend other forms of treatment before deciding a uterus transplant is right for you. There is an extensive selection process and patients may remain in the study for 5-10 years after the transplant and pregnancies.

Who is a candidate for a uterine transplant? 

  • The UNTIL trial is focusing on women diagnosed with uterine factor infertility (UFI). UFI is an irreversible form of female infertility that affects as many as 5% of women worldwide. 
  • A woman with UFI cannot carry a pregnancy. Either because she was born without a uterus, has had the uterus surgically removed, or has a uterus that does not function.  In the UNTIL trial we will only be including patients who were born without a uterus or who had their uterus surgically removed.
  • Gestational carriers (surrogates) and adoption are the only ways women with UFI can have children.

Facts about uterine transplant

  • A successful Swedish research team paved the way for the UNTIL study. After years of uterus transplant research, the Swedish team was able to successfully transplant a uterus from a living donor into a woman with UFI. As of October 2016, 9 uterus transplants had been performed in Sweden resulting in live births in 6 of the 9 women who participated in the study.  As of September 2017, eight babies have been born in Sweden following uterine transplantation.
  • Penn Medicine is one of three centers in the United States offering uterus transplant through an experimental protocol to women with UFI.
  • The UNTIL trial will use a donor uterus from an unrelated deceased donor for transplantation.  Deceased donors are individuals who die from accidents, medical conditions or other events, and either they or their next of kin consent to donating their organs to individuals in need.  Although ~10 uterine transplants from deceased donors have been performed around the world, no live births have been reported yet.

Selection process

  • Candidates
    • Women between the ages of 21 and 40 with UFI. 
    • Live in or near the Philadelphia area for the duration of the study.
  • Candidates will undergo an extensive evaluation by a team of physicians, psychologists, nurses and social workers – the evaluation is extensive since women will undergo multiple surgeries and in vitro fertilization (IVF) as part of this trial.
  • Donor search – for a uterus from a woman that has donated her organ/uterus to research upon her death. 
  • Following uterine transplant women cannot become pregnant without assistance.  Therefore, prior to undergoing uterine transplant, embryos must be created through IVF.  IVF requires stimulation of the woman’s ovaries to produce multiple eggs. This is followed by removal of the eggs and fertilization of the eggs with sperm in the IVF lab.  Embryos that are created are frozen for later use.  For more information on the IVF process, visit the Penn Fertility Care website 
  • Transplant
    • The organ procurement agency will search for a donor between 18 to 40 years old.  The donor’s next-of kin must agree to donate the uterus.
    • The donor’s uterus is removed along with its blood vessels.
    • The uterus is transplanted into the woman’s pelvis.  The donor’s blood vessels are connected to her blood vessels.
    • Recipients will be administered anti-rejection drugs for as long as they retain the uterus. 
    • After transplant –  recipient will need frequent blood tests, ultrasounds and cervical biopsies to monitor for signs of rejection.
  • After Transplant Surgery 
    • Once the uterus heals (6-12 months), and is functioning, with no infections or rejection episodes that could not be treated, a single embryo is put back into the uterus.
  • When a pregnancy is achieved, the pregnancy is monitored closely by a team of high-risk obstetricians and the recipient will continue to take anti-rejection medications for the duration of the pregnancy.  These medications may have effects on the developing baby.
  • The baby will be delivered via C-section (about 37 weeks) or earlier if needed for the health of the mother and/or baby. To date, all of the babies born to women who have had uterine transplants have been born early (about 35 weeks).
  • After the recipient has delivered 1 or 2 healthy babies the uterus is removed (hysterectomy) and anti-rejection mediations are stopped. 

For more information, please contact the Penn UNTIL Research Staff at (215) 662-7727.

Please click below to complete a preliminary screening questionnaire online, and someone from the research team will contact you.  

 

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