Even if reproductive medicine has been remarkably successful during the past few decades, with the introduction of in vitro fertilization in the late 1970s and intracytoplasmic sperm injection in the early 1990s, it has been repeatedly mocked by infertility due to an absolute uterine factor. No treatment has been available for the women suffering from an absent or dysfunctional uterus, in terms of carrying a pregnancy. Approximately one in 500 women suffer from absolute uterine infertility, and the option so far to become a mother has been to either adopt or utilize gestational surrogacy. For women whose uterus is not healthy, or who do not have one, a transplant is the newest form of infertility treatment. In India, about 17% of all women face issues relating to infertility, and the reason is related to the uterus in 20% of such cases. In some cases, the uterus is altogether missing from birth.
The uterine transplant is the surgical procedure where a healthy uterus from a donor (can be from living or deceased) is transplanted into a female who is born without uterus or whose uterus is diseased. The recipient woman is monitored closely for over a year. If all goes well, an embryo is implanted in the uterus using an IVF procedure. Later the delivery of the baby is done through a caesarean section. Once the uterus is no longer needed, the womb can be removed to prevent the side-effects due to intake of immunosuppressants, usually taken by organ recipients for the rest of their life.
Uterine transplantation may be recommended for women who wish to conceive who have uterine malformation or who have undergone previous hysterectomy due to neoplasm, post-partum hemorrhage, increased uterine bleeding or intrauterine adherences (Asherman syndrome).
The world’s first womb transplant was successfully conducted in the year 2011 in Turkey from a deceased donor at Akdeniz University Hospital in Antalya on the then 21 years old Turkish woman, Derya Sert, who was born without a uterus.
For the first time, a healthy baby was born to a woman who received a uterus transplant from a deceased donor, on 15 December 2017 at the University of São Paulo School of Medicine in Brazil. The baby girl was born via caesarean section at 35 weeks and three days, and weighed 2550g (around 6lbs). The transplanted uterus was removed during the caesarean section and showed no anomalies.
Early tests of uterine transplantation have been much more promising than the early phases of transplantation of other solid organs, such as the kidney, heart and liver. However, the first uterine transplantation surgeries performed required a long time in surgery. In the future, following the completion of a larger number of cases and with the improvement of surgical techniques, this time will be reduced, as has been observed in the evolution of the transplantation of other organs.
In sum, uterine transplantation is a new and viable therapeutic option for patients with uterus-related infertility who wish to have a child, as long as this transplantation is performed at centers of expertise that specialize in human reproduction and transplantation techniques and related skills.
By – Nursing Tutor – Mrs Deepika
Department of Nursing
College Of Nursing UCBMSH
Uttaranchal (P.G.) College Of Bio-Medical Sciences & Hospital
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