Possibilities for fertility restoration: A new surgical technique

Krishen Sieunarine, Faris B.P. Zakaria, Deborah C.M. Boyle, David J. Corless, David E. Noakes, Iain Lindsay, Andrew Lawson, Laszlo Ungar, Giuseppe Del Priore, J. Richard Smith

Research output: Contribution to journalArticle

61 Scopus citations


Previously published work concluded that uterine artery microvascular anastomosis in the porcine model was feasible with subsequent normal vascular function in pregnancy of the anastomosed vessels. The objective of this study was to assess the feasibility of uterine autotransplantation in a porcine model using microvascular anastomoses. Eight large white/landrace sows of proven fertility were used. A supracervical hysterectomy with or without bilateral salpingo-oophorectomy (BSO) was performed. After 1 hour of cold storage in a transplant solution, the specimen was reintroduced and followed by stepwise vascular reanastomosis. Objective perfusion index measurements suggested adequate uterine perfusion after transplantation. Postoperatively, sow 1 survived to 3 months with no signs of oestrus, and sows 2, 6, and 8 were killed on days 6, 33, and 54, respectively, for pelvic infection. Histopathology of the uterine grafts revealed gradual vessel thromboses. Microvascular reanastomosis is feasible, however, unsuccessful in uterine autotransplantation because of gradual vessel thromboses. The porcine model is highly susceptible to postoperative infection.

Original languageEnglish (US)
Pages (from-to)249-256
Number of pages8
JournalInternational Surgery
Issue number5
StatePublished - 2005


  • Infertility
  • Porcine model
  • Uterine transplantation

ASJC Scopus subject areas

  • Surgery

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    Sieunarine, K., Zakaria, F. B. P., Boyle, D. C. M., Corless, D. J., Noakes, D. E., Lindsay, I., Lawson, A., Ungar, L., Del Priore, G., & Smith, J. R. (2005). Possibilities for fertility restoration: A new surgical technique. International Surgery, 90(5), 249-256.