Uterus transplant: Evidence and ethics

Anjana Nair, Jeanetta Stega, J. Richard Smith, Giuseppe Del Priore

Research output: Chapter in Book/Report/Conference proceedingConference contribution

45 Scopus citations

Abstract

Absolute uterine infertility affects millions of women in the United States and more throughout the world. For instance, each year in the United States about 5,000 hysterectomies are performed in women under the age of 24. In total, nearly 9 million women of reproductive age have had a hysterectomy. Based on fecundity rates, thousands of these women may be candidates for uterus transplantation. An ongoing study enrolling some of these potential recipients onto a uterus transplant "waiting list" has revealed that most of these women have Rokitansky syndrome, hysterectomy secondary to endometriosis, cervical cancer, or compelling personal accounts justifying their candidacy. Fertility restoration by uterus transplantation was derived from fertility preservation research, including the development of the radical trachelectomy, oxygenation and perfusion of the in situ uterus, and work with organ donor networks. A decade of modern animal research set the foundation for this human work. Ongoing experiments include stable, long-term large animal allografts for investigating immunosuppression regimens and other transplantation details. Each of the animal models has contributed to the current knowledge base. Recently, nonhuman primates have been used to further investigate the possibility of human uterus transplantation. Nonhuman primate anatomy is analogous to that of humans with notable exceptions. The first human uterus transplant surgery took place in 2000, but it did not result in a pregnancy. However, taken in total, the magnitude of the intervening work from multiple groups throughout the world has made uterus transplantation a topic for discussion. It may also soon be a reality.

Original languageEnglish (US)
Title of host publicationAssessment of Human Reproductive Function
PublisherBlackwell Publishing Inc.
Pages83-91
Number of pages9
ISBN (Print)9781573317207
DOIs
StatePublished - Apr 2008

Publication series

NameAnnals of the New York Academy of Sciences
Volume1127
ISSN (Print)0077-8923
ISSN (Electronic)1749-6632

Keywords

  • Uterine factor infertility
  • Uterus transplant

ASJC Scopus subject areas

  • Neuroscience(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • History and Philosophy of Science

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    Nair, A., Stega, J., Smith, J. R., & Del Priore, G. (2008). Uterus transplant: Evidence and ethics. In Assessment of Human Reproductive Function (pp. 83-91). (Annals of the New York Academy of Sciences; Vol. 1127). Blackwell Publishing Inc.. https://doi.org/10.1196/annals.1434.003