The idea of not being able to conceive and carry their own child through pregnancy is a terrifying concept for most women and for women who have Mayer-Rokitansky-Küster-Hauser syndrome, (MRKH) they face this reality. MRKH syndrome, which is the absence of a uterus, occurs in 1 out of 4,500 newborn girls. For these women, the possibility of carrying children is impossible, but a new procedure gives women with this syndrome and other issues the option to carry and deliver their own children through a uterus transplant.
The Cleveland Clinic is pioneering the new procedure in the United States following success in Sweden. This innovative procedure will allow women who are born with no uterus, had their uterus removed or damaged, the option to still parent biological children. Adoption and surrogacy are typically the options for women who face these issues, but this new procedure will allow women with personal, cultural or religious conflicts with adoption or surrogacy the opportunity to have children.
Dr. Tzakis, 65, of the Cleveland Clinic is heading the procedure and has performed over 4,000 abdominal transplants of kidneys, liver and other abdominal organs. To prepare for the procedure, Dr. Tzakis traveled to Sweden, where successful uterus transplants in nine women have occurred, resulting in five pregnancies and four live births. He has spent time with the Swedish team, practicing on miniature swine and baboons as well as observing all nine of the successful uterine transplants.
While all the transplants by the Swedish team involved live donors, the Cleveland Clinic will use deceased donors to reduce the risk possibility to any live donor. In September, The Cleveland Clinic began conducting screenings to choose ten women to undergo the transplants. Dr. Rebecca Flyckt is the Director of Fertility Preservation at the Cleveland Clinic and will be overseeing the In Vitro Fertilization (IVF) process for each patient.
The patient will undergo treatments to stimulate the ovaries and obtain a minimum number of viable eggs. The eggs will then be fertilized by the partner’s sperm through In Vitro Fertilization (IVF) and the embryos will be frozen until needed. Once a donor is found, matching the same blood and tissue type, the procedure will be done. A year will be allotted for recovery and to ensure that the uterus is accepted. Doses of the anti-rejection medicine will be regulated and adjusted before trying to get pregnant. Doctors will then transfer one of the ten embryos at a time until the patient becomes pregnant. Once pregnancy occurs and progresses, shortly before term a cesarean section will be needed to deliver the baby as the uterus is too fragile to allow for a natural birth.
After the birth, the mother can keep the uterus to try to have one more child (two is the limit for safety reasons) or have it removed to stop the need for anti-rejection drugs. If the patient decides against the surgery, doctors say it is possible to stop the anti-rejection treatment, causing the body to reject the uterus which should then wither away.
