Uterus transplantation has been successful in some cases – but comes with major difficulties and side-effects, according to an analysis published today.
So far, worldwide, 11 babies have been born since the first successful birth in 2014. The operation has been undertaken in 42 women.
An analysis in BJOG, the journal of the UK Royal College of Obstetrics and Gynaecology, says the treatment should be regarded as still being experimental – without standardised protocols.
The authors call for standardised criteria for screening donors and recipients.
Major complications for recipients have included urinary tract problems, thrombosis, infection and haematoma.
Immunosuppressants may also trigger pre-eclampsia in pregnancy – and there is a huge risk of rejection of the transplanted organ during pregnancy, according to Dr Iori Kisu, Assistant Professor from the Department of Obstetrics and Gynaecology at the Keio University School of Medicine, Japan, and colleagues.
The article’s concerns were echoed by Richard Smith, college spokesperson on the procedure. But, he said, the use of live donors had become simpler – making a live donor programme feasible in the UK.
He said: “Infertility can have a devastating impact upon couples, particularly for women with absolute uterine factor infertility, for which there has been no effective treatment to date and – for some of these women, womb transplantation is the only way they can carry a pregnancy.
“While there are a number of documented successful cases of women with womb transplants giving birth, we must be cautious and employ appropriate, selection and preparation processes to ensure the safety and efficacy of the therapy for women and their babies.”
Journal deputy editor Dr Patrick Chien said: “Womb transplantation is a promising area of fertility treatment that is beginning to advance worldwide. This is the first review to bring together published literature in order to synthesis and evaluate the existing concerns and unknowns of the procedure.”
Emerging problems in uterus transplantation. BJOG 5 June 2018
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