Will It Work? Uterus Transplant Recipient Hopeful

“I have prayed that God would allow me the opportunity to experience pregnancy, and here we are,” a 26-year-old woman named Lindsey told the world today.

Lindsey (who has chosen not to reveal her last name) was wheeled into a press conference held by the Cleveland Clinic on Monday after her groundbreaking uterus transplant last month. The surgery is a first in the U.S., and surgeons and the transplant team say the procedure could offer hope to women who wish to carry a child but cannot because they were born without a uterus.

(Update: On Wednesday, March 9, the patient suffered complications and the transplant failed, according to a statement from the Cleveland Clinic. The hospital said it would release more details as they become available.)

Approximately one out of every 4,500 newborn girls are born without a uterus.

Lindsey is one of 10 women the clinic has identified for the procedure. All have uterine factor infertility, or UFI. The protocol was approved by the Cleveland Clinic Institutional Review Board after more than 250 women were initially screened for the study.

Surgeons say they hope their research and the procedure gives women another viable option to conceive a child.

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This first groundbreaking uterine transplant procedure took place on Feb. 24 — the surgery took nine hours. Dr. Toby Cosgrove, CEO of the Cleveland Clinic, said in a press conference on Monday that the transplant brought together about 70 professionals and 8 surgeons.

The donor in this particular case was deceased. Research on living donors is also underway.

Lindsey thanked the donor’s family and the transplant team, saying they have all provided her with a “gift” she will never be able to repay. She was told at the age of 16 that she could never have children on her own. Lindsey and her husband, Blake, adopted three children through the foster care system before the surgery.

New Hope for Infertility 
Ethics and high-risk fertility experts on the panel this morning explained that Lindsey and any other transplant recipient will still be years away from having a baby post-surgery. Lindsey will be on anti-rejection medications for some time.

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The procedure works this way: Women who receive a transplanted uterus must first undergo in vitro fertilization (IVF) to produce eggs, which are then removed and fertilized in a lab. The embryos are put into the woman’s uterus after it has been transplanted and in place for at least a year.

“These woman are born with normal ovaries that produce healthy eggs … The problem is that there’s nowhere for these eggs to go,” said Dr. Rebecca Flyckt, a gynecologist and obstetrician with the Cleveland Clinic.

“We must remember, uterus transplant is not just about a surgery, it’s about having a healthy baby. And that goal is still a couple of years away,” added Flyckt.

The transplanted uterus is not intended to stay in place permanently. After the woman carries one to two children via C-section, she will stop taking drugs so her body rejects the organ. Upon rejection, the uterus will then be removed or allowed to disintegrate.

Dr. Julie Bindeman, a reproductive psychologist in the Washington, D.C. area, works with women who have UFI and related conditions. She told LifeZette the psychological impact of the surgery is incredible.

“My clients see it and feel hopeful for their future fertility. Previous to the surgery, their only option for a biologically related child was to go through the gestational carrier process, which can be lengthy and expensive,” she said.

Safety and Ethical Concerns
“We used to do transplants to save lives, but now are doing them to improve quality of life,” said Dr. Serena Chen, a reproductive endocrinologist at the Institute for Reproductive Medicine and Science at Saint Barnabas in New Jersey.

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“Using a gestational carrier is logistically much easier but may not be acceptable to some women,” she told LifeZette.

Chen said using a gestational carrier can be safer for mothers and babies, but can put the carrier at risk — plus it’s expensive. The transplant, on the other hand, can require significant immunosuppressive medications, and also be risky as well as costly.

“There is still a lot to understand about this process. As with many new procedures, the question is always raised: ‘Just because we can do it, does that mean we really should be (doing it)?’” she said.

“This is an unbelievable event,” said Dr. Andreas Tzakis, the transplant surgeon. “It may not be a life-saving operation but the hope is that it will bring a new life into this world.”