July 11, 2019

Cleveland Clinic doctors have delivered the first baby born in the United States to a woman who received a uterus transplant from a deceased donor, the medical center announced Tuesday.

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How the process works

Before receiving a uterus transplant, recipients must take hormone treatments that cause their ovaries to release multiple eggs. Those eggs are harvested, fertilized, and frozen to be implanted via in vitro fertilization (IVF) after the transplant.

Doctors attempt IVF about six months after the transplant, when the woman has healed and begun menstruating.

The pregnancies are inherently high risk, and the babies are delivered via cesarean-section to avoid straining the uterus.

The transplant is intended to be temporary. At a later date—possibly after a successful pregnancy—the uterus is removed so the patient can stop taking powerful anti-rejection drugs.

In 2017, Baylor University Medical Center announced the first birth from a live uterus donor. The sparsity of willing living donors has pushed researchers to also explore whether a successful birth could be achieved from a deceased donor. The first and only other known successful birth from a deceased donor was announced in 2018 by doctors in Brazil, according to USA Today. The baby was delivered by doctors at the University of Sao Paulo.

Cleveland Clinic's trial delivers a baby girl

Several years ago, Cleveland Clinic launched a clinical trial to see whether uterus transplants from a deceased donor can allow women without a uterus to become pregnant and eventually deliver a baby.

By using a recently deceased donor, surgeons can eliminate harm to living donors "who would need to have major abdominal surgery to have her uterus removed," the medical center said.

The trial involves 10 women who are between 21 and 39 years old and have uterine factor infertility (UFI), meaning they "don't have a uterus, or had their uterus removed, so they aren't able to get pregnant," Cleveland Clinic said in a news release.

Last month, a woman in her mid-30s gave birth to a healthy baby girl, the clinic said.

Since the beginning of the trial, Cleveland Clinic has performed three successful uterus transplants. Two women are awaiting embryo transfers and several other participants are awaiting transplants.

Implications

Cleveland Clinic transplant surgeon Andreas Tzakis said he hopes the Cleveland Clinic's ongoing trial will eventually "make these extraordinary events ordinary for the women who choose this option."

But while the medical community has made big strides with the transplants, Uma Perni, a maternal-fetal medicine specialist for Cleveland Clinic, said "It's important to remember that this is still research, but it's exciting to see what the options may be for women in the future" (Cleveland Clinic news release, 7/9; Culver, USA Today, 7/9; Burke, AP/NBC News, 7/9).

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