How the Cleveland Clinic performed the first uterus transplant in the US

Last week, a team of Cleveland Clinic transplant and gynecological surgeons performed the United States’ first uterus transplant.

Pregnancy is often one of a woman’s most cherished memories, but for women with uterine factor infertility (UFI), that is not an option. They cannot carry a pregnancy because they were born without a uterus, have lost their uterus, or have a uterus that no longer functions.

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Late last year, Cleveland Clinic began screening candidates for uterus transplants as part of a clinical trial approved by the company’s Institutional Review Board.

In this new research study — groundbreaking for the United States — Cleveland Clinic will perform uterus transplants in 10 women with UFI.

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With the green light, Cleveland Clinic began screening 21-to-39-year-old women with UFI for transplant. Each candidate was put through extensive rounds of medical and psychological evaluations by experts from different disciplines and must be unanimously approved by the team.

“Although there appears to be potential for treating UFI with uterine transplantation, it is still considered highly experiemental,” said Tommaso Falcone, MD, Ob/Gyn & Women’s Health Institute Chair. “Cleveland Clinic has a history of innovation in transplant and reproductive surgery and will explore the feasibility of this approach for women in the United States.”

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The exact incidence of UFI is unknown, but experts estimate that it affects thousands of women of childbearing age worldwide. Some have congenital UFI, meaning that the uterus is absent at birth (as in Mayer-Rokitansky and other syndromes). Others acquire UFI after hysterectomy or because of damage from a serious pelvic infection, or abdominal or pelvic surgery.

“Women who are coping with UFI have few existing options, “said Falcone. “Although adoption and surrogacy provide opportunities for parenthood, both pose logistical challenges and may not be acceptable due to personal, cultural or legal reasons.”

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