Topline
Uterus transplants may be a promising solution for some women with infertility, after a new study found that the transplants didn’t appear to cause any health risks in children born from this method, nor any major complications for transplant recipients, though the procedure carries a hefty price tag that could be cost-prohibitive for some.
Key Facts
Some 20 female participants with uterine factor infertility and at least one functioning ovary were selected to be recipients, and underwent uterus transplant surgery between September 2016 and August 2019, according to the study published Thursday in JAMA.
Researchers selected 18 living donors with an average age of 37, and two deceased donors—aged 30 and 42—to donate their uteri to the 20 participants.
The recipients—who had an average age of 30—had 14 successful transplants, a combined total of 24 pregnancies, resulting in 16 live births; 12 of the recipients had one live birth while two recipients had two successful live births.
Though none of the 14 recipients who had successful transplants had any severe complications, 11 recipients had at least one adverse event, while four of the 18 living donors had grade 3 complications—which required surgical, endoscopic or radiological intervention.
The transplants presumably didn’t have any negative impact on the children, as none of the 16 children have any developmental delays or congenital abnormalities as of May 1, 2024.
An accompanying editorial—written by doctors who weren’t authors of the study—called uterus transplantation a “major step forward for patients with uterine-factor infertility,” and likened it to in vitro conception, which was at first met with a lot of skepticism, but is now regarded as an innovative solution to infertility.
What Is Uterine Factor Infertility?
The uterus is an important organ for pregnancy because it’s where the fetus grows. Uterine factor infertility is a type of female infertility that occurs when a woman can’t get pregnant because she either doesn’t have a uterus, or her uterus doesn’t function properly, according to the Cleveland Clinic. Women can be born with this condition or acquire it later in life through another condition—like fibroids, radiation damage or scar tissue—or by surgically removing their uterus via a hysterectomy. The condition accounts for between 2.1% and 16.7% of all female infertility cases. Symptoms vary, but they can include irregular periods, absent periods, the inability to conceive and pelvic pain.
What Complications Were The Most Common?
Among recipients, gestational hypertension—pregnancy-induced high blood pressure—was the most common maternal adverse event, occurring in 14.3% of the 16 live-birth pregnancies, according to the study. Preterm labor and cervical insufficiency—when the cervix dilates and shortens before the pregnancy has reached full term—were the most common labor-related complications, and each happened in 14.3% of pregnancies. Vaginal bleeding during pregnancy happened in three recipients, two needed blood transfusions due to abnormal placental location and one had a subchorionic hematoma—when blood collects under the chorion membrane during pregnancy.
How Much Does A Uterus Transplant Cost?
The study’s accompanying editorial said uterus transplantation’s high cost is an inevitable concern. It’s estimated uterus transplants can range between $100,000 and $300,000 in the U.S., according to a previous JAMA study. The procedure is considered an advanced form of assisted reproductive technology, and it’s already been proven these methods have disparities in access by race and ethnicity. Uterus transplantation is not covered by private insurance, or by Medicare because it doesn’t have enough proven evidence of its safety and efficacy to be considered medically reasonable or necessary.
Big Number
48. That’s how many uterus transfers have been completed in the U.S. as of May 1, 2024, according to the study. These transfers resulted in 33 live births.
