Curiosities About Uterus Transplantation

Curiosities About Uterus Transplantation

Congenital infertility in women (of an attached uterus) is called uterine factor infertility. They are in the womb until fertilization is complete, with the chance of meeting in what will be bred in the ovaries. Operations without this advanced uterus or related to any health problem will not be the ones to be learned from the uterus. Although this is the only case of uterine transplantation, this is an area that has been discussed at length, can be interpreted through interpretation, and is subject to ethical interpretation. With the numerous uterine transplant surgeries performed around the world, little can be grown in a healthy way. In the design of education as well as education, the first choice in transportation is made to the lap in the first days of 2011, the first days of pregnancy.

What is Uterus Transplantation and When Was It First Performed?

The uterus (uterus) is the organ between the fallopian tubes extending from the ovaries and the vagina in women, and in the case of pregnancy, the baby clings to and continues its development until birth. Uterine transplantation is a type of organ transplantation performed in the form of transplanting a uterus taken from a living donor or cadaver to a woman who does not have a uterus or cannot function for any reason. In the past years, uterine factor infertility was one of the biggest and unsolved infertility reasons against the rapid steps taken in the field of infertility treatment. While the only solution for women with this problem is surrogacy, this treatment has not been adopted in many countries, including our country, especially due to the social and cultural structure. With the advancing medical technologies and important steps taken in the field of organ transplantation, the idea of ​​uterus transplantation emerged and concrete studies were started in this field towards the 2000s. The first uterus transplant was performed in Saudi Arabia in 2000 by transplanting a uterus from a 46-year-old premenopausal female donor to a young woman whose uterus was removed due to postpartum hemorrhage, to a living donor recipient. Since the organ transplant operation was successful, the transplanted uterus had to be removed due to the clot formed a few months after the operation, so the first transplant was unsuccessful. The next uterus transplant was performed in our country in 2011. Uterus taken from a 22-year-old cadaver was transplanted into a 21-year-old woman who had no congenital uterus due to MRKH (Mayer Rokitansky Kuster Hauser) Syndrome. Transplantation was successful, several pregnancies were achieved, but these pregnancies were terminated because the gestational sac did not grow. As a result of years of research and follow-up, the patient, who became pregnant again in 2020, gave birth in a healthy way. In this process, in 2013, 9 women in Switzerland had a uterus transplant from living donors, most of whom were related to the recipient. In 5 of the other patients, a healthy progressing pregnancy was achieved and delivery took place as a result.

How is Uterus Transplant done?

Uterine transplant; It can be performed in two different ways, just as in organ transplants such as kidney and liver. The first of these is carried out in the form of transplanting the uterus from a living donor to the recipient, while the second is carried out in the form of transplanting the uterus from a cadaver, an organ donor. In addition to these two methods, one of the possible future uterine transplantation applications is the transplantation of the uterus, which was created in a laboratory environment using stem cells, to the patient. It is predicted that with the help of organ development methods, which have been extensively researched in the field of bioengineering and which have been the subject of many studies, uterus transplantation can be performed together with many organ transplantations in the future. Uterine transplantation performed in our country was made from cadavers. In organ transplants performed in Switzerland, the uterus from a living donor was used. During the transplant operation, basically, the uterus is taken from a cadaver or a living donor with different techniques, and then transferred to the recipient as a result of some surgical interventions related to the joining of the vessels (anastomosis) and the preservation of the vascular structures of the neighboring organs. After the operation is completed successfully and adequate blood flow is provided to the organ, an intensive immunosuppressive (immunosuppressive) treatment process is initiated, as in all other organ transplants, so that the body does not reject the organ. Immunosuppressive therapy usually has to continue as long as the transplanted organ remains in the recipient’s body. After a period of successfully completed transplants, the menstrual cycle begins in people who do not have any different hormonal or gynecological problems. In addition, studies are started to achieve pregnancy through embryo transfer. The number of uterine transplant cases performed worldwide is still very low. After successful transplants, there is a high probability of problems related to the formation or natural continuation of pregnancy. Although studies in this area are still being carried out intensively, the factors affecting pregnancy after uterine transplantation are not yet fully known.

What Are the Risks of Uterus Transplantation?

Uterine transplant risks are one of the most curious issues of people who plan to apply for this operation in the future. As with all organ transplants, some risks can be mentioned in uterus transplant. These risks can be examined in two different areas as the risks that may occur for the recipient and the risks for the donor in case of transplantation from a living donor. Among the risks for the buyer,

  • Rejection of the transplanted organ by the body and having to be re-operated,
  • Complications such as bleeding and infection due to surgical operation,
  • Problems related to immunosuppressive therapy,
  • Possibility of not achieving pregnancy despite uterine transplantation,
  • Some possible risks, such as complications that may occur in the baby due to immunosuppressive therapy, can be mentioned in women who become pregnant after transplantation.

Despite these risks for the recipient, uterus transplantation also carries certain risks for living donors. Compared to other organ transplants, uterus transplant requires more surgical intervention in the donor’s abdomen. In this respect, the risks of the surgery are higher for the donor than for the recipient. Therefore, the success and experience of the surgeon is of great importance in uterine transplants from a living donor. Although cadaveric transplants seem to be a higher priority because they do not pose such risks for the donor, the success rate in these operations is lower than that of living donors. Among the benefits of uterine transplantation for the recipient are increased psychological well-being and quality of life. Uterine transplantation, which is still a new treatment application and has very limited examples around the world, needs various regulations in the medical field in order to become widespread. In particular, since the uterus, as an organ, is only necessary for fertility, there is no life threat in its absence, so uterus transplantation has led to many ethical debates around the world. Since organ transplant laws also cover cadaver heart, pancreas, liver, lung, kidneys and small intestines, new legal regulations are needed for cadaver transplants.

If you also want to have a child but cannot conceive naturally, you can apply to health institutions and have your gynecological and urological examinations done. You can get information about infertility treatment methods in line with your doctor’s recommendations, and you can start your treatment process if the appropriate conditions are met.

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