Uterine Transplantation (Scientific Impact Paper No. 65)
The purpose of this Scientific Impact Paper is to summarise the pertinent published literature on uterine transplantation (UTx) and to propose a framework for establishing a sustainable UTx programme in the UK. Potential recipients and donors are discussed, as well as the surgical, immunological, fertility, obstetric, psychological and ethical considerations associated with this procedure.
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This Scientific Impact Paper was developed prior to the emergence of the COVID-19 coronavirus. Please note that the information provided in this paper will be considered for update 3 years after publication, with an intermediate assessment of the need to update 2 years after publication.
This is the first edition of this paper.
Plain language summary
A uterine transplant, or womb transplant, provides a potential treatment for women who cannot become pregnant or carry a pregnancy because they do not have a womb, or have a womb that is unable to maintain a pregnancy. This is estimated to affect one in 500 women.
A womb transplant is undertaken when the woman is ready to start a family, and is removed following the completion of their family.
Womb transplants have been performed all over the world, with more than 70 procedures carried out so far. At least 23 babies have been born as a result, demonstrating that womb transplants can work.
While the procedure offers a different option to adoption and surrogacy, it is associated with significant risks, including multiple major surgeries and the need to take medications that help to dampen the immune system to prevent rejection of the womb.
Although the number of transplants to date is still relatively small, the number being performed globally is growing, providing an opportunity to learn from the experience gained so far.
This paper draws on these experiences to propose a framework for the future, while acknowledging that long-term follow-up of cases will be essential to draw reliable conclusions about any overall benefits of this procedure.
Declaration of interests (guideline developers)
Mr BP Jones MRCOG, London: None declared.
Mr S Saso MRCOG, London: None declared.
Mr JM Yazbek MRCOG, London: None declared.
Dr M-Y Thum MRCOG, London: None declared.
Miss I Quiroga FRCS, The Oxford Transplant Centre, Oxford University Hospitals NHS Trust: None declared.
Dr S Ghaem-Maghami MRCOG, London: None declared.
Mr JR Smith FRCOG, London: Chair of Womb Transplant UK.
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