Uterus Transplantation

Uterus TransplaNT for Uterine Factor InfertiLity (UNTIL) Trial

 

This trial is not accepting new applications. Please review the information below for information on our uterus transplant program.

 

Uterine transplantation is a major breakthrough in the field of fertility. The goal of a uterus transplant is to enable women with uterine factor infertility to carry a child.  14 children have been born around the world to women who have undergone uterus transplantation.  A uterine transplant is not for everyone and your physician may recommend other forms of treatment before deciding a uterus transplant is right for you. There is an extensive selection process and patients may remain in the study for 5-10 years after the transplant and pregnancies.

Frequently asked questions

Who is a candidate for a uterus transplant?


The UNTIL trial is focusing on performing uterus transplants on women diagnosed with uterine factor infertility (UFI). UFI is an irreversible form of female infertility that affects as many as 5% of women worldwide. A woman with UFI cannot carry a pregnancy. Either because she was born without a uterus, has had the uterus surgically removed, or has a uterus that does not function. In the UNTIL trial we will only be including patients who were born without a uterus or who had their uterus surgically removed. Gestational carriers (surrogates) and adoption are the only ways women with UFI can have children.




What are some general facts about uterus transplantation?


A successful Swedish research team paved the way for the UNTIL study. After years of uterus transplant research, the Swedish team was able to successfully transplant a uterus from a living donor into a woman with UFI. As of October 2016, 9 uterus transplants had been performed in Sweden resulting in live births in 6 of the 9 women who participated in the study. As of September 2017, eight babies have been born in Sweden following uterus transplantation. Penn Medicine is one of three centers in the United States offering uterus transplant through an experimental protocol to women with UFI. The UNTIL trial will use a donor uterus from a living or deceased donor for transplantation. A living donor is an individual who has completed her childbearing and is willing to donate her uterus to a woman with uterine factor infertility. Deceased donors are individuals who die from accidents, medical conditions or other events, and either they or their next of kin consent to donating their organs to individuals in need. Two children have been born in the United States following uterus transplantation at Baylor University medical Center in Texas. One child was born following uterus transplantation in Brazil. As of January 2019, 14 babies have been born following uterus transplantation.




How does the selection process work?


Candidates to receive a uterus transplant are women between the ages of 21 and 40 with UFI who live in or near the Philadelphia area (or are able to relocate to the area) for the duration of the study. Potential recipients will undergo an extensive evaluation by a team of physicians, psychologists, nurses and social workers – the evaluation is extensive since women will undergo multiple surgeries and in vitro fertilization (IVF) as part of this trial. Living donors will also undergo an extensive evaluation by a team of physicians, psychologists, nurses and social workers.




What happens before and during the procedure?


Removal of the uterus (hysterectomy) for transplantation from both a living and deceased donor takes approximately 6-10 hours. The expected recovery time in the hospital for living donors undergoing hysterectomy is 4-5 days. Some patients will be discharged from the hospital with a catheter in place that drains urine from the bladder and is removed at a subsequent clinic visit. The cost of the evaluation, surgery and hospitalization will be covered by the UNTIL research trial. However, as is the case with donation of other organs, individuals will not be compensated for donating their uterus. After the donor’s uterus is removed along with its blood vessels, the recipient surgery can begin. The recipient surgery also takes 6-10 hours. The uterus is transplanted into the woman’s pelvis. The donor’s blood vessels are connected to her blood vessels. The expected recovery time in the hospital after surgery is 7-10 days.




What happens after donating a uterus?


Full recovery following hysterectomy for the purpose of uterus transplant can take up to 6 weeks. We require living donors to stay in the Philadelphia area following hysterectomy to ensure healing occurs and any complications are successfully managed. Donors will be followed by phone for up to two years following hysterectomy.




Who is a candidate to donate a uterus?


A woman between the ages of 30 and 50 years who is in good health overall, has had children and has completed her child bearing is eligible to be a living uterus donor.




How do women who have undergone uterus transplant achieve pregnancy?


Following uterus transplant, women cannot become pregnant without assistance. Therefore, prior to receiving the uterus, embryos (the earliest stage of development for a baby) must be created through IVF. IVF requires stimulation of the woman’s ovaries to produce multiple eggs. This is followed by removal of the eggs and fertilization of the eggs with sperm in the IVF lab. Embryos that are created are frozen for later use. For more information on the IVF process, visit the Penn Fertility Care website.




What happens after receiving a uterus transplant?


Recipients will be administered anti-rejection drugs for as long as they retain the uterus. After transplant, the recipient will need frequent blood tests, ultrasounds and tissue sampling and clinical visits to monitor for signs of rejection, infection and complications. Once the uterus heals and is functioning, with no infections or rejection episodes that could not be treated, a single embryo is put back into the uterus. When a pregnancy is achieved, the pregnancy is monitored closely by a team of high-risk obstetricians and the recipient will continue to take anti-rejection medications for the duration of the pregnancy. These medications may have effects on the developing baby. The baby will be delivered via C-section (about 37 weeks) or earlier if needed for the health of the mother and/or baby. After the recipient has delivered 1 or 2 healthy babies the uterus is removed and anti-rejection mediations are stopped.





UNTIL in the news
Meet our Team

The UNTIL team is multidisciplinary team of physicians, nurses, and research investigators within University of Pennsylvania, including multiple divisions of the Department of Obstetrics & Gynecology as well as the Penn Transplant Institution.

oneill.jpg

Kathleen O'Neill, MD, MTR

Principal Investigator

latif.jpg

Nawar Latif, MD

Co-Investigator

schwartz.jpg

Lauren Schwartz, MD

Co-Investigator

sawinski.jpg

Deidre Sawinski, MD

Co-Investigator

lindawood.jpg

Linda Wood, BSN, RN

Living Donor Nurse Coordinator

zaho.png

Dan Zhao, Rn, MNHP

Research Nurse Coordinator

porrett.jpg

Paige Porrett, MD, PhD

Principal Investigator

wang.jpg

Eileen Wang, MD

Co-Investigator

Lindsay_Sortor_headshot.jpg

Lindsay Sortor, PsyD

Co-Investigator

veasey.jpg

Stephanie Veasey, CRNP

Post-transplant Nurse Practitioner

addis.png

Senayish Addis

Social Worker

© 2017 by Penn Medicine Women's Health Clinical Research Center

University of Pennsylvania, Philadelphia PA

(215) 662-7727