Uterus transplantation: A clinical breakthrough after systematic preclinical research.

Abstract

Background: Uterus transplantation is a groundbreaking solution for absolute uterine factor infertility, offering women the potential for full biological motherhood. Since the first human trial in 2012 and the birth of the first baby in 2014, over 140 procedures have been performed globally, resulting in more than 70 live births.

Methods: This review synthesizes data from foundational animal research, patient eligibility criteria, and advancements in surgical techniques for uterus transplantation. It examines live and deceased donor grafts, the role of assisted reproductive technologies, and obstetrical outcomes.

Main findings: Animal studies have been pivotal in transitioning uterus transplantation into clinical practice. Surgical advancements, including robotic-assisted live donor hysterectomy, have improved precision. Protocols for in vitro fertilization have evolved, optimizing treatment before and after transplantation and reducing the time between transplantation and embryo transfer. Obstetrical outcomes show increased risks, such as hypertensive disorders and preterm births, underscoring the importance of thorough monitoring during pregnancy.

Conclusion: Despite its complexities, uterus transplantation represents a transformative advance in reproductive medicine. It provides a viable path to biological motherhood for women with uterine infertility and marks significant progress in both transplantation and fertility treatments, paving the way for further refinement and broader application.