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What is a uterus transplant?

Uterine transplantation is a multi-step process that requires coordination among numerous physicians. Upon encountering a suitable candidate and donor, doctors must act quickly to remove the uterus and transport it to the patient. The patient must then undergo an operation implanting the new uterus into her body.

Who is a candidate?

Women who have irreversible infertility are the primary candidates to receive a transplant. Infertility, in general, affects about 15% of couples of reproductive age. Within this group about one in 500 women have irreversible infertility -- which can be due to a congenital malformation, cancer, or other illness, leading to genetic absence or removal of the uterus.

In the case announced on Tuesday, the mother is a 32-year-old female who had congenital infertility. She has a disease called Mayer-Rokitansky-Kuster-Hauser Syndrome, commonly known as congenital uterine absence. It's a rare genetic condition, affecting about 4500 women worldwide, in which they are born without a uterus.

Who are the donors?

In this study, recently deceased women who had given consent for organ transplant were screened based on previous ability to give birth, blood type, and a lack of any history of sexual disease.

What are the risks?

The major risks associated with this process are organ rejection through blood type mismatch, inadequate immune system suppression or severe infection of the transplanted organ.

In this trial, the mother was given standard doses of immune suppression medications for almost six months, with positive results, before implantation of the embryo was completed. Normal prenatal testing including blood sugar tests and ultrasounds were all done and returned without any abnormalities.

\"PHOTO:
Dr. Wellington Andraus/AP
PHOTO: Dr. Wellington Andraus, left with magnifying glasses, and Dr. Dani Ejzenberg, second left, confer with colleagues at the Hospital das Clinicas of the University of Sao Paulo School of Medicine.
>

Is a uterus transplant permanent?

No. In order to keep the uterus after birth, the mother would have to continue taking immune system suppression medications which can pose risks. In this case, a cesarean section was performed for birth at 35 weeks gestation, and along with the delivery of an almost 6 pound healthy baby girl, the uterus was also removed.

The authors of the study acknowledge that, as a new medical procedure, there is much further work to be done to make the procedure safer and more efficient.

However this advance serves as motivation to expand prospects for a novel technique in giving some women a chance at childbirth by greatly enlarging the potential donor population.

Sumir Shah, M.D. is an emergency medicine physician in New York City, and a member of the ABC News Medical Unit.

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