Uterine Transplantation: An Option beyond Surrogacy.

ABSTRACT

Over the years, a lot has developed in the field of infertility and artificial reproductive techniques worldwide, but the uterine factor infertility still remains an unresolved issue in reproductive medicine. Absolute uterine factor infertility is synonymous with congenital absence of uterus or a physiologically nonfunctioning uterus. Very few options including surrogacy and adoption are available for these patients. Both surrogacy and adoption are associated with legal, ethical, financial, religious, and psychological issues. For some of these patients, uterine transplant could be a viable option in future. However, the ability of uterus to carry the pregnancy to the period of viability and the effect of immunosuppressant on the fetus make the uterine transplant a more complex operation than any other transplants. From the earliest uterine transplant tried in 1931 in Germany to the first successful child birth following transplant in Sweden in 2014, uterine transplantation has come a long way. Among the countries that have tried this till now, Sweden has reported five cases of successful births posttransplant. Behind these successful cases, there is dedication and perseverance of few individuals who continued their efforts in spite of repeated failures. At the moment, the uterine transplant can be considered experimental at the best. However, considering the large number of hysterectomies done all over the world and uteruses available for transplantation, uterine transplant has potential to surpass, in numbers, the other transplant in near future.