All About Uterus Transplants

If you were born without a uterus or have some other type of uterine factor infertility, it used to be true that you didn’t have a single option if you wanted to carry your own baby. Now, that’s no longer the case. Uterus transplants, while still rare, are slowly gaining in popularity as researchers and physicians work toward making them safer and more effective. Here, we’ll discuss what’s involved in a uterus transplant, where you can get one if you are a candidate, and how people feel about having a baby with a donated uterus. What’s Involved in a Uterus The post All About Uterus Transplants appeared first on The Pulse.

All About Uterus Transplants


If you were born without a uterus or have some other type of uterine factor infertility, it used to be true that you didn’t have a single option if you wanted to carry your own baby. Now, that’s no longer the case. Uterus transplants, while still rare, are slowly gaining in popularity as researchers and physicians work toward making them safer and more effective. Here, we’ll discuss what’s involved in a uterus transplant, where you can get one if you are a candidate, and how people feel about having a baby with a donated uterus.

What’s Involved in a Uterus Transplant?

 Women with genetic anomalies that mean that a uterus does not grow, who have had a hysterectomy, or who have a uterus that doesn’t function in a way that allows it to be able to safely grow a baby may be eligible for a uterus transplant. There are four sites in the United States where uterus transplants are available, largely as part of ongoing clinical trials, including Baylor University Medical Center in Texas, the University of Pennsylvania, the Cleveland Clinic, and the University of Alabama at Birmingham. There are also several programs around the world including in Sweden and Spain.

Each of these programs has extensive screening criteria to determine whether people qualify to move forward with transplantation. If you do qualify, you would first do an egg collection, so that embryos can be created with in vitro fertilization. Then you’d receive a uterus in a transplant operation, either from a living or deceased donor. It is therefore possible to donate your uterus either during life or after death if you meet the health-related criteria.

Once you receive the uterus and live with it for a while (usually about a year), an embryo will be transferred to your uterus. If your pregnancy is successful, your baby will be born via cesarean section. At some sites, you may have the option to try for a second child starting as early as six months after your baby is born, or you may have a hysterectomy shortly after your birth, during which the donated uterus is removed.

When you have any organ transplant, it’s necessary to stop your immune system—the part of your body that protects from invaders—from attacking the donor organ. It’s therefore necessary to take immune suppressant drugs from the time that you receive your donor uterus until it is removed after childbearing.

Despite the challenges of organ donation, transplantation, and subsequent pregnancy, there have been several babies born to mothers who received uterus transplants. In a particularly touching story from Penn Medicine News, two women—Chelsea and Cheryl—will be connected forever, as Chelsea received Cheryl’s uterus and then had a healthy baby boy, Telden. [1]

Why not surrogacy? 

In countries where it is legal to be a gestational carrier—that is, to grow and birth a baby for someone else—some people wonder why someone would choose uterine transplantation instead. The truth is that sometimes surrogacy doesn’t work out because it’s hard to find a surrogate or is prohibitively expensive. And sometimes, the biological desire to carry one’s own baby is just too strong. In a review article published in Transplantation in 2018, physician scientist Mats Brännström, who is the leader of the group doing uterus transplants in Sweden, and colleagues write that a survey from Japan suggests that uterine transplantation is preferable to gestational surrogacy for many people. [2]

In a study published in January 2021 in JAMA Network Open, researchers surveyed 182 transgender women and found that they overwhelmingly felt that vaginal and uterus transplant would improve their sexual experiences and quality of life. The majority of these women also desired children and would consider uterus transplant in order to carry them themselves. [3] The safety and feasibility of such a surgery has not yet been evaluated, but it may be possible in the future.

  1. Kluthe, “After Penn Medicine’s First Living Donor Uterus Transplant, Donor Meets Baby Carried in Her Transplanted Womb,” Penn Medicine News, 2021.
  2. Brännström et al., “Uterus Transplantation: A Rapidly Expanding Field,” Transplantation, 2018.
  3. P. Jones et al., “Perceptions and Motivations for Uterus Transplant in Transgender Women.” JAMA Network Open, 2021.

The post All About Uterus Transplants appeared first on The Pulse.

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The Future of Birth Control

You’ve heard of the pill, IUDs (intrauterine devices), and barrier methods like condoms, of course. But researchers are working on some exciting new options for birth control—some of which have already been approved by the U.S. Food and Drug Administration. Read on to learn more. Phexxi is a vaginal gel that you insert less than an hour before vaginal sex and lasts up to an hour. It works by lowering the pH of your vagina, which makes it hard for sperm to move and find an egg. In the phase 3 clinical trial to test Phexxi, which was published in The post The Future of Birth Control appeared first on The Pulse.

The Future of Birth Control


You’ve heard of the pill, IUDs (intrauterine devices), and barrier methods like condoms, of course. But researchers are working on some exciting new options for birth control—some of which have already been approved by the U.S. Food and Drug Administration. Read on to learn more.

Phexxi is a vaginal gel that you insert less than an hour before vaginal sex and lasts up to an hour. It works by lowering the pH of your vagina, which makes it hard for sperm to move and find an egg. In the phase 3 clinical trial to test Phexxi, which was published in 2020 in  the journal Contraception: X, researchers found that Phexxi was 86.3 percent effective at preventing pregnancy. [1] If used perfectly, it’s likely that the gel would be even more successful. A few great things about Phexxi are that it is not hormonal and that you don’t have to remember to take it every day like a pill—you just have to use it right before sex. It comes in a pack of twelve doses and is available by prescription from your doctor or nurse practitioner.

One birth control method that is still under development is a non-hormonal male pill. In a study published in Nature Communications in February 2021, Wei Yan, a physician and researcher affiliated with UCLA and the University of Nevada, Reno, and colleagues showed that a chemical isolated from an herb used in traditional Chinese medicine could be a promising male contraceptive. [2]

The researchers gave the chemical, which they named triptonide, to male mice and monkeys. They found that triptonide gave the mice deformed sperm that did not swim as well as typical sperm after just four weeks of taking it. In addition to being deformed and bad at swimming, these sperm were not capable of fertilizing an egg, either naturally or via in vitro fertilization, suggesting that taking triptonide induces sterility. Importantly, this sterility was reversible. When the mice stopped taking the drug, their sperm recovered within months.

Yan and colleagues also tested the drug in monkeys for nearly two and a half years. They found that triptonide had a similar effect on monkey sperm, causing deformation and defects in swimming, that were reversible. After the monkeys had taken the drug for years, they were able to then father children. Importantly, the monkeys had no obvious side effects over the more than two-year period that they took the triptonide. Because this strategy has so far only been tested in animals, the next steps will be to examine safety and efficacy in people.

Another birth control method that is currently still in early stages of development is an antibody that binds and immobilizes sperm. Antibodies are a natural part of our immune system, the system of the body responsible for fighting invaders, such as viruses and bacteria, that cause diseases. Researchers at the University of North Carolina at Chapel Hill showed in a paper published in August 2021 that they could immobilize sperm in the reproductive tract of female animals using an antibody, which they engineered.

The antibody is designed to stick part of sperm cells. Once the antibodies glom on to the sperm, the sperm clump together, rendering them ineffective at swimming and thus finding an egg to fertilize. The authors of the antibody paper have formed a company through which they hope to commercialize the technology, so that it can be used widely, perhaps as a special vaginal film with tons of these sperm binding antibodies stuck to it. The idea is that you could just insert this film before having sex and then it will make it very hard for you to get pregnant.

While some of these methods might seem like a pipe dream, the call for innovative and exciting new ways to prevent pregnancy is only getting louder. We can only hope that the scientists working in this area answer that call sooner rather than later.

  1. A. Thomas et al., “A novel vaginal pH regulator: results from the phase 3 AMPOWER contraception clinical trial,” Contraception: X, 2020.
  2. Chang et al., “Triptonide is a reversible non-hormonal male contraceptive agent in mice and non-human primates.” Nature Communications, 2021.
  3. Shrestha et al., “Engineering sperm-binding IgG antibodies for the development of an effective nonhormonal female contraception,” Science Translational Medicine, 2021.

The post The Future of Birth Control appeared first on The Pulse.

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