What is Uterus (Womb) Transplantation?

Uterus transplantation is a special organ transplant procedure applied to women who are born without a uterus or who have lost their uterus due to surgery, cancer, trauma, or other medical reasons. The aim of this procedure is to give the person a chance to carry a pregnancy. Uterus transplantation is especially considered in a condition called absolute uterine factor infertility.

In this operation, the uterus taken from a living or deceased donor is surgically transplanted to the recipient. Unlike other organ transplants, uterus transplantation is not life-saving; it is a fertility-restoring transplant. Therefore, the process is evaluated not only by surgical success but also together with pregnancy, birth, immunosuppressive treatment, and long-term follow-up.

Who Can Receive Uterus Transplantation?

Uterus transplantation may be considered in women who are born without a uterus, have uterine development disorders, or have lost their uterus for medical reasons. In conditions such as MRKH syndrome, the person may have ovaries but cannot carry a pregnancy because there is no uterus. Uterus transplantation may be an advanced treatment option that makes pregnancy possible for this group of patients.

However, uterus transplantation is not suitable for every patient. The candidate’s general health status, ovarian function, ability to carry pregnancy, immune system, chronic diseases, psychological condition, and surgical risks are evaluated in detail. The process is also planned together with IVF treatment, embryo preparation, and pregnancy follow-up.

How Is Uterus Transplant Surgery Performed?

Uterus transplantation is a long and complex surgical operation requiring a multidisciplinary team. The uterus taken from the donor is removed together with its vascular structures and transplanted to the recipient using microsurgical techniques. Ensuring blood flow to the uterus is one of the most critical stages of the surgery.

After transplantation, the recipient is followed regularly. Immunosuppressive medications are used to prevent organ rejection. Uterine function, blood flow, infection risk, and possible complications are closely monitored. Pregnancy planning may be done with IVF after the uterus heals and doctors consider it appropriate.

What Are The Risks Of Uterus Transplantation?

Uterus transplantation is a procedure that carries serious surgical and medical risks. These risks may continue not only during surgery but also during the long follow-up period and possible pregnancy process. Therefore, the decision for uterus transplantation should be evaluated from all aspects by the patient and specialist team.

Main risks that may be seen in uterus transplantation include:

• Bleeding
• Infection
• Vascular blockage
• Organ rejection
• Side effects related to immunosuppressive medications
• Medication effects on the kidneys, liver, or bone marrow
• Miscarriage risk during pregnancy
• Preterm birth risk
• Pregnancy complications such as preeclampsia
• Psychological stress and anxiety

Pregnancies after uterus transplantation are considered high-risk. Therefore, pregnancy should be followed jointly by obstetrics and gynecology, perinatology, transplantation, and other relevant specialties.

How Does The Process Continue After Uterus Transplantation?

The first period after uterus transplantation involves close hospital follow-up. Uterine blood flow, signs of organ rejection, infection symptoms, and the effects of the medications used are evaluated regularly. Blood tests, imaging methods, and clinical controls may be performed during this process.

Pregnancy is not planned immediately. First, whether the transplanted uterus is functional, whether the body accepts the uterus, and whether the patient’s general condition is suitable for pregnancy are evaluated. The pregnancy plan is usually created through IVF because the fallopian tubes may not be connected to the uterus in a way that enables natural pregnancy during transplantation.

Is It Possible To Become A Mother With Uterus Transplantation?

Pregnancy and birth are possible after uterus transplantation. Live birth cases after uterus transplantation have been reported around the world and in Turkey. However, this process is different from a standard pregnancy and is followed as a high-risk pregnancy.

During pregnancy after uterus transplantation, preterm birth, miscarriage, pregnancy hypertension, organ rejection, and medication-related risks are monitored more carefully. Birth is generally planned by cesarean section. After the person has children, removal of the transplanted uterus may be considered in some centers; this may reduce the need for long-term immunosuppressive medication.

Turkey’s Leading Role In Uterus Transplantation

Turkey is one of the countries that has attracted attention worldwide in the field of uterus transplantation. The operation performed at Akdeniz University by Prof. Dr. Ömer Özkan and his team has gained an important place in uterus transplantation literature. This successful initiative in Turkey opened the door to a new scientific era in fertility.

The case of Derya Sert has taken its place in medical history as one of the first successful uterus transplantation cases in the world. Achieving pregnancy and birth after this operation showed that uterus transplantation is not only a surgical success but also a comprehensive treatment requiring long-term follow-up and multidisciplinary management.

What Is The Özkan Technique?

The Özkan Technique is one of the surgical approaches introduced to the literature through the experience of Prof. Dr. Ömer Özkan and his team in the field of uterus transplantation. This technique is considered important for preserving the vascular structures of the uterus, ensuring blood flow during transplantation, and increasing surgical safety.

In advanced surgeries such as uterus transplantation, success does not depend only on transplanting the organ. Vascular connections, organ blood flow, medication management, pregnancy planning, and early detection of complications determine the entire process. Therefore, Turkey’s experience in this field has attracted attention in international medical literature.

The Psychological Process In Uterus Transplantation

Uterus transplantation is a physically and psychologically challenging process. The person may face many uncertainties such as surgery, organ rejection, pregnancy possibility, fear of failure, and long-term medication use. Therefore, candidates should also be prepared psychologically.

Psychological support may help the patient adapt to the process in a healthier way. Especially during long treatment periods, emotions such as anxiety, stress, hope, and disappointment may be experienced together. Specialist support during this process is an important protective factor for the patient and family.

What Does The Future Of Uterus Transplantation Promise?

Uterus transplantation is a promising but carefully managed advanced treatment option in the field of fertility. With the development of surgical techniques, improvement of immunosuppressive medication protocols, and increasing pregnancy follow-up experience, success rates in this field are expected to improve further.

However, uterus transplantation is still not a suitable method for every patient. Candidate selection, ethical evaluation, surgical risks, pregnancy risks, and long-term outcomes should be carefully examined. Therefore, people considering uterus transplantation should definitely receive information from experienced centers and specialist teams in this field.

Obstetrics And Gynecology Support With Happ Health

Uterus transplantation is a subject that requires advanced evaluation in terms of fertility, pregnancy planning, and women’s health. It is important for people who want information about uterine development disorders, uterine loss, inability to carry pregnancy, IVF process, or fertility options to consult a specialist.

As a digital health platform, Happ Health makes access to obstetrics and gynecology specialists easier from home or remotely. You can create a more informed roadmap by receiving support from an obstetrics and gynecology specialist for your questions about fertility, uterine health, pregnancy planning, and women’s health.

References

• American Society For Reproductive Medicine - ASRM Position Statement On Uterus Transplantation
  https://www.asrm.org/practice-guidance/practice-committee-documents/asrm-position-statement-on-uterus-transplantation-a-committee-opinion-2018/
• Cleveland Clinic - Uterus Transplant: Purpose, Procedure, Recovery And Risks
  https://my.clevelandclinic.org/health/procedures/uterus-transplant
• Journal Of Clinical Medicine - The Ozkan Technique In Current Use In Uterus Transplantation
  https://www.mdpi.com/2077-0383/12/8/2812
• PubMed - Immunosuppression In Uterus Transplantation: Experience From The Dallas Uterus Transplant Study
  https://pubmed.ncbi.nlm.nih.gov/36445981/
• PMC - Uterine Transplantation And IVF For Congenital Or Acquired Uterine Factor Infertility
  https://pmc.ncbi.nlm.nih.gov/articles/PMC7190173/
• Anadolu Ajansı - Turkey: World’s First Uterus Recipient Gives Birth
  https://www.aa.com.tr/en/health/turkey-worlds-first-uterus-recipient-gives-birth/1891233