Uterine
transplantation is developed as a possible future treatment for patients with absolute uterus factor
infertility. Patients with the Mayer-Rokitansky-Kuster-Hauser (
MRKH) syndrome, patients having had
hysterectomy for benign or malignant
uterine/cervical diseases and patients with intrauterine adhesions are the major groups of patients, who could benefit from this procedure. There has been one attempt to transplant a human uterus, which however failed. Since then, several uterine
transplantation animal models have been developed to examine various aspects of the uterus
transplantation procedure and to optimize it for human use. In a mouse model, normal pregnancy rate and offspring were seen after syngeneic uterus
transplantation. The tolerance for cold ischemia from the time the uterus is taken out from the donor until placed in the recipient is around 24 h, as shown in a mouse uterine
transplantation model and on human uterine tissue. The rejection pattern of the transplanted uterus was tested in an allogeneic mouse model with signs of rejection after 5 to 10 days. High doses of
cyclosporin A (CyA) could partly suppress rejection but pregnancies have not yet been achieved in allogeneic uterus transplants in any species. In the sheep and pig models, the vascular anastomosis technique and the tolerability to cold ischemia have been evaluated. Normal offspring have been delivered in the sheep model after
autotransplantation and presently allogeneic uterine transplants in sheep treated with
corticosteroids and CyA are tested. Initial studies on uterus
transplantation is also now conducted in primates. It is predicted that uterus
transplantation may reach a clinical stage within 2-3 years, in the event of a continuous high research activity within this field.