BIRMINGHAM– Many women and families spend their early reproductive years thinking and planning when to have children, so when they have trouble getting pregnant, it can be both unexpected and …
BIRMINGHAM– Many women and families spend their early reproductive years thinking and planning when to have children, so when they have trouble getting pregnant, it can be both unexpected and upsetting. Infertility can take many forms, but for those with uterine factor infertility, a new potential avenue for having a child is available through the University of Alabama at Birmingham.
In October 2020, amid a global pandemic, the UAB Comprehensive Transplant Institute launched the Southeast's first uterus transplant program — only the fourth of its kind in the United States. Led by Paige Porrett, M.D., Ph.D., associate professor of surgery in the UAB Division of Transplantation, the program provides women who have uterine factor infertility with the only option to become pregnant and bear a biological child without the use of a gestational carrier or surrogate.
Uterine factor infertility may affect as many as 5 percent of reproductive-age women worldwide and was a previously irreversible form of female infertility. A woman with UFI cannot carry a pregnancy to term because she either was born without a uterus, has had the uterus surgically removed during a hysterectomy or has a uterus in place that does not function properly. Congenital absence of the uterus is a condition called Mayer-Rokitansky-Küster-Hauser syndrome, which affects approximately one out of every 4,500 females and makes it impossible for a woman to get pregnant.
Most uterus transplants performed to date in the world have been in women with MRKH syndrome. However, women who have undergone a hysterectomy and had the uterus removed surgically are also potential candidates for uterus transplantation.
In 2022, UAB performed its first uterus transplant, and the patient — who prefers to remain anonymous — is faring well as she awaits the next steps of embryo transfer.
A network of support
Communities, whether in-person or virtual, create a network of support for those experiencing uterine factor infertility. Deidre Gunn, M.D., assistant professor with the UAB Division of Reproductive Endocrinology and Infertility, says having adequate support systems in place can be important for anyone going through infertility treatment but says it is not something that is talked much about.
"Infertility can be a really difficult journey — medically and emotionally," Gunn said. "Having people who can support you — not just family, but friends — and being able to connect with others who have gone through a similar journey are important. A lot of social media groups online are great ways to connect and support."
Journey of hope
While the road ahead for these patients is long and fraught with hurdles to overcome, Porrett is optimistic for her patients.
"Uterus transplant brings so much hope to patients with UFI," Porrett said. "This hope extends even to women who are not candidates for transplant, as the mere existence of this transplant opportunity brings treatment to a community suffering from a devastating and previously refractory disease. There are many key celebratory milestones ahead for patients who enroll in the program, from embryo generation to successful transplantation, to pregnancy, and our team is prepared to guide our patients through the process, every step of the way."
One of those patients is Elizabeth Goldman from Mobile, Alabama.
Diagnosed with MRKH at age 14, Goldman says the devastating diagnosis stripped away a future she had dreamed about — having a child — but after receiving a uterus transplant at UAB in April 2022, she has new hope that she will one day be able to become pregnant.
"Until I shared my story, I felt like I was the only one that had this [MRKH]; but with that support and my cheerleaders walking alongside me, it just feels different," Goldman said. "This whole process has given me a hope that wasn't there before my uterus transplant journey."
Now 11 weeks post-transplant, Goldman is hopeful to begin embryo transfer in a few short months.