Uterus Transplant

You must be of child-bearing age.

It is important to maintain a healthy lifestyle while preparing for transplant and pregnancy. You should be at a healthy weight, with a body mass index (BMI) of 30 or below to proceed with a uterus transplant.

No, but there are specific times you will be required to stay in Dallas, including:

• Evaluation appointments
• Transplant surgery and several weeks after surgery
• Additional times specific to each uterus transplant recipient, as determined by your transplant team

A living donor is usually the quickest way to receive a transplant. We will screen any potential donors who come forward on your behalf.

We also can match you with a non-directed donor or deceased donor.

• Complete the online questionnaire. This initial screening is used to determine if you are a potential candidate for the procedure
• Once approved for evaluation, a financial deposit is required
• Evaluation happens at the Baylor University Medical Center transplant clinic in Dallas, TX. The series of appointments typically take two days
• If you do not already have embryos, you will see a fertility doctor who will retrieve eggs and sperm to create embryos. This can be done at a clinic of your choice in Dallas
• After in vitro fertilization (IVF), you will be matched with either a living or deceased donor
• You then will have the uterus transplant surgery. Recovery takes about three months
• After you recover from the transplant surgery, the embryo transfer occurs, which hopefully, results in a successful pregnancy
• During the first pregnancy, a potential second pregnancy can be discussed
• Delivery of your baby will be by caesarean section. The uterus is removed after the birth of your first or second child

The uterus transplant surgery usually takes four to six hours

Yes, you may return to work after surgery restrictions are lifted. However, you will have many appointments throughout the process of uterus transplant and pregnancy that will require you to miss work.

After uterus transplant surgery, patients are seen in clinic every two to four weeks for gynecological exams, labs to monitor your health and immunosuppressive therapy, and biopsies.

Getting a menstrual period means the transplanted uterus is functioning. Most recipients get a menstrual period within four to six weeks after transplant. Periods usually occur monthly until pregnancy.

No. During surgery, the uterus is transplanted with the cervix but not the fallopian tubes. You cannot get pregnant naturally without fallopian tubes, as they act as a bridge between the ovaries and the uterus.

No. Uterus transplant is a temporary transplant to allow for one or two pregnancies. The transplanted uterus is removed after the first or second pregnancy is complete. Once the transplanted uterus is removed, you will stop taking immunosuppressive medications.

After the transplant, recipients recover for about three months. Typically, embryo transfer is done three to six months after the transplant surgery.

Yes. Due to the organ transplant and the immunosuppressive medications you must take, it is considered a high-risk pregnancy. You will be followed by a maternal fetal medicine doctor and a high-risk obstetrician to monitor the health of you and the baby.

At this time, babies from uterus transplant are delivered by caesarean section for the safety of both mother and baby.

At this time, we follow the American Society of Reproductive Medicine’s recommendation to do single embryo transfer to decrease the risks associated with twins.

Yes. With the guidance of your physician team, the transplanted uterus is either removed after delivery of the first child or retained to try for a second pregnancy.

Uterus transplantation is not covered by insurance, but several components of the process may be covered. For example, your insurance may cover some costs related to in vitro fertilization (IVF) and/or delivery of the baby.

Uterus transplant is offered as a private pay service. The special package pricing amount is based on an estimate of the hospital charges and certain physician charges for uterus transplant-related services. A transplant team financial representative will discuss the requirements with you.

The cost of the uterus transplant is paid in multiple payments:

• An initial payment is due prior to starting the uterus transplant evaluation
• A second payment is due in full within six months of medical approval for transplant and prior to transplant surgery
• A third payment is required if the recipient is approved for a second pregnancy and delivery

• Donor evaluation, donor hospitalization for hysterectomy, and care for donor hysterectomy-related complications
• Recipient pre-transplant evaluation, transplant hospitalization, immunosuppression therapy, and post-transplant follow-up care, including removal of the transplanted uterus after delivery
• Potential for two deliveries, including prenatal care and medical management of complications of pregnancies and deliveries

• In vitro fertilization (IVF) and all other services related to becoming pregnant. All physician, hospital and other charges for these services, whether elective or medically necessary, are your financial responsibility
• Newborn follow-up and all pediatric care after delivery. All physician, hospital and other charges for these services, whether elective or medically necessary, are your financial responsibility
• All other medical care, whether elective or medically necessary, that is not in the list of included services are your financial responsibility

For all services that are excluded from the deposit, you will need to make all payment arrangements directly with the physician, hospital or other healthcare provider that you choose to provide the excluded service

Payment can be made by check, bank wire transfer, and/or credit card.

The approximate cost of IVF is $15,000 to $20,000.

For any services covered by the special package pricing, you must use specific physicians selected by the uterus transplant team.

Many of these physicians were involved in the uterus transplant clinical trial and have experience with this innovative treatment. These physicians have a contract with the hospital so that they can be paid from your payment.

The potential uterus donor will have a thorough medical and psychosocial evaluation to determine if she is healthy and if there are any risks related to the surgery, anesthesia and/or donation that may impact the donor’s health in the future.

Uterus donation is a scheduled surgery. The uterus is removed from the donor in a procedure called a hysterectomy. In addition to removing the uterus, the surgeon also removes the vessels that supply blood to the uterus, the fallopian tubes, cervix and vaginal cuff. On average, the surgery lasts about eight hours. The most common ways to perform this hysterectomy are:

• Robotic hysterectomy – a minimally invasive procedure to remove the uterus laparoscopically through five smaller incisions
• Open hysterectomy – an open surgery to remove the uterus through an incision that is vertical from belly button to pubic hairline

As with any surgery, the risks include adverse reaction to anesthesia, bleeding, blood clots and infection. Your surgeon will discuss risks of surgery with you.

Most uterus donors state they “feel recovered” two to four weeks after donation.

Uterus donors are restricted from heavy lifting and should refrain from intercourse for three months after donation.

During surgery, the donor is under general anesthesia. While under anesthesia, a nerve block is used to reduce incisional pain. Oral pain medication is also prescribed.

Uterus donors stay in the hospital an average of five days. Before discharge the patient should be up walking, eating and drinking, having a bowel movement and urinating after the catheter in her bladder is removed.

Donors are seen in the transplant clinic 10 to 14 days after surgery. After that, donors are seen in the transplant clinic at three months, six months, one year and two years after surgery.

• Medical expenses are the costs of the hospital and physician services for the donor evaluation, donation surgery and routine follow-up visits. These medical expenses are covered by the recipient. A donor should not have costs associated with these services or complications from the hysterectomy.
• Non-medical expenses are out-of-pocket costs for travel and lodging, parking, meals, lost wages from work, child care costs, caregiver expenses, etc. Organizations such as the National Living Donor Assistance Center may be able to assist a donor with non-medical expenses.

Uterus donors are required to have health insurance so that they have access to care in case of non-donor-related health issues after donation.

It is illegal for a living donor to be compensated or paid directly or indirectly by the recipient, recipient family or any other party.