Category: Pre- and Post-Natal

Female infertility is a sensitive issue that affects approximately 48 million women worldwide.  Several factors affects fertility, including genetic factors and various acquired factors (ex. infections, eating disorders, and chemotherapy).  Uterine malformations or fibroids may also interfere with pregnancy.  On rare occasion (approximately 1/ 4,500), women may even be born without a uterus, something which certainly interferes with fertility.
Fortunately, recent research in Sweden by Dr. Mats Brannstrom, Professor of Obstetrics and Gynecology at University of Gothenburg in Sweden resulted in the first successful pregnancy and delivery after uterine transplant (September 2014).  The transplant involved detachment of the womb from the donor, and then a different team of surgeons delicately inserted the uterus and its respective blood vessels into the recipient, a woman who had born without a uterus.

This procedure has not yet been successfully performed in the United States.  Opponents of the surgery claim that this elective surgery, which is not a lifesaving procedure (such as a heart or lung transplant), places both uterine donor and recipient at risk.  Furthermore, as with any organ transplant recipient, the woman is required to take immunosuppressive medication for the duration of the foreign organ remaining in her body.  Therefore, the plan for this surgery is for the uterus to be removed after the woman delivers the amount of desired children in order to allow her to terminate immunosuppressive medication.  However, as the procedure becomes refined and perfected, it will probably become more accepted within the medical community due to the potential benefits.

Furthermore, Brannstrom predicts that within five to ten years, additional medical advances may obviate the need for a uterine donor altogether- namely, that doctors will be able to create a uterus from the woman’s very own cells.  An additional benefit of this type of procedure is that the recipient will not need immunosuppressive medication AT ALL, and there is a decreased risk of organ rejection.  For Brannstrom, the possibilities are endless.  May he have continued success with all his amazing endeavors in order to bring babies and joy into the world.

The placenta is a fascinating and versatile organ which connects fetus to mother during the forty weeks of pregnancy.  It is a temporary organ which brings oxygen and nutrients to the fetus during pregnancy and allows for removal of waste and other toxic substances.  It is the “elastic clause” of organs, so to speak, due to the fact that it serves as many organs for the price of one!  The placenta acts as the kidneys, the liver, the lungs, the endocrine system, the gastrointestinal system, and the immune system.  The hormones produced by the placenta promote fetal development and maintenance of the pregnancy.  In addition, the placenta protects the fetus from the immune system of the mother (which perceives the fetus as a foreign object).  If we women thought that we were good at multitasking, be even more impressed with your placenta’s ability to do so!
 

The health of the placenta plays a large role in the health of the developing fetus.  Medical problems such as preeclampsia, gestational diabetes, stillbirth, and premature labor and deliver may occur when placental problems exist.  In addition, lifelong health of both mother and child are influenced by the placenta.  To date, not much is known regarding what actually constitutes a “normal placenta” and how it actually functions.  According to Dr. Diana Bianchi (Executive Director, Mother Infant Research Institute, Tufts Medical Center), the placenta is “the Rodney Dangerfield of organs.  It doesn’t get respect. It gets thrown out at the end of pregnancy.”  The only research that we have involves studying the placenta AFTER delivery, as opposed to during pregnancy itself.

Fortunately, the National Institute of Health (NIH) has initiated the Human Placenta Project, a $41.5 million project which has multiple goals.  Several of these goals include developing improved technology to analyze placental development during pregnancy and the creation of non-invasive methods to predict poor pregnancy outcomes.  Furthermore, the project is aimed at better understanding the connection between placental health with long term maternal and fetal health, and researchers seek to develop interventions in the case of poor predicted placental and fetal outcomes.   Hopefully, these research objectives will be achieved in order to improve maternal and fetal outcomes.

For more information on the Human Placenta Project, please watch the following short YouTube video from the NIH: http://youtu.be/MGhGkMM9-B0.