Japanese medical body conditionally approves uterus transplants

The Japanese Association of Medical Sciences said Wednesday it had conditionally approved uterus transplants to be performed in Japan on a clinical trial basis.

In a report compiled by the association’s review panel, it said such transplants will be limited to a small number of cases. The procedure involves transplanting the uterus of a living donor to a woman who lacks a uterus so that she can give birth.

Current organ transplant laws in Japan do not permit uterine transplants from deceased donors, so a donor is likely to be a family member of the patient.

A team at Keio University now plans to carry out a clinical trial of a uterine transplant. Under the procedure, egg retrieval will be performed on the patient in advance, fertilized in vitro, and then frozen for storage. The embryos will be later implanted inside the transplanted uterus.

There are believed to be around 60,000 women in their 20s or 30s in Japan who are either born with Mayer-Rokitansky-Kuester-Hauser syndrome, a condition that causes the uterus to be underdeveloped or absent, or who have lost their uterus as the result of cancer treatment and other causes.

While it is hoped uterine transplants will provide these women with a new option for having children, there are still many issues left to be resolved, including whether it is appropriate to perform a hysterectomy on a healthy woman, and the unknown side effects of immunosuppressive drugs, administered to suppress organ rejection, on a fetus.

In 2014, doctors in Sweden became the first to successfully deliver a baby from a transplanted human uterus. Since then, the procedure has been performed in 15 countries, including the United States, resulting in 37 successful births as of October 2020, according to Keio University. In most cases, the donor is the patient’s mother.

The association’s report stipulates that a uterus transplant can be performed in Japan on condition that the donor has voluntarily agreed to the donation, and both the donor and patient have been fully briefed on the process.