Advancing Uterus Transplantation and Bioengineered Uterus: Current and Future Approaches to Treating Uterine Factor Infertility

BACKGROUND Infertility affects 15% of couples. By introduction of IVF and ICSI in 1980-90s most types of infertility could be treated. Absolute uterine factor infertility (AUFI) remained the only major untreatable female infertility group.

Women with AUFI either lack a uterus or have a uterus that precludes the possibility of a pregnancy or its maintenance to a stage that permits neonatal viability.Our group pioneered development of uterus transplantation (UTx), as the first treatment for AUFI. This was performed by a translational approach with systematic animal research for 15-years.

This was followed by the first clinical UTx trial and the world´s first live birth in 2014.

During the last decade we have performed basic studies on bioengineered uterus, as a possible future alternative to UTx.AIMSTo futher develop and assess UTx for safety and efficacyTo further develop bioengineered uterus in animal models PROJECTSUTxComparison of laparototomy and robotics UTxFollow up of patients/children after UTxAssessing long-term renal function and immunologyAdvancing rejection diagnosisAssessing influence of microbiota/uterine contractility Assesing international registry dataEstimating true AUFi prevalenceHealth economy analysisBioengineered uterusAdvancing recellularization of uterine scaffoldIn vivo transplantation3D printingSIGNIFICANCEWe have developed the first infertility treatment for hundreds of thousands of AUFI women worldwide and will continue further development.