A group from Keio University has applied to the university's review committee for the first clinical research in Japan on ``womb transplantation'', which aims to give birth by transplanting a uterus provided by a relative to a woman who has not been born with a uterus. .
The research group hopes to carry out the transplant within the next fiscal year.
On the 24th, a research group led by Assistant Professor Iori Kisu of Keio University, who is planning to transplant the uterus, applied to the university's review committee for implementation as a "specified clinical research".
In clinical research, we plan to transplant uteruses donated by relatives to three women in their 20s and 30s, including women who were born without a uterus and women who had their uterus removed due to cancer.
Then, the egg collected from the woman's ovary and the partner's sperm are fertilized in vitro, and the fertilized egg that has been cryopreserved is returned to the uterus to aim for pregnancy and childbirth.If implemented, it will be the first in Japan.
The clinical research is expected to be reviewed by an internal committee from January next year, and the research group hopes to perform the first transplant operation within the next fiscal year.
Since 2014, it has been reported that at least 40 children have been born from uterus transplantation in Sweden and the United States. I was compiling a report that I would approve with conditions such as giving an explanation.
Assistant Professor Kisu says, "I would like to carefully proceed with the plan so that it will be a great good news for patients."
What is uterine transplantation
Uterus transplantation is a procedure in which a uterus is donated by a relative, etc., with the aim of achieving pregnancy and childbirth. There have been reports of cases overseas in which the uterus was donated by a brain-dead person.
Targets are patients with "Rokitansky syndrome" born without a uterus and women in their 20s and 30s who have had their uterus removed due to cancer, etc., and it is estimated that there are about 60,000 people in Japan.
According to a research group at Keio University, since the first woman who received a uterus transplant in Sweden in 2014 gave birth, as of March last year, more than 80 surgeries have been performed in the United States and the Czech Republic, and at least 40 have been operated. It means that a human baby is born.
On the other hand, there have been reports of miscarriages and cases in which the transplanted uterus did not settle well and was removed again.
In Keio University's plan this time, after confirming the progress while administering a drug that suppresses the function of the immune system so that rejection does not occur after the transplant is performed, the egg collected from the woman's ovary in advance and the partner's In vitro fertilized sperm and cryopreserved fertilized eggs are returned to the uterus.
Then, when the baby grows in the womb after pregnancy, the baby will be delivered by caesarean section, and the transplanted uterus will be surgically removed again.
Although uterus transplantation has never been performed in Japan, two years ago, a research group at Keio University announced that it was the first in the world to succeed in giving birth to a uterus-less female monkey by transplanting a uterus from another monkey. I'm here.
The Japanese Association of Medical Sciences accepts conditionally, but there are also issues
In July last year, a review committee of the Japanese Association of Medical Sciences compiled a report on uterine transplantation, pointing out that there were many issues from a medical and ethical perspective. I am compiling a report that I will accept it conditionally.
The report states that uterus transplantation entails risks, specifically for women who
donate
uteruses .
Losing the uterus may have psychological implications for women.
In addition, women who receive uterus donations should be
warned that the transplanted uterus may not function, that
they need to continue receiving immunosuppressive drugs to prevent rejection, and that
strong immunosuppressive drugs are used. It is pointed out that there is a risk that the possibility of affecting the fetus cannot be denied.
Furthermore,
▽If pregnancy and childbirth do not occur, both the woman who donated the uterus and the woman who received the transplant will experience greater emotional distress
, It is possible that pressure within the family and society that sees this as an essential role for women may increase, and consideration and measures are necessary.
In addition to showing these risks, the report states that the implementation of clinical research is conditionally permitted only in a small number of cases, and shows the basic concept and conditions for implementation.
Specifically, the conditions for clinical research to be approved are:
▽Because the long-term effects, including women who donate wombs, women who receive transplants, and unborn children, have not been sufficiently clarified, there is sufficient risk, including to explain,
▽ To ensure that the person concerned wishes to have the transplant voluntarily,
▽ To conduct long-term health observation.
In addition, the report states that the Japan Society for Transplantation and the Japan Society of Obstetrics and Gynecology have jointly set up a review committee to ensure that clinical research is conducted properly. We are requesting that we give advice according to the situation and make it possible to examine whether to continue the research.