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Uterustransplantation – Perspektiven und Risiken

Uterus transplantation—perspectives and risks

  • Leitthema
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Der Gynäkologe Aims and scope

Zusammenfassung

Die absolute uterine Infertilität (AUI) betrifft 3–5 % aller Frauen und galt als unheilbar. Zur Erfüllung des Kinderwunsches kam für diese Frauen bisher nur eine (in Deutschland verbotene) Leimutterschaft oder eine Adoption in Frage. Dank der modernen Fortschritte in der Chirurgie und Transplantationsimmunologie ist es heutzutage aber möglich, Frauen mit AUI neue Hoffnung durch eine Uterustransplantation zu geben. Im vergangenen Jahrzehnt wurde die Methodik anhand einer Reihe von Tierversuchen erprobt, und international sind bislang insgesamt 11 Fälle von humanen Uterustransplantationen publiziert. Fünf gesunde Kinder wurden bereits in Schweden nach einer Uterustransplantation geboren. Die Option, einer Frau eine Gebärmutter zu implantieren und ihr so (zurzeit noch nach außerkörperlicher Befruchtung/In-vitro-Fertilisation und Embryotransfer) zu einer Schwangerschaft zu verhelfen, hat sich, auch wenn sich das Verfahren noch in einem experimentellen Stadium befindet, als eine realistische Option bei AUI erwiesen. Die Uterustransplantation eröffnet neue Horizonte in der modernen Frauenheilkunde, wirft aber gleichzeitig medizinische und ethische Fragen auf.

Abstract

Absolute uterine infertility (AUI) affects 3–5 % of all women and has previously been regarded as incurable. To realize the wish of becoming a parent, the only available options for these women are surrogacy, which is not allowed in Germany, or adoption. With recent advances in surgery and transplant immunology, uterus transplantation can give hope to women with uterine infertility. In the last decade, a number of animal experiments have been used to test the methodology and 11 cases of human uterus transplantations have been published internationally. In Sweden, 5 healthy children have already been born after uterus transplantation. Although still in an experimental stage, the option of implanting a donor uterus into a woman and helping her to achieve pregnancy after extracorpeal fertilization/in vitro fertilization and embryo transfer has been proven to be a viable option for women with AUI. Uterus transplantation opens new horizons in modern women’s health, but at the same time raises medical and ethical questions.

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Authors and Affiliations

  1. Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Universitätsstr. 21–23, 91054, Erlangen, Deutschland

    M. W. Beckmann, L. Lotz, S. P. Renner, T. Hildebrandt, I. Hoffmann & R. Dittrich

  2. Plastisch- und Handchirurgische Klinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91054, Erlangen, Deutschland

    R. E. Horch, A. Weigand & A. M. Boos

  3. Gefäßchirurgische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91054, Erlangen, Deutschland

    W. Lang

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  1. M. W. Beckmann
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  8. W. Lang
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  9. I. Hoffmann
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  10. R. Dittrich
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Correspondence to M. W. Beckmann.

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Interessenkonflikt

M.W. Beckmann, L. Lotz, S.P. Renner, T. Hildebrandt, R.E. Horch, A. Weigand, A. Boos, W. Lang, I. Hoffmann und R. Dittrich geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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K. Diedrich, Hamburg

R. Felberbaum, Kempten

W. Küpker, Bühl

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Beckmann, M.W., Lotz, L., Renner, S.P. et al. Uterustransplantation – Perspektiven und Risiken. Gynäkologe 50, 389–396 (2017). https://doi.org/10.1007/s00129-017-4080-9

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  • DOI: https://doi.org/10.1007/s00129-017-4080-9

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