The first uterus transplant in the US failed this week, but doctors at the Cleveland Clinic plan to keep trying, hoping to replicate the success of surgeons in Sweden. It’s an exciting time for reproductive medicine around the world. Here’s a rundown of the latest advances in the lab, the operating room, and the fertility clinic.
1. Creating three-parent embryos
Women with certain genetic diseases are one step closer to being able to have healthy children, through a controversial procedure that involves creating an embryo using genetic material from three parents. The technique involves combining parts of the eggs from two women and fertilizing them with a man’s sperm. An expert panel recommended last month that research proceed in the US.
2. Experimenting with penile transplants
The first US patient to have a penis transplant has been selected: He’s a soldier reportedly injured in Afghanistan. Johns Hopkins doctors will carry out this procedure, which has been in the works for over a year — and they have permission to do dozens more. Only the penis will be transplanted — not the testes, which house the sperm — so the individual may or may not be able to have children after the procedure, depending on his prior injuries. Doctors are still looking for a donor.
3. Helping immature eggs get up to speed
A new technique known as in vitro maturation, or IVM, takes immature eggs from a woman and grows them in a lab. When mature, they’re fertilized and implanted. The procedure has the potential to help women with certain ovarian disorders have children, but it is still experimental.
4. Building sperm in a lab
Researchers in China have created sperm-like mouse cells in a Petri dish, which may prove useful for the millions of couples struggling with male infertility. Since these cells lack tails, they can’t swim into an egg, and must be injected. But they’re otherwise viable: They were able to fertilize eggs and generate offspring in mice. Scientists are excited about the prospects but caution that clinical applications are a long way off.
5. Squishing embryos to test their strength
Stanford researchers announced last month that they’d developed a technique to determine whether an embryo should be implanted in an in vitro fertilization procedure. The trick: Check how squishy it is. The squishiness predicts how well the embryos will undergo cell division — and, in theory, how likely they are to thrive. A human trial is underway.
6. Transplanting a womb to make pregnancy possible
As the failure in Cleveland this week demonstrated, uterus transplants are tricky. But they can work: Swedish doctors have done several successful uterus transplants, and at least four of their patients have been able to carry pregnancies to term in the donated womb. It may even one day be possible to implant a uterus in a transgender woman, who could then become pregnant despite having been born a biological male.
7. Expanding the freezing of eggs and sperm
Back in 2014, tech companies like Facebook and Google made headlines when they decided to cover the cost of female employees freezing their eggs for later use. Now the American military is following suit. It announced this year that it will cover freezing of both eggs and sperm. The procedure could let service members have children even after an injury to their reproductive organs.