title: Achieving an early pregnancy following allogeneic uterine transplantation in a rabbit model.
abstract: OBJECTIVE
  Uterine transplantation (UTx) has been proposed as a treatment option for women diagnosed with absolute uterine factor infertility (AUFI). The goal of UTx remains achieving pregnancy and live birth of a healthy neonate following allogeneic UTx. Our aim was to assess whether fertility was possible following allogeneic uterine transplantation (UTx), when the recipient had demonstrated long-term survival and had been administered immunosuppression.
  
  
  METHODS
  Nine allogeneic UTx in New Zealand White rabbits were performed using a pre-determined protocol. Tacrolimus was the immunosuppressant selected. Embryos were transferred into both cornua of the sole living recipient via a mini-midline laparotomy. The pregnancy was monitored with regular reproductive profiles and serial trans-abdominal ultrasound to measure conceptus growth (gestation sac and crown rump length (CRL)).
  
  
  RESULTS
  In the sole surviving doe a gestation sac was visualised on ultrasound from Day 9 (D9) after embryo transfer. Gestation sac diameter and CRL increased from D9 to D16 but by D18 the gestation sac had reduced in size. The fetus was no longer visible, suggesting fetal resorption had occurred. Subsequent scans on D22 and D25 did not demonstrate a gestation sac. Scheduled necropsy on D27 and histopathology confirmed evidence of a gravid uterus and presence of a gestational sac. A single episode of acute rejection occurred on D13.
  
  
  CONCLUSIONS
  Pregnancy was achieved after rabbit allogeneic UTx but serial ultrasound suggested that fetal demise occurred prior to scheduled necropsy. The study represents only the third example of conception and pregnancy following an animal allogeneic UTx.
authors.affiliation: Division of Surgery and Cancer, Institute of Reproductive & Developmental Biology, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK. Electronic address: srdjan.saso@imperial.ac.uk.
authors.forename: Srdjan
authors.initials: S
authors.lastname: Saso
authors.affiliation: Department of Pathology, Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed Street, London W2 1NY, UK.
authors.forename: Gemma
authors.initials: G
authors.lastname: Petts
authors.affiliation: Institute for Women's Health, Faculty of Population Health Sciences, University College London, 86-96 Chenies Mews, London WC1E 6HX, UK.
authors.forename: Anna L
authors.initials: AL
authors.lastname: David
authors.affiliation: The Lister Hospital, Chelsea, London SW1W 8RH, UK.
authors.forename: Meen-Yau
authors.initials: MY
authors.lastname: Thum
authors.affiliation: Division of Surgery and Cancer, Institute of Reproductive & Developmental Biology, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK.
authors.forename: Jayanta
authors.initials: J
authors.lastname: Chatterjee
authors.affiliation: Institute of Science and Animal Technology (ICTA), Universitat Politècnica de València, Camino de Vera s/n, 46071 Valencia, Spain.
authors.forename: Jose S
authors.initials: JS
authors.lastname: Vicente
authors.affiliation: Institute of Science and Animal Technology (ICTA), Universitat Politècnica de València, Camino de Vera s/n, 46071 Valencia, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Marco-Jimenez
authors.affiliation: Mid Cheshire NHS Trust, Leighton Hospital, Crewe CW1 4QJ, UK.
authors.forename: David
authors.initials: D
authors.lastname: Corless
authors.affiliation: Biological Services Unit, Royal Veterinary College, Royal College Street, London NW1 0TU, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Boyd
authors.affiliation: Royal Veterinary College, Royal College Street, London NW1 0TU, UK.
authors.forename: David
authors.initials: D
authors.lastname: Noakes
authors.affiliation: Department of Pathology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK.
authors.forename: Iain
authors.initials: I
authors.lastname: Lindsay
authors.affiliation: Southeastern Regional Medical Center, Georgia, USA.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Del Priore
authors.affiliation: Division of Surgery and Cancer, Institute of Reproductive & Developmental Biology, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK.
authors.forename: Sadaf
authors.initials: S
authors.lastname: Ghaem-Maghami
authors.affiliation: West London Gynaecological Cancer Centre, Queen Charlotte's Hospital, Hammersmith Hospital Campus, Imperial College London, Du Cane Road, London W12 0NN, UK.
authors.forename: J Richard
authors.initials: JR
authors.lastname: Smith
mesh_terms: D000818:Animals; D005260:Female; D005298:Fertility; D007165:Immunosuppression Therapy; D011247:Pregnancy; D011817:Rabbits; D014184:Transplantation, Homologous; D014599:Uterus / Q000637:transplantation*
keywords: Fertility; Pregnancy; Rabbit; Uterine transplantation