Ovine model of functional uterine transplantation

Options for uterine infertility that prevents parenthood are limited to gestational surrogacy or adoption. To demonstrate efficacy of the sheep as a model for uterine allograft transplantation and successful birth using assisted reproductive technology, advanced veterinary and neonatal care, non‐related African ewes (Sudanese and Ethiopian: n = 12) were studied. Each breed received the uterus from the other. Blood screening tests for parasitic/bacterial infection were used to assess tolerance to anesthesia (xylazine/ketamine/Isofluorane). Parasitic infections were treated (Ivermectine); pre/post operative care included antibiotic (Ceftiofur ), anti‐inflammatory/analgesic (Meloxicam), and immunosuppressant therapy (Cyclosporine, prednisone). Pregnancy was facilitated by time‐release progesterone implant and estrous synchronization (PgF2α, PMSG). C‐section delivery was performed near term (138 days gestation) to preclude labor and preserve uterine tissues. Five successful allografts resulted based on macroanatomy, allograft viability, and lack of infection. Three allografts progressed to implantation with one resulting in a normally developed lamb demonstrating age‐appropriate gas exchange and lung mechanics. These data demonstrate a successful interdisciplinary protocol to support functional uterine transplantation in the sheep. RAFAM, Inc, Discovery Laboratories, Inc., Vapotherm, Inc.