Uterine transplantation has been proposed as a possible solution to absolute uterine factor infertility untreatable by any other option. Since the first human attempt in 2000, various teams have tried to clarify which immunosuppressant would be most suitable for protecting the allogeneic uterine graft while posing a minimal risk to the fetus. Cyclosporine A (CsA) is an immunosuppressant widely used by transplant recipients. It is currently being tested as a potential immunosuppressant to be used during UTn. Its effect on the mother and fetus and its influence upon the graft during pregnancy have been of major concern. We review the role of CsA in UTn and its effect on pregnant transplant recipients and their offspring. 1. Background Uterine transplantation (UTn) has been proposed as a possible solution to absolute uterine factor infertility (AUFI) untreatable by any other option [1]. The inability to experience a pregnancy, give birth, and bring up a child because of infertility issues may be one of the most traumatic and devastating situations to affect a woman or couple, with the capacity to have a severely detrimental effect on the quality of life of both parties [2–4]. The term “infertile” is an all-encompassing term and includes women with AUFI. Causes which render women “unconditionally infertile” are either congenital, namely, Müllerian duct anomalies, or acquired causes (such as leiomyomata, radiation damage, intrauterine adhesions, or premenopausal hysterectomy for obstetric bleeding or cervical/endometrial cancer). Tremendous advances have been made during the last decades in the fields of transplantation and reproductive medicine, in particular, the first reports of successful transplantation of a solid organ, the kidney [5, 6], and live birth after IVF [7]. Transplantation surgery today includes types of organ/tissue transplantation that will enhance the quality-of-life as exemplified by transplantation of the hand [8], the abdominal wall [9], the larynx [10], and the face [11], with the aim to add UTn to the list. UTn was first performed in a human in 2000 on a 26-year-old female who had previously lost her uterus as a result of postpartum haemorrhage. The event granted much needed impetus for research into UTn, which since then has been a slow, methodical process within an animal setting involving multiple institutions and disciplines over several continents. Research has focused on several important areas, mainly surgical, immunological, and reproductive aspects. The second UTn attempt in a human model is anticipated in the
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