Scientists at Northwestern Medicine have taken the first steps in working out how to alter the uterus to avoid these kinds of devasting and painful conditions.
They say that certain stem cells can be reprogrammed to become healthy – fixing any defects and potentially disease-causing cells. Those then may be able to be placed inside the uterus.
Currently, womb transplants are quite rare and often unsuccessful, because some women's immune systems reject other people's uteruses.
But these newly engineered cells are being developed so that they won't be rejected.
This study suggests that soon experts will be able to replace defective endometrial cells with normal ones derived from a woman's own skin or blood.
"This is huge. We've opened the door to treating endometriosis," said senior author Dr Serdar Bulun, who has been researching treatments for endometriosis for the past 25 years and is the chair of the department of obstetrics and gynaecology at Northwestern University Feinberg School of Medicine.
"These women with endometriosis start suffering from the disease at a very early age, so we end up seeing young high school girls getting addicted to opioids, which totally destroys their academic potential and social lives."
Endometriosis happens when the endometrial cells in a woman's uterus don't respond to enough the hormone progesterone.
When that occurs, abnormal cells travel through the fallopian tubes towards the lower abdominal tissues and ovaries – which results in extra-uterine growth of womb-like tissue, which can be severely painful. It can also cause infertility and heightens the risk of ovarian cancer.
What is endometriosis, uterine-factor infertility and womb cancer?
All of these conditions involve the uterus (womb).
Endometriosis
Endometriosis is a chronic condition which occurs when tissue from the lining of the womb is found outside of the womb – in areas of the body including the ovaries, Fallopian tubes, the abdomen and the bladder.
Symptoms of endometriosis can vary, but the most common include:
- painful or heavy periods
- pain during and following sex
- bleeding between periods
- pain in the lower abdomen
- difficulty conceiving or infertility
Endometriosis can also cause sufferers to be constantly tired, and experience discomfort when using the toilet.
Womb cancer
More than 8,000 new cases of womb cancer are diagnosed in the UK every year – that's about three per cent of all cancers diagnosed in women.
It is more common in women who have more tummy fat and women who have been through the menopause.
Symptoms include:
- abnormal bleeding from the vagina
- pain in the lower abdomen
- pain during sex
- pain in the back
- loss of appetite
- tiredness
- nausea
This study, however, shows that scientists are on the path to being able to alter and reproduce these cells to respond properly to progesterone.
The next step would be to replace the diseased cells in the uterus with the newly healthy uterine cells – which scientists claim would help to eliminate pain in the long-term.
"One day we hope to make a whole uterus using this cell-based treatment employing the patient's own iPS cells," Dr Bulun said.
In the past, experts have simply tried to do womb transplants but the problem is that some women's immune systems actually reject other people's uteruses.
But that woudn't be a problem if a uterus could be bioengineered using someone's own cells to form a new womb.
Dr Bulun admits that that's quite a long way in the future but nevertheless, this signals some potential hope for a pain-free, fertile future.
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