Uterus Transplant

A uterus transplant places a donated uterus into a woman who cannot carry a pregnancy because she has no uterus or because hers does not work. It is unlike every other transplant on this site in two ways: it does not save a life, and it is not meant to be permanent. Its purpose is to make one or two pregnancies possible, after which the uterus is removed and the immunosuppressant medication is stopped.

Who it is for

Women with absolute uterine factor infertility — born without a uterus, born with one that does not function, or having had one removed for a medical reason. It is a small and specific group, and the assessment covers physical and mental health together, because the process is long and demanding from beginning to end.

Living donor or deceased donor

A living donor, most often a mother or sister, allows unhurried investigation before the operation, but the donor undergoes major surgery with real risk to herself and that risk is not incidental to the decision. A deceased donor removes it entirely, and allows a wider dissection with larger blood vessels, which reduces complications in the graft. The trade is that inflammation following brain death can affect the quality of the organ and may raise the chance of rejection.

How the sequence actually runs

IVF comes first. The transplanted uterus is not connected to the fallopian tubes, so conception cannot happen naturally and embryos have to be created and frozen before the transplant. Then the donor hysterectomy and the transplant itself. Then a waiting period — embryo transfer usually happens six to twelve months afterwards, once the graft has settled and the medication is stable. Delivery is by caesarean section, around thirty-seven to thirty-nine weeks or earlier if there is a medical reason. When the family is complete the uterus is removed and immunosuppression ends, which is the one respect in which this transplant is kinder than the others.

What to weigh before you start

This is a programme rather than an operation, and it runs over years: IVF, major surgery, months of immunosuppression, a monitored pregnancy, a caesarean, and a final operation to remove the graft. It is offered in relatively few centres. Ask how many the centre has done, who supervises the pregnancy, and what happens if the graft fails before a transfer — those answers matter more here than in almost any other procedure we coordinate. We arrange the hospital, the team and the stay; donation is governed by law and is not something we can arrange.