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What Is Uterus Transplantation?

Uterus transplantation is a vascularized composite allotransplantation that places a donor uterus into a recipient with absolute uterine-factor infertility. The donor can be living or deceased, and the graft is intended to function temporarily rather than remain for the recipient's lifetime. After successful transplantation and healing, pregnancy is achieved through in vitro fertilization because embryos are created before or around the transplant process and transferred into the graft later. Immunosuppressive medication is required while the transplanted uterus remains in the body.

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What Is Uterus Transplantation?

Uterus transplantation is a vascularized composite allotransplantation that places a donor uterus into a recipient with absolute uterine-factor infertility. The donor can be living or deceased, and the graft is intended to function temporarily rather than remain for the recipient's lifetime. After successful transplantation and healing, pregnancy is achieved through in vitro fertilization because embryos are created before or around the transplant process and transferred into the graft later. Immunosuppressive medication is required while the transplanted uterus remains in the body.

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Why Is Uterus Transplantation Performed?

The procedure is designed for selected people who cannot carry a pregnancy because the uterus is absent or permanently nonfunctional. Causes include congenital absence of the uterus, previous hysterectomy, or severe uterine disease that prevents gestation. Candidates undergo extensive transplant, reproductive, medical, psychological, and obstetric assessment because treatment involves major surgery, immunosuppression, in vitro fertilization, high-risk pregnancy, cesarean delivery, and later hysterectomy. Uterus transplantation is highly specialized and remains available only through a limited number of experienced programs.

How Is Uterus Transplantation Performed?

The donor uterus is removed with arteries, veins, and surrounding supporting tissues needed for implantation. In the recipient, the graft is placed in the pelvis and its blood vessels are connected microsurgically to pelvic vessels so circulation can be restored. The donor vagina or cervical-vaginal segment is connected to the recipient's vaginal vault, and supporting ligaments are secured to hold the uterus in position. After graft recovery and stable immunosuppression, a previously created embryo can be transferred into the transplanted uterus through in vitro fertilization treatment.

What Is Recovery Like After Uterus Transplantation?

Early recovery includes close monitoring for graft blood flow, infection, thrombosis, wound problems, and episodes of immune rejection. Cervical biopsies are commonly used to monitor rejection because the cervix provides accessible graft tissue for sampling. Pregnancy is attempted only after the transplant team determines that healing and graft function are adequate, and pregnancies require specialized maternal-fetal and transplant monitoring. Delivery is by cesarean section, and the transplanted uterus is generally removed after the recipient completes planned childbearing so immunosuppressive therapy can be stopped when medically appropriate.

What Are the Risks and Complications?

Recipient risks include major bleeding, vascular thrombosis, infection, rejection, urinary or pelvic complications, medication toxicity, and loss of the graft requiring hysterectomy. Immunosuppression increases susceptibility to infection, kidney injury, metabolic effects, and other transplant-related complications. Pregnancy carries risks including preterm birth and other high-risk obstetric complications, while cesarean delivery adds another major abdominal operation. Living donors also face substantial surgical risks because uterus procurement requires extensive pelvic vascular dissection beyond a routine hysterectomy.

Frequently Asked Questions About Uterus Transplantation

Who can receive a uterus transplant?

Programs consider carefully selected people with absolute uterine-factor infertility who meet transplant, reproductive, medical, psychological, and obstetric eligibility criteria.

Can the uterus come from a living or deceased donor?

Yes. Successful uterus transplantation and live births have been reported using both living and deceased donors.

Why is IVF needed after uterus transplantation?

Pregnancy is established by transferring an embryo into the transplanted uterus. Embryos are typically created through in vitro fertilization because the transplanted uterus is not connected to the recipient's fallopian tubes in a way intended for natural conception.

Is a transplanted uterus permanent?

Usually not. The graft is generally removed after planned childbearing is complete so the recipient can stop long-term immunosuppression when medically appropriate.

References

Living Donor Uterus Transplantation. PubMed. https://pubmed.ncbi.nlm.nih.gov/40609089/. Date Accessed September 11, 2026.

Monitoring of Human Uterus Transplantation With Cervical Biopsies: A Provisional Scoring System for Rejection. PubMed. https://pubmed.ncbi.nlm.nih.gov/27868389/. Date Accessed September 11, 2026.

Uterus transplantation - donor and recipient work-up. PubMed. https://pubmed.ncbi.nlm.nih.gov/34714790/. Date Accessed September 11, 2026.

Uterus Transplantation-Current Evaluation, Monitoring, and Emerging Diagnostics. PubMed. https://pubmed.ncbi.nlm.nih.gov/41468146/. Date Accessed September 11, 2026.

Live versus deceased donor in uterus transplantation. PubMed. https://pubmed.ncbi.nlm.nih.gov/31277763/. Date Accessed September 11, 2026.