Uterus transplant is a procedure developed to enable women without a uterus, or non-functional uterus or badly damaged, to become pregnant. The operation involves transplanting a uterus from a living or deceased donor to a recipient. Uterine transplantation is a form of transplant, a real and valid alternate to adoption or Surrogacy. Organ transplants are successful only if the organ works properly in the host's body. But for a uterus transplant, success is defined more narrowly: not only does the uterus have to work, but the woman has to give birth to a healthy baby.

First successful uterine transplant with live birth happened in Sweden in 2014 and so far 72 cases of uterine transplantation were done globally, out of which 18 live births are reported. Over 6 Lakh women in India are born without a uterus and of late surrogacy has also been a subject in India hence, uterus transplant can serve as an alternative to surrogacy for people who want to give birth and experience their own pregnancy.

Dr. Padmapriya Vivek

Uterus transplantation is a complex procedure and is surrounded by not only medical and psychological implications but also ethical, moral, and cultural concerns and expectations. Transplantation of a uterus, unlike any other organ transplantation, involves no less than four parties – recipient, donor, partner of the recipient, and the possible future child.

Facts On Uterine Transplantation

The aim of the procedure is to allow women with absolute uterine factor infertility to have a baby. Absolute Uterine factor infertility is caused due to congenital or surgical absence of the uterus or the presence of a non-functional uterus.

Who Needs A Uterine Transplant?

  1. Women who are born without a uterus but have their intact native ovaries – MRKH SYNDROM.
  2. Women who lost their uterus (surgical removal of the uterus) due to conditions like fibroids and cancer.
  3. Women with uterine malformations or hypoplastic uterus.
  4. Women with non-functional uterus due to damage caused by radiation exposure and intrauterine adhesions.
  5. Women between 18-40 years of age, married or having a stable partner, with a good general health condition.

Who Can Be A Donor?

  1. The uterus to be transplanted will be obtained from a living related donor or cadaveric donor.
  2. The uterus will be matched to the subject using a number of selection parameters – to reduce the chance of rejection.
  3. Women must be between 40-60 years of age.
  4. Women who are younger than 40 years of age, who have had successful pregnancies and have undergone permanent sterilization.
  5. Women with a good health condition.

How Is The Procedure Done?

Uterus with its blood supply will be removed from the donor and transplanted to the recipient through the microvascular anastomosis. Before performing the transplant surgery; the recipient should undergo controlled ovarian hyperstimulation and egg collection before the transplant surgery.

Recipient husband’s sperm and recipients’ egg is fertilized by IVF-ICSI, Embryo cryopreservation will be performed in order to use them for embryo transfer after successful transplantation.

- Dr Padmapriya Vivek, is the HOD Department of Obstetrics, Gynecology & Fertility, Gleneagles Global Hospitals, Chennai. She is the first surgeon in India to have successfully performed Uterine Transplant, in 2017.