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A uterus transplant is a complex fertility treatment that may help some women carry a pregnancy when they do not have a uterus or when their uterus cannot support pregnancy. It is mainly considered for absolute uterine factor infertility, also called AUFI.
Unlike a kidney or liver transplant, a uterus transplant is not done to save life. It is done to make pregnancy possible. It is also temporary. After one or two successful pregnancies, the transplanted uterus is usually removed so that the person can stop taking anti-rejection medicines.
What Is Uterus Transplant?
A uterus transplant is a procedure in which a healthy uterus from a donor is surgically placed inside a recipient. The donor may be living or deceased, depending on the transplant programme and local regulations.
The transplanted uterus is connected to the recipient's blood vessels and vagina. The fallopian tubes are not connected. This means natural conception is not possible after the transplant. Pregnancy can happen only through IVF, where an embryo is placed inside the transplanted uterus.
A uterus transplant is still rare and highly specialised. It requires a team that may include fertility specialists, transplant surgeons, gynaecologists, anaesthetists, maternal-fetal medicine experts, psychologists, and laboratory specialists.
How Uterus Transplant Works
The uterus transplant process starts before the actual surgery. First, the recipient usually undergoes IVF. Eggs are collected, fertilised with sperm, and the embryos are frozen for later use.
Next, doctors identify a suitable donor. The donor is screened carefully to check blood group match, uterus health, infection risk, medical fitness, and psychological readiness. In a living donor, doctors also consider the donor's surgical risk.
During uterus transplant surgery, the donor uterus is removed with its blood vessels and supporting tissues. It is then placed in the recipient's pelvis. Surgeons connect the uterus to the recipient's blood vessels so that the organ gets proper blood supply. They also connect the uterus to the vagina.
After surgery, the recipient takes immunosuppressant medicines to reduce the risk of rejection. Once healing is complete and the uterus is functioning well, embryo transfer may be planned.
Is Uterus Transplant Possible?
Yes, uterus transplant is possible. It has led to successful pregnancies and live births in several countries. However, it is not widely available and is offered only in selected centres with advanced expertise.
The answer to "can a uterus be transplanted" is yes, but the process is long and demanding. It includes IVF, major surgery, anti-rejection medicines, high-risk pregnancy care, caesarean birth, and later removal of the transplanted uterus.
It is important to understand that a uterus transplant does not guarantee pregnancy or childbirth. Success depends on many factors, including embryo quality, blood supply to the uterus, absence of rejection, overall health, and pregnancy monitoring.
Who Can Benefit From Uterus Transplant?
A uterus transplant may benefit women with absolute uterine factor infertility. This may include:
- Women born without a uterus, such as those with MRKH syndrome
- Women who had a hysterectomy at a young age
- Women who lost the uterus due to severe postpartum hemorrhage
- Women with severe uterine scarring that cannot support pregnancy
- Women with major uterine damage after infection, surgery, or trauma
- Women with a non-functioning uterus but healthy ovaries
- Women who can safely undergo IVF, transplant surgery, pregnancy, and caesarean delivery
- Women who understand the medical, emotional, financial, and ethical aspects of the procedure
Not everyone with infertility is a candidate. A uterus transplant is considered only when the main reason for infertility is the absence or non-function of the uterus.
Uterus Transplant Surgery Process
The uterus transplant journey usually includes these steps:
Initial Evaluation
Doctors assess your medical history, fertility history, general health, mental health, and suitability for major surgery.
Fertility Assessment And IVF
Your ovaries are checked. If suitable, eggs are collected and fertilised. Embryos are frozen before transplant surgery.
Donor Screening
The donor is checked for blood group match, infections, uterine health, surgical fitness, and consent.
Donor Uterus Retrieval
The uterus is removed carefully with blood vessels and supporting tissues.
Recipient Surgery
Surgeons place the uterus in the recipient's pelvis and connect the blood vessels and vagina.
Blood Flow Check
Doctors confirm that the uterus has good blood supply. Poor blood flow can raise the risk of vascular thrombosis and Graft Failure.
Recovery And Monitoring
The recipient is monitored for bleeding, infection, rejection, vascular thrombosis, and other complications.
Embryo Transfer
After healing, one embryo is transferred into the transplanted uterus.
Pregnancy Monitoring
Pregnancy is managed as high-risk because Pregnancy Complications can occur.
Caesarean Birth And Later Hysterectomy
Delivery is done by caesarean section. The transplanted uterus is usually removed after one or two pregnancies.
Uterus Transplant In India
Uterus transplant in India is available only in highly specialised settings. India reported its first uterus transplant in Pune in 2017, followed by the birth of India's first baby after uterus transplant in 2018.
The procedure is still uncommon in India. It requires strict medical selection, advanced surgical expertise, transplant permissions, fertility care, high-risk pregnancy support, and long-term monitoring. If you are considering it, you should consult a specialist reproductive medicine and transplant team.
Legal, ethical, donor safety, cost, and access issues are also important. Your doctor can help you understand whether uterus transplant surgery is suitable for your condition or whether other family-building options may be safer or more practical.
Risks And Complications Of Uterus Transplant
A uterus transplant carries risks for both the donor and the recipient. For the recipient, possible risks include bleeding, infection, rejection, vascular thrombosis, Graft Failure, kidney strain from immunosuppressant medicines, and complications linked to IVF.
Surgical risks may include hemorrhage, injury to nearby organs, blood clots, anaesthesia-related problems, and wound complications. The transplanted uterus may fail if the blood vessels clot or if blood supply is poor. This is one reason vascular thrombosis is closely watched after surgery.
Pregnancy after uterus transplant is also high-risk. Possible Pregnancy Complications include miscarriage, preterm birth, high blood pressure, gestational diabetes, fetal growth concerns, and the need for close monitoring.
Living donors also face risks. These may include bleeding, infection, ureter injury, bladder problems, blood clots, and emotional stress if the transplant is unsuccessful.
Success Rates And Long-Term Outcomes
Success can be measured in different ways. Doctors may look at whether the uterus survives after surgery, whether periods start, whether embryo transfer leads to pregnancy, and whether there is a live birth.
Key points include:
- Uterus transplant has led to successful live births worldwide
- It is still rare and available only in selected centres
- A functioning transplant does not always lead to pregnancy
- Graft Failure may require removal of the transplanted uterus
- Rejection can often be detected through monitoring and biopsies
- Most births after uterus transplant are by caesarean section
- Pregnancy Complications need specialist care throughout pregnancy
- Long-term data is still developing because the procedure is relatively new
The aim is not only pregnancy, but a safe outcome for both mother and baby.
What To Expect After Uterus Transplant Surgery?
After the surgery, you can expect a structured follow-up plan.
Hospital Recovery
You may stay in hospital while doctors monitor pain, bleeding, infection, urine output, and blood flow to the uterus.
Anti-Rejection Medicines
You will take immunosuppressant medicines to reduce the risk of rejection.
Regular Blood Tests
Blood tests help check kidney function, liver function, medicine levels, infection markers, and overall recovery.
Ultrasound And Doppler Checks
These tests help assess blood flow to the transplanted uterus and detect vascular thrombosis early.
Rejection Monitoring
Cervical biopsies may be done to check for rejection.
Return Of Periods
Menstrual periods may begin after the transplanted uterus starts functioning.
Embryo Transfer Planning
If recovery is stable, embryo transfer may be planned after a few months.
High-Risk Pregnancy Care
Pregnancy is closely monitored by specialists to detect Pregnancy Complications early.
Tests Before Uterus Transplant Surgery
Before uterus transplant surgery, you may need several tests and evaluations, such as:
- Complete blood count
- Blood group and cross-match
- Kidney function test
- Liver function test
- Blood sugar test
- Thyroid function test
- Coagulation profile
- Infection screening, including HIV and hepatitis tests
- Hormonal tests
- Ovarian reserve testing
- Pelvic ultrasound
- MRI or other pelvic imaging
- ECG and cardiac evaluation
- Chest imaging when needed
- Anaesthesia fitness assessment
- IVF-related tests
- Psychological evaluation
- Donor compatibility tests
- Urine tests to check infection or Urinary Tract Injuries when clinically relevant
Your doctor may also assess existing conditions such as hypertension, diabetes, autoimmune disorders, or blood clotting problems before approving the procedure.
Tests After Uterus Transplant Surgery
After surgery, tests are done regularly to check organ function, rejection, infection, and pregnancy readiness.
Common tests may include:
- Complete blood count
- Kidney function test
- Liver function test
- Immunosuppressant drug level monitoring
- Infection markers
- Urine tests
- Coagulation profile
- Pelvic ultrasound
- Doppler blood flow studies
- Cervical biopsy for rejection monitoring
- Hormone tests when needed
- Pregnancy tests after embryo transfer
- Fetal ultrasound during pregnancy
- Blood pressure monitoring, especially if there is hypertension risk
- Screening for gestational diabetes during pregnancy
These tests help doctors detect rejection, Graft Failure, vascular thrombosis, infection, and other complications as early as possible.
How Long Does A Uterus Transplant Last?
A uterus transplant is temporary. It usually lasts only until the recipient has completed one or two pregnancies, or until doctors decide that it should be removed for safety reasons.
If the transplant does not function well, if repeated embryo transfers fail, if rejection is difficult to control, or if complications occur, the uterus may be removed earlier. Once the uterus is removed, the person can usually stop taking anti-rejection medicines under medical supervision.
This temporary approach helps reduce long-term exposure to immunosuppressant medicines.
Uterus Transplant And Fertility
A uterus transplant can help with carrying a pregnancy, but it does not treat all types of infertility.
Important points include:
- You need functioning ovaries or stored eggs for IVF
- Pregnancy is possible only through embryo transfer
- The fallopian tubes are not connected to the transplanted uterus
- One embryo is usually transferred at a time
- Pregnancy is managed as high-risk
- Delivery is done by caesarean section
- The uterus is removed after the planned pregnancy journey is complete
- Alternatives such as adoption or surrogacy may also be discussed where legally and personally acceptable
A uterus transplant is a deeply personal decision. It needs medical guidance, emotional support, and clear understanding of risks and expectations.
Conclusion
A uterus transplant can offer hope to women with absolute uterine factor infertility who wish to carry a pregnancy. It is possible, but it is complex, rare, and medically demanding. It involves IVF, major surgery, immunosuppressant medicines, high-risk pregnancy care, and later removal of the transplanted uterus.
If you are exploring fertility treatment, surgery, or pregnancy planning, accurate diagnostic testing is an important part of safe decision-making. Metropolis Healthcare supports preventive and specialised care with 4,000+ tests, full body checkups, advanced diagnostics, expert pathologists, accurate reports, quick turnaround time, and home sample collection. You can book tests through the website, call, app, or WhatsApp, supported by a strong home collection network and 10,000 touchpoints.
FAQ
Can A Uterus Be Transplanted?
Yes, a uterus can be transplanted. The procedure has resulted in successful pregnancies and live births in different parts of the world. However, it is rare, complex, and available only in selected specialist centres.
What Tests Are Required Before A Uterus Transplant?
Tests before a uterus transplant may include:
- Complete blood count
- Blood group and cross-match
- Kidney and liver function tests
- Blood sugar and thyroid tests
- Infection screening
- Coagulation profile
- Hormonal tests
- Ovarian reserve testing
- Pelvic ultrasound or MRI
- ECG and cardiac evaluation
- IVF-related tests
- Psychological assessment
- Donor matching tests
What Tests Should Be Done After A Uterus Transplant?
Tests after a uterus transplant may include:
- Complete blood count
- Kidney and liver function tests
- Infection markers
- Drug level monitoring for immunosuppressants
- Pelvic ultrasound
- Doppler blood flow studies
- Cervical biopsy for rejection
- Urine tests
- Coagulation profile
- Pregnancy tests after embryo transfer
- Fetal monitoring during pregnancy
How Long Does A Uterus Transplant Last?
A uterus transplant usually lasts until one or two pregnancies are completed. It is then removed so the recipient can stop taking anti-rejection medicines. It may be removed earlier if there is Graft Failure, uncontrolled rejection, repeated IVF failure, infection, or another serious complication.
What Are The Risks Associated With Uterus Transplant Surgery?
Risks include bleeding, infection, hemorrhage, organ injury, rejection, vascular thrombosis, Graft Failure, side effects from immunosuppressant medicines, and Pregnancy Complications. Living donors may also face surgical and emotional risks.
How Successful Are Uterus Transplants In India?
Uterus transplant in India has achieved important milestones, including India's first transplant in 2017 and first reported baby after uterus transplant in 2018. However, it remains rare and limited to specialised centres. Success depends on careful patient selection, donor suitability, surgical expertise, IVF outcomes, and pregnancy monitoring.
References
- Brännström M. A decade of human uterus transplantation. Acta Obstet Gynecol Scand. 2025;104(2):181-188.
- Cleveland Clinic. Uterus Transplant: Purpose, Procedure, Recovery And Risks. Medically reviewed health procedure guide. Updated 2025.
- Johannesson L, et al. Past, Present, And Future: A Review Of Uterus Transplant. Transplant International. 2025.
- Richards EG, et al. Uterus transplantation: State of the art in 2021. J Assist Reprod Genet. 2021;38(9):2251-2259.
- Ejzenberg D, Andraus W, Baratelli Carelli Mendes LR, Ducatti L, Song A, et al. Livebirth after uterus transplantation from a deceased donor in a recipient with uterine infertility. Lancet. 2018;392(10165):2697-2704. PMID: 30527853.
- Johannesson L, et al. Uterus transplantation trial: 1-year outcome. Fertil Steril. 2015;103(1):199-204. PMID: 25439846.
