For thousands of women, the dream of carrying a child has long been sidelined by a diagnosis of absolute uterine factor infertility (AUFI). Whether born without a uterus, having had the organ removed due to disease or trauma, or living with a defective womb, these women—estimated to comprise about one in 500 women—were historically told that biological pregnancy was an impossibility.
However, a specialized surgical frontier is changing that narrative. Uterus transplants can provide a path to pregnancy and parenthood, transforming a once-experimental procedure into a clinical reality that has already resulted in more than 70 births globally over the last decade.
The journey toward this medical milestone began in 2014 with the first successful birth following a transplant in Sweden. The United States followed three years later, establishing a framework for a complex process that blends advanced transplant surgery with assisted reproductive technology. Today, the procedure offers a biological bridge for women who wish to experience the physical and emotional journey of gestation and childbirth.
Recent data highlights the increasing reliability of the procedure. In a large-scale case series published in the Journal of the American Medical Association (JAMA) on May 1, researchers detailed the outcomes of women treated at Baylor University Medical Center in Dallas, currently the largest uterus transplant center in the world.
Measuring Success: The Baylor Experience
Between 2016 and 2024, Baylor performed the procedure on 44 women. The results indicate a high rate of surgical and reproductive success: 37 of those women had a successfully functioning transplanted uterus one month after surgery. Of those, 33 underwent embryo transfers, leading to 31 pregnancies and 27 live births.
The data suggests that once the organ is successfully integrated, the odds of a healthy baby are strong. Most of the women who gave birth had one child, though four women successfully carried two pregnancies. The health of the newborns remained high, with all infants recording an Apgar score—a standard measure of a newborn’s heart rate and breathing—of at least 7 out of 10 at five minutes post-birth.
While the outcomes are largely positive, the process is not without risk. Eleven of the newborns required admission to the neonatal intensive care unit (NICU) due to prematurity, with stays ranging from a few days to nearly two months. Among the mothers, eight experienced common pregnancy complications, such as high blood pressure or gestational diabetes, which clinicians note are risks present in any pregnancy regardless of the transplant.
| Baylor Patient Milestone | Number of Women/Infants |
|---|---|
| Total Procedures Performed | 44 |
| Successful Transplants (at 30 days) | 37 |
| Confirmed Pregnancies | 31 |
| Live Births | 27 |
| NICU Admissions (Prematurity) | 11 |
The Clinical Pathway: From IVF to Delivery
A uterus transplant is not a standalone surgery; it is part of a rigorous multi-step reproductive strategy. The process begins with in vitro fertilization (IVF), where patients create and freeze embryos before the transplant occurs. This ensures that the goal of fertilization is achievable before the patient undergoes the risks of major surgery.
The surgery itself involves connecting the donor uterus to the recipient’s blood vessels and vaginal canal. Following the procedure, the first sign of success is typically the onset of menstruation within a few months. Approximately three months after the transplant, clinicians proceed with the first embryo transfer.
Because the recipient’s body may view the new organ as foreign, they must take immunosuppression drugs to prevent rejection. This creates a unique medical timeline: once the woman has completed her desired number of pregnancies, the uterus is surgically removed. This allows the patient to stop taking immunosuppressants, avoiding the long-term health risks associated with lifelong drug dependency.
All deliveries are performed via C-section to protect the integrity of the transplanted organ and the health of the mother and child.
The Role of Living Donors
While uteruses can be sourced from deceased donors, the field has seen a significant shift toward living donation. Many women have come forward specifically to donate the “experience” of pregnancy to another.
Dr. Liza Johannesson, a surgeon who was part of the original Swedish team and now practices at Baylor, notes that the motivation for these donors is often deeply personal. In a study published in the American Journal of Surgery in 2021, donors expressed that because pregnancy and childbirth were such pivotal moments in their own lives, they felt a profound desire to grant that experience to someone else.
For the recipients, the motivation is equally visceral. One participant in the Baylor study described the longing to “be able to look down and see my belly growing and feel my baby kick,” while others expressed a desire to contribute to the research so that future women with AUFI could benefit.
Overcoming Barriers to Access
Despite the clinical success, uterus transplants remain inaccessible to many. The procedure is resource-intensive and costly, and currently, most insurance companies do not cover the surgery or the preceding IVF treatments.
Clinicians are now focusing on three primary goals to move the field forward: the creation of standardized protocols to ensure consistent outcomes across different medical centers, the collection of long-term data on the children born via this method, and the pursuit of more equitable funding models.
As the first children born from these procedures enter middle school, the medical community continues to monitor their development to ensure long-term health and safety. The goal is to transition the procedure from a luxury for the wealthy into a standard clinical option for all eligible women.
Disclaimer: This content is for informational purposes only and does not constitute medical advice. Patients should consult with a qualified healthcare provider regarding fertility treatments and surgical options.
Medical researchers are currently working toward a standardized global protocol to increase the safety and availability of the procedure. Future updates will likely center on the long-term pediatric outcomes of the first generation of transplant-born children.
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