Uterus transplant symbol image.

Uterus Transplants: A New Dawn for Fertility?

Rhea Morgan in Health & Wellness December 2025 • 4 min read.

"A breakthrough study explores the success of uterus transplants from deceased donors, offering hope and raising important ethical questions."

The field of reproductive medicine has witnessed remarkable progress, especially in the area of uterus transplantation. Since the first live birth following a uterus transplant from a living donor in 2015, over ten successful births have been reported. This surge in successful outcomes is due to an increase in uterus transplantation procedures, with approximately 50 completed in the last three years, involving both living and deceased donors.

A significant challenge remains: defining clear inclusion criteria for both donors and recipients. Striking a balance between maximizing the chances of success, minimizing risks to patients, and increasing the availability of organs is crucial. In a landscape where human data remains limited, a recent report by Danielle Ejzenberg and colleagues represents a pivotal advancement: the first healthy live birth resulting from a uterus transplanted from a deceased donor.

This achievement provides proof of concept for the functionality of uteri procured from deceased donors. The donor was a 45-year-old woman who suffered a subarachnoid hemorrhage. The recipient, a 32-year-old with Rokitansky syndrome (agenesia of the distal vagina), had normal ovarian reserve, evidenced by the creation of eight high-quality embryos via in vitro fertilization (IVF).

Key Differences in Surgical Approach

The surgical approach in the Ejzenberg study differed significantly from previous successful cases involving living donors. In prior instances, venous outflow was achieved through the exclusive use of uterine or ovarian veins. However, in this case, the venous outflow was duplicated, utilizing both the uterine and ovarian veins. This innovative modification demonstrates adaptability and refinement in surgical techniques.

Furthermore, the study challenges existing protocols regarding the waiting period post-transplant before attempting pregnancy. Traditionally, a one-year waiting period has been recommended to ensure the stability and health of the transplanted organ. However, Ejzenberg and her team initiated embryo transfer earlier than this established timeframe.

Extended Ischemic Time: The team demonstrated that a human uterus could remain functional even after being subjected to cold ischemia for a period four times longer than the average observed with live donations (7 hours 50 minutes vs. 1 hour 18 minutes).
Challenging Waiting Times: The authors also challenged the principle of waiting at least a year after transplantation before attempting pregnancy by doing the embryo transfer earlier.

While some data suggest that perinatal outcomes might be compromised during the first year after solid organ transplantation, it's essential to consider that adverse outcomes may be linked to the underlying conditions necessitating the transplant rather than the transplant itself. Therefore, a careful evaluation of each case is needed to determine the optimal timing for embryo transfer.

Future Directions and Ethical Considerations

As uterus transplantation evolves, further research is essential to standardize techniques, refine patient selection criteria, and explore new sources for uteri, including bioengineering. The ultimate goal is to maximize live birth rates, minimize risks to all parties involved (donors, recipients, and offspring), and improve access to this life-changing procedure. Collaborative networks and societies will play a crucial role in promoting education, establishing best practices, and ensuring transparent reporting of outcomes.

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Everything You Need To Know

What exactly is a uterus transplant?

A uterus transplant involves surgically implanting a healthy uterus into a woman who does not have one or whose uterus is not functioning properly. This procedure aims to enable women with uterine factor infertility to carry a pregnancy. Uterus transplants can come from both living and deceased donors. While not explicitly discussed, this is different than surrogacy, which involves carrying a child for someone else using the surrogate's own uterus.

Why is using deceased donors important in uterus transplantation?

The utilization of uteri from deceased donors represents a significant advancement because it broadens the availability of organs for transplantation. This approach can potentially help more women affected by uterine infertility. In particular, the Ejzenberg study demonstrated that uteri from deceased donors can result in successful live births, offering a new avenue for those who may not have access to living donors. This is significant because it allows for more ethical options.

What are 'inclusion criteria' and why are they important for uterus transplants?

In the context of uterus transplantation, inclusion criteria are the specific requirements and guidelines used to determine which individuals are suitable to be either donors or recipients of a uterus. These criteria are essential for maximizing the chances of a successful transplant, minimizing risks to all parties involved, and ensuring that the available organs are used effectively. Defining these criteria is challenging because human data is limited, but it is an important part of the future of transplants. These criteria are not the same as general medical guidelines; they are very specific.

What does 'extended ischemic time' mean for uterus transplants and why is it important?

Extended ischemic time refers to the duration that a uterus remains outside the body, without blood supply, during the transplantation process. The Ejzenberg study demonstrated that a human uterus could remain functional even after being subjected to cold ischemia for a significantly longer period than previously observed with live donations. This finding is crucial because it expands the possibilities for organ procurement and logistics, potentially allowing for a wider geographic range for organ donation and transplantation. This is in contrast to organs like hearts, which have shorter ischemic times.

What is Rokitansky syndrome, and how does uterus transplantation relate to it?

Rokitansky syndrome, also known as Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, is a congenital condition in which a female is born without a uterus and the upper part of the vagina. Women with Rokitansky syndrome typically have normal ovarian function, meaning they can produce eggs. In the context, uterus transplantation offers women with Rokitansky syndrome the opportunity to carry a pregnancy, which would otherwise be impossible. IVF is needed since the patient requires a uterus but can produce eggs. This highlights the transformative potential of uterus transplantation in addressing specific causes of infertility.