Uterus transplants allow successful pregnancies, study shows

More than half of American women who have received a uterus transplant have had successful pregnancies, a new study shows.

Between 2016 and 2021, 33 women underwent uterus transplants in the United States, and so far 19 of them, or 58%, have given birth to a total of 21 babies, researchers reported in Jama Surgery.

“Uterine transplantation should be considered a clinical reality in the US,” the researchers wrote.

All the women had so-called absolute uterine factor infertility, meaning they were either born without a uterus or had to have it removed.

More than a million American women could benefit from a uterus transplant, study leader Liza Johannesson of Baylor University Medical Center in Dallas (Texas) said in an email.

In 74% of recipients, the uterus was still functioning one year after the transplant. In that group, 83% had live births, the researchers reported. The babies were all born by cesarean section, on average 14 months after the transplant. More than half were born after 36 weeks of gestation. After the recipient gives birth, the transplanted uterus is removed to avoid the need for lifelong immunosuppressive drugs.

The US surgeries, performed at Baylor University, the Cleveland Clinic and the University of Pennsylvania Hospital, are among more than 100 uterus transplants performed so far worldwide.

Cost can be a barrier for many women. “Uterine transplantation is indeed a fertility treatment,” and some insurers may refuse to cover it, said co-author Giuliano Testa of Baylor University.

“Insurance coverage for uterus transplant is part of a broader discussion that involves coverage of infertility care in general,” Johannesson said.

In two-thirds of transplants in the US, the uterus came from a living donor, and approximately 1 in 4 patients suffered a complication from the surgery.