In that first trial, Brännström’s team transplanted uteruses into nine women, each of whom had IVF to create and store embryos beforehand. The woman who was the first to give birth had IVF over a 12-month period, which ended six months before her surgery. It took a little over 10 hours to remove the uterus from the donor, and just under five hours to stitch it into the recipient.
The recipient started getting her period 43 days after her transplant. Doctors transferred one of her embryos into the uterus a year after her surgery. Three weeks later, a pregnancy test confirmed she was pregnant.
At 31 weeks, she was admitted to hospital with preeclampsia, a serious medical condition that can develop during pregnancy, and her baby was delivered by C-section 16 hours later. She was discharged from hospital after three days, although the baby spent 16 days in the hospital’s neonatal unit.
Despite those difficulties, her story is considered a success. Other uterus recipients have also experienced pregnancy complications, and some have had surgical complications. And all transplant recipients must adhere to a regimen of immunosuppressant drugs, which can have side effects.
The uteruses aren’t intended to last forever, either. Surgeons remove them once the recipients have completed their families, often after one or two children. The removal is also a significant operation.
Given all that, uterus transplants are not to be taken lightly. And there are other paths to parenthood. Some ethicists are concerned that in pursuing uterus transplantation as a fertility treatment, we might reinforce ideas that define a woman’s value in terms of her reproductive potential, Natasha Hammond-Browning, a legal scholar at Cardiff University in Wales, said at the event. “There is debate around whether we should be giving greater preference to adoption, to surrogacy, and to supporting children who already exist and who need care,” she said.
We also need to consider whether there is a “right to gestate,” and if there is, who has that right, said Hammond-Browning. And these concerns need to be balanced with the importance of reproductive autonomy—the idea that people have the right to decide and control their own reproductive efforts.
Further questions remain over whether uterus transplants might ever be an option for trans women, who not only lack a uterus but also have a different pelvic anatomy. I asked the speakers if the surgery might ever be feasible. They weren’t hugely optimistic that it would, at least in the near future.