Uterus transplant surgery

Uterine transplantation (uterus transplant) is a surgical procedure where a healthy uterus from a donor is placed in a female recipient for the purpose of childbearing. This groundbreaking procedure was pioneered by the Penn Transplant Institute through our Uterus Transplantation for Uterine Factor Infertility (UNTIL) trial and is performed by experts through our uterine transplant program.

Uterus transplant surgery offers a promising treatment for uterine factor infertility (UFI), a previously irreversible condition affecting hundreds of thousands of reproductive-aged people in the U.S. Those diagnosed with UFI are unable to carry a pregnancy due to being born without a uterus, having had their uterus surgically removed, or having a nonfunctioning uterus.

This innovative procedure offers a remarkable opportunity to experience pregnancy and childbirth, potentially expanding the pool of reproductive options.

People diagnosed with uterine factor utility who wish to carry and deliver a child may be eligible for uterus transplant. In addition to a UFI diagnosis, criteria include:

• Age between 21 and 40
• BMI of less than 35
• Good general health, as determined by medical tests
• Non-smoking status
• In a stable relationship that has lasted at least three years

We determine eligibility for uterine transplant through an extensive evaluation. We get to know you, go over your medical history, and conduct tests and exams to ensure you are a suitable candidate and that a uterus transplant is safe for you.

If you’re approved for enrollment in the trial, we place you on the United Network for Organ Sharing (UNOS) transplant waiting list for a uterus from a deceased donor. We also perform transplants from living donors, which may shorten your wait time.

Prior to your uterus transplant, you undergo in vitro fertilization (IVF), a process where we remove your eggs and fertilize them with sperm to create embryos. We freeze the embryos to preserve them for after you’ve healed from the uterus transplant.

You’ll receive general anesthesia before surgery, so you’ll be asleep and comfortable during the procedure. To begin the surgery, your surgeon makes an incision across your abdomen. The donor uterus, without the donor fallopian tubes and ovaries, is positioned in your abdomen. Your surgeon connects your blood vessels to the uterus and then closes the incision with stitches.

Uterus transplant surgery takes about six to ten hours. We understand this can be an emotional time for your partner and loved ones. We welcome them in our waiting room during the procedure, and your surgical team will update them frequently about your progress.

Potential risks of transplant surgery include bleeding, blood clots, infection, and injury to your nerves. Every transplant carries the risk of organ rejection, where your immune system mistakenly attacks and damages the transplanted organ.

Our transplant providers have decades of expertise preventing organ rejection. We’ll perform frequent tests so we can spot signs of rejection early. There’s also a risk that the transplanted uterus doesn’t function properly or successfully carry a pregnancy.

Long-term use of immunosuppressant medications can increase the risk of kidney damage and diabetes. We monitor you closely for these conditions and remove the uterus when you’re done having children so you can stop taking immunosuppressant medications and reduce your risk.

Penn Medicine is one of the only hospitals in the nation advancing uterus transplantation as a fertility treatment. Our UNTIL trial was the first of its kind in the Northeastern U.S.

In 2019, we welcomed the first baby born as part of the UNTIL trial, who was also only the second baby in the U.S. to be born following uterus transplantation from a deceased donor. Since then, we’ve successfully helped several families grow using this novel approach.

Many other programs around the world focus on only uterus transplantation from living donors. However, Penn Medicine’s trial is one of few to explore donation from either living or deceased donors—an approach that significantly expands the pool of available organs.

Your dream of building a family is at the center of everything we do, and we’re passionate about helping you achieve your dream.