Uterine transplant: How it’s done, risks and debate

As the first Indian child born after mother’s uterine transplant celebrates her first birthday, a look at the landmark procedure

Uterine transplant, Uterine transplant baby, baby born from uterine transplant, what is uterine transplant, uterine transplant hospitals, uterine transplant hospitals in India, Express Explained, Indian Express

Radha is India’s first baby born following a uterine transplant of the mother. (Express Photo)

IT IS now one year since India’s first baby was born to a mother with a transplanted uterus (The Indian Express, October 18). Such cases are rare across the world — Radha, whose parents have just celebrated her first birthday, is the 12th such baby worldwide. Now demand has risen, especially at Pune’s Galaxy Care Hospital, where the transplant had been done on Radha’s mother Meenakshi Valan of Gujarat on May 19, 2017. Since them the hospital has got over 1,000 applications.

The reasons, the results

Approximately 1 in 500 women are estimated to have uterine factor infertility according to the September issue of the British Medical Bulletin. In India, about 17% of all women face issues relating to infertility, and the reason is related to the uterus in 20% of these. For women whose uterus is not healthy, or who do not have one, a transplant is the newest form of infertility treatment.

Valan had a scarred uterus due to multiple abortions and cases of stillbirth. Her mother donated the uterus. Usually, women related to the recipient are potential donors. The donor may be either living or deceased, and is chosen from among women up to the age of 50 years.
Dr Shailesh Puntambekar, laparoscopic surgeon and Director of Galaxy Care Hospital, said worldwide there have been 30 uterine transplants and 15 babies born. Among the babies, one was born after a cadaveric uterus was transplanted. The transplanted uterus is generally intended to be removed after the woman has undergone one or two childbirths.

Normal reproduction is not possible with a transplanted uterus — a transplant makes sense only with in vitro fertilisation (outside the body). The first successful transplant was performed in Saudi Arabia in 2002 but did not result in pregnancy. In Turkey, pregnancy following a 2011 transplant lasted only eight weeks. The first birth after a transplant, in 2014, happened in Sweden.

Is it the future?

Uterine transplants are still extremely rare, complicated and expensive. In the case of Meenakshi — and Shivamma, a woman who had undergone a transplant the day before Valan underwent hers — the entire process (up to the birth of Valan’s child) was made free because these were the first two such cases in India.

In the earliest cases, doctors took almost 13 hours to retrieve the uterus, because they performed open surgery. With laparoscopic intervention, the time has now come down to about six hours, Dr Puntambekar said. While the donor should ideally be a cadaver, it is difficult in practice — the donor has to be less than age 50, her uterus should have produced children, and the risk of organ rejection is higher when it is from a dead person. Minimally invasive surgery (robotic surgery) has become the standard procedure and in the future, it is likely that the recipient of the uterine transplant has to undergo only one surgery as vessels can also be sutured laparoscopically, Dr Puntambekar said.

A uterine transplant, like that for other organs, requires clearances at several levels. Now the cost is going down as patients are being discharged on the 14th day following the transplant.

Story continues below this ad

Ethical considerations

There has been debate whether uterus transplants are ethically justified. There is vast literature on this debate, covering psychological and physical risks as well as complications arising out of immunosuppressive therapy. According to the British Medical Bulletin’s September issue, concerns have been raised about the welfare of living donors who may end up regretting their choice to donate. Experts suggest that a living donation is justified only after informed consent by the donor, and this after counselling by physicians and psychologists.
Dr Puntambekar said that in the last two years, they have done eight transplants and kept several on hold as they wanted the couples and family members to be extremely sure and committed about a transplant.

Anuradha Mascarenhas

Anuradha Mascarenhas is a Senior Editor at The Indian Express, based in Pune. With a career spanning three decades, she is one of the most respected voices in Indian journalism regarding healthcare, science and environment and research developments. She also takes a keen interest in covering women's issues . Professional Background Education: A gold medalist in Communication and Journalism from Savitribai Phule Pune University and a Master’s degree in Literature. Author: She authored the biography At The Wheel Of Research, which chronicles the life and work of Dr. Soumya Swaminathan, the former Chief Scientist at the WHO. Key Focus: She combines scientific accuracy with storytelling, translating complex medical research into compelling public and human-interest narratives. Awards and Recognition Anuradha has won several awards including the Press Council of India's national award for excellence in journalism under the gender based reporting category in 2019 and the Laadli Media award (gender sensitivity -2024). A recipient of the Lokmat journalism award (gender category-2022), she was also shortlisted for the RedInk awards for excellence in journalism-2021. Her debut book At The Wheel Of Research, an exclusive biography of Dr Soumya Swaminathan the inaugural chief scientist of World Health Organisation was also nominated in the Popular Choice Category of JK Paper AUTHER awards. She has also secured competitive fellowships including the Laadli Media Fellowship (2022), the Survivors Against TB – New Research in TB Media Fellowship (2023) and is part of the prestigious 2025 India Cohort of the WomenLift Health Leadership Journey.” Recent Notable Articles (Late 2025) 1. Cancer & Specialized Medical Care "Tata Memorial finds way to kill drug-resistant cancer cells" (Nov 26, 2025): Reporting on a breakthrough for triple-negative breast cancer, one of the most aggressive forms of the disease. Discipline, diet and purpose; How a 97-year-old professor defies ageing'' (Nov 15, 2025) Report about Prof Gururaj Mutalik, the first Head of Department at Pune's B J Government Medical College who at 97 credits his longevity to healthy habits and a strong sense of purpose. 2. Environmental Health (The "Breathless Pune" Series) Long-term exposure even to 'moderate' air leads to chronic heart, lung, kidney issues" (Nov 26, 2025): Part of an investigative series highlighting that even "safe" pollution levels are damaging to vital organs. "For every 10 µg/m3 increase in PM2.5 level, there was 6-8% jump in medicine sales" (Nov 23, 2025): Using commercial data to prove the direct link between air quality and respiratory illnesses in Pune. 3. Lifestyle & Wellness News "They didn't let cancer, diabetes and heart disease stop them from travelling" (Dec 22, 2025): A collaborative piece featuring survivors who share practical tips for traveling with chronic conditions. At 17, his BP shot up to 200/120 mmHG; Lancet study flags why child and teen hypertension doubled between 2000 and 2020'' (Nov 12,2025)--A report that focusses on 17-year-old-boy's hypertensive crisis and reflects the rising global trend of high blood pressure among children and adolescents. 4. Scientific Recognition & Infrastructure For promoting sci-comm, gender diversity: IUCAA woman prof highlighted in Nature" (Nov 25, 2025): Covering the global recognition of Indian women scientists in gender studies and physics. Pune researchers find a spiral galaxy like the Milky Way from early universe'' (December 3, 2025)- A report on how Indian researchers discovered a massive galaxy that existed when the universe was just 1.5 billion years old , one of the earliest to have been observed so far. Signature Beat: Health, Science & Women in Leadership Anuradha is known for her COVID-19 reportage, where she was one of the first journalists to provide detailed insights into the Covishield and Covaxin trials. She has a dedicated interest in gender diversity in health and science, often profiling women researchers who are breaking the "leaky pipeline" in STEM fields. Her writing style is scrupulous, often featuring interviews with top-tier scientists and health experts from various institutions. ... Read More