UK woman has baby after receiving womb from deceased donor: Doc explains science breakthrough

“In early cases worldwide, many living donors were close relatives such as mothers or sisters. In India, living donor transplants have been performed, but now deceased donor transplants are also medically feasible. The donor does not have to be a family member. However, in India, donation must comply with the Transplantation of Human Organs and Tissues Act. This law governs consent, approval by authorisation committees, documentation and ethical safeguards, especially when the donor is not a near relative,” says Dr Neelam Suri, senior consultant, Obstetrics and Gynaecology, Robotic Surgery, Indraprastha Apollo Hospitals, New Delhi. Excerpts:

What is a uterus transplant?

A uterus transplant, also known as a womb transplant, is one of the most complex procedures in reproductive medicine. It is designed for women who are unable to carry a pregnancy because they do not have a uterus or their uterus cannot function adequately. While the recent UK case has drawn global attention, uterine transplants have been performed in India as well. However, the procedure is still not commonly done, due to surgical complexity, medical risks, ethical considerations and the need to strictly follow Indian legal frameworks under the Transplantation of Human Organs and Tissues Act. Then there are high costs.

Most transplants in India are done through minimally invasive laparoscopic procedures (using live donors, often mothers), which reduce pain and aid faster recovery.

How complex is the procedure?

A uterine transplant is not a single operation but a multi stage medical process. First, the donor uterus must be surgically removed with extreme precision, preserving delicate blood vessels. If the donor is living, this surgery itself can last several hours and carries its own risks.

The recipient then undergoes a lengthy transplant surgery where the uterus is placed in the pelvis and connected to blood vessels and supporting structures. This procedure can take 8 to 12 hours or longer.

After surgery, the recipient must take immunosuppressive medication to prevent organ rejection. Doctors monitor closely for complications. Only once the transplanted uterus shows stable blood flow and normal function can embryo transfer be attempted through IVF. Natural conception is not possible because the transplanted uterus is not connected to the fallopian tubes. Delivery is usually by planned caesarean section.

Who needs it?

This procedure is meant for women with absolute uterine factor infertility. This includes women born without a uterus, such as those with Mayer Rokitansky Küster Hauser syndrome, women who have had their uterus removed due to cancer, severe bleeding or other medical reasons and women whose uterus is severely damaged and cannot sustain a pregnancy. It is not a treatment for routine infertility issues like hormonal imbalance, low ovarian reserve or male factor infertility.

Who qualifies and who does not?

Eligibility criteria are strict. Candidates are usually of reproductive age, having functioning ovaries to produce eggs, medically fit for major surgery, free from active cancer or serious systemic illness, cleared through psychological evaluation.

Women with uncontrolled diabetes, severe heart or kidney disease, active infections, or contraindications to long term immunosuppressive therapy are generally excluded. The threshold for safety is high.

Does it increase chances of conception?

A uterine transplant does not improve fertility in the conventional sense. It does not enhance egg quality or increase natural conception rates. Its purpose is to make pregnancy possible for women who otherwise have no uterus to carry one. Pregnancy is achieved through IVF using the woman’s own eggs or donor eggs. Success rates are improving globally but not every transplant leads to a live birth.

Does the donor have to be a family member?

No. Donors can be living or deceased.

What are the risks?

For the recipient, risks include major surgical complications such as bleeding or infection, rejection of the transplanted uterus, side effects of immunosuppressive drugs, including increased infection risk and possible long-term impact on organs.

During pregnancy, there is a higher risk of preterm birth and pregnancy related complications like hypertension.

If the donor is living, she undergoes major surgery without direct medical benefit, which raises ethical concerns. This is one reason why strict screening and counselling are essential.

What about guardrails and oversight?

Because uterine transplantation is life enhancing rather than life saving, oversight is particularly rigorous. In India, apart from medical and surgical challenges, institutions must comply with national transplant regulations under the Organ Transplant Act. This includes ethical approvals, multidisciplinary review boards, psychological screening and detailed informed consent processes.

While uterine transplantation represents a major medical advancement and has been successfully carried out in India, it remains highly specialised, resource-intensive and tightly regulated. It offers hope to a small group of women with absolute uterine factor infertility but it is not a routine fertility treatment. The transplanted uterus is usually temporary.