Abstract
Uterus transplantation (UTx) offers women with absolute uterine factor infertility the option to gestate and birth their own biologically related child. The first birth following living donation UTx happened in 2014. The first birth following deceased donation happened in December 2017, with further successes since. Interest in deceased donation UTx is increasing. The authors established a database to track UTx clinical trials and outcomes. Utilising this database and existing literature, this article reviews the first reported cases of deceased donation UTx and outcomes, and drawing upon comparisons with living donor UTx, comments upon the future for this area of reproductive transplantation research. This is the first article to bring together the literature on deceased donation UTx procedures and outcomes.
Highlights
The reproductive options for women with absolute uterine factor infertility (AUFI) are surrogacy or adoption, availability of which is highly dependent upon the legal jurisdiction within which women reside
Since the first birth achieved by the Swedish team in 2014 [4], the interest in, and number of clinical trials in, both living donor (LD) and deceased donor (DD) UTx have greatly increased
With a preference for younger donors, there is a significant chance that a DD will be nulliparous; if such donors were automatically excluded from uterus donation, this would further shrink the potential pool of DD
Summary
The reproductive options for women with absolute uterine factor infertility (AUFI) are surrogacy or adoption, availability of which is highly dependent upon the legal jurisdiction within which women reside. Women with AUFI may be unwilling or unable to access surrogacy or adoption due to financial reasons and/or religious, ethical, social, or personal objections. Since 2014, women with AUFI have been presented with the possibility of gestating their own biological child following a uterus transplant. Uterus transplantation (UTx) is a developing technique, still in its research infancy, and is heralded as a way of increasing the reproductive autonomy of women with AUFI. More than 70 attempts at human UTx have taken place, resulting in ≥24 live births across 11 countries [2]. Notable milestones include the first human UTx in Saudi Arabia in 2000 [3], the first birth following a living donor (LD) transplant in Sweden in 2014 [4], and the first birth following a deceased donor (DD) transplant in Brazil in 2017 [5]
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