Uterus Transplant Surgery Could Help Trans Women To Become Pregnant

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Transgender women may soon be able to bear children of their own thanks to the growing possibility of uterus transplants.

Earlier this month a Ohio-based clinic revealed plans to take uteri from deceased donors and transfer them to cis women - women whose personal identity matches the biological body assigned to them at birth - who suffered from uterine damage or didn't have a uterus at all.

Meanwhile in Sweden, doctors have successfully transplanted uteri in nine cis women which they have taken from living donors. From this, five pregnancies and four births were achieved in the women who had previously suffered from infertility.

Questions have since been raised over whether transgender women could also have uterus transplants to enable them to carry their own children.

Dr Karine Chung, director of the fertility preservation program at the University of Southern California’s Keck School of Medicine, estimated that the procedure could happen between five and 10 years time or "maybe sooner", according to Yahoo.

pregnant bump

Eleanor Burns, 36, from Cardiff, Wales, identifies as a trans woman. She says she'd be "very tempted" by the surgery if it were to become available in the UK.

"I would love to be a mother of whatever kind I can be, but my husband and I have had to rule out natural options. He is a pre-op trans man and the idea of pregnancy is horrifically triggering to him," she says.

"I believe that the experience of pregnancy and nursing would vastly improve the way I feel about my own body, but that is - I can accept - very selfish logic. A better focus might be on improving the availability of adoption and fostering options for loving LGBT couples.

"That is our most likely option, though we are aware being a trans couple will probably not play in our favour."

Alex Forshaw, 42, from Hampshire, also identifies as a transgender woman and says uterus transplants are an "exciting development" for all.

"I believe that there's a significant number of trans women, particularly those who transition at a younger age, who desire children and this offers them a chance to be a mother in every sense," she says.

"This is, naturally, something that is very important to many women, both trans and cis."

Despite this, she says she wouldn't consider the surgery because she already has an 18-year-old daughter.

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But there are potential issues facing trans women in terms of the medical logistics of uterus transplants and growing a baby in the womb.

For example, how to go about transferring an embryo, that is grown elsewhere, into the transplanted womb.

With cis women this is done through the vagina and cervix. But because a uterus has never been transplanted into a trans woman, surgery to connect a constructed vagina to a transplanted uterus has not yet been attempted.

There's also the matter of cost - both in terms of the transplant itself, and the amount of drugs needed to support pregnancy - as well as the long-term health of both the parent and child.

Justine Evans from Creation Fertility tells HuffPost UK Lifestyle: "The amount of synthetic drugs that would be required to support a pregnancy raises the question of how healthy the child would be long-term and if there's a hormonal health risk for the child and future generations."

She adds that it would be "amazing" if scientists could manipulate the body so that trans women could develop ovaries, eggs and fallopian tubes to allow pregnancy to occur more naturally.

Dr Geeta Nargund, medical director of Create Fertility, believes transplanting a uterus into a trans women raises "safety concerns".

"Uterine transplant in women is still an experimental procedure," she explains. "It is a major breakthrough to help women who are born without a womb or for those who have their wombs removed or non-functioning due to a medical condition.

"For successful uterine transplantation, ‎skilled and complex vascular surgery is performed using specific blood vessels already present in women followed by surgical reconstruction and the use of anti-rejection drugs.

"These uterine blood vessels are not present in trans women, therefore it adds another layer of complexity to what is already a complex surgery."

Dr Nargund explains that in women who have a damaged uterus or who have had it removed, they still have connecting blood vessels prevalent. This means that when another uterus is transplanted, the connecting blood vessels are all there and ready - so you can connect a new uterus with all of the surrounding parts.

But for trans women, who aren't born with a uterus, they don't have these connective blood vessels.

"I question the efficacy and safety of womb transplantation in trans women," she adds.

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