Changing Wombs: Could uterine transplants become a reality in Australia?

Meet the woman who could carry a baby in the same uterus she grew in.

Two women sitting.

Kirsty is hoping to receive her mother’s uterus.

It seems like it shouldn’t be possible - but in an Australian first, Kirsty could carry a child in the same womb she herself grew.

“That's what this clinical trial is giving us the opportunity for,” says Kirsty. “It's magical. It's amazing.”

Dr Rebecca Deans is a gynaecologist and fertility specialist in Sydney. Originally she wasn’t sold on the idea of a uterine transplant.

“So when I first was asked about… transplants from patients, I thought, well, do you really need this?” she says.

But her view changed when she saw the success of Swedish gynaecologist Dr Mats Brännström. Since he started performing these procedures, there have been 75 uterine transplants worldwide, resulting in over 30 live births.
A photo of a doctor in scrubs.
Dr Rebecca Deans is hoping to lead Australia’s first uterine transplant trial.
“And he really did turn my mind on this topic… [because] there's been a number of pregnancies and he's trained many, many teams around the world,” says Dr Deans.

One in 4,500 to 5,000 women are born without a uterus - due to a condition known as MRKH Syndrome. But there are also women who have lost their uterus to conditions such as cervical cancer or emergency hysterectomies in childbirth.

Mother’s body, grandmother’s womb

Kirsty, 29, lost her uterus to a life-saving hysterectomy after complications during a c-section. She spent two days in an induced coma before she could meet her baby girl.
“So, it probably wasn't for… a good couple of weeks that I started to fully understand the repercussions and what my life was gonna look like without a uterus,” she says.

Kirsty had always planned on having a big, loud family; the full football team. She never expected to lose her womb after safely carrying her daughter for nine months.

She started to research her options and that's how she discovered a uterine transplant trial was set to take place in Sydney.

“I very quickly rang my mum and I said, ‘Hey mum...how would you feel about having a hysterectomy for me and for me getting your uterus to potentially carry another baby?’” says Kirsty. “And I think she thought I was joking.”

It sounds impossible, but there’s precedent. In 2014, a uterine transplant performed by Dr Brännström resulted in a Swedish baby being the first to be born from its mothers body but its grandmother’s womb.

The upcoming Australian trial will take on 12 candidates; six with deceased donors and six with living donors like Kirsty’s mum. But it won’t be an easy process.

“So it's a big surgery for the donor,” says Dr Deans. “And in fact, the risks for the donor are greater than for the recipient.”
A baby outside.
Kirsty hopes to carry a sibling for her daughter through a uterus transplant. Credit: The Feed
The extraction isn’t a standard hysterectomy, because they need to take quite a lot of the blood vessels surrounding the uterus to be able to attach it to the recipient.

But Kirsty’s mum Michelle says she’s willing to do what it takes.

“Kirsty's not just my daughter. She's my best friend,” says Michelle. “If I could help in any way, then I'm there … book me in.”

Reversing menopause

Kate, 32, was just 23 when she had a hysterectomy. She had been diagnosed with a rare form of cervical cancer, and when her first round of chemotherapy and radiation weren’t successful, they performed the hysterectomy as a life saving procedure.

“You think …if that's what you need to do, that's what you need to do. So I definitely wasn't aware of the implications long term,” she says.

So when Kate went to see what her options were with a fertility specialist, they told her she didn’t have any.
A woman sits on a rock facing the ocean with her legs crossed.
Kate is another hopeful future candidate for a uterine transplant in Australia. Credit: The Feed
“They just said 'you're in menopause,'” says Kate. “'You're never gonna have a kid'”.

But when Kate heard about the uterine transplant trial, she couldn’t help wondering at the possibilities.

“Oh my gosh, what does this mean for me?” she asks. “Like, does this mean that I can potentially carry my own baby?”

To be selected for the uterine transplant you need to have successfully produced five embryos through IVF.
While Kate was technically in menopause, her medical team had extracted some of her ovarian tissue before her chemo and radiation therapy. They were able to implant that back into her pelvis, in the hope it would trigger a hormonal response. It worked!

“They were reversing menopause,” says Kate. “Something that we thought was going to be impossible.”

Not only has her body hormonally returned to a pre-menopausal state - but her medical team were able to successfully harvest 11 of Kate’s eggs.
“This procedure is quite rare,” says fertility fellow Dr Stephanie Sii, who has been instrumental in Kate’s ovary extraction. “[But] it's no longer deemed as experimental because we have had, you know, quite a few pregnancies, worldwide”.

Not only does this mean Kate has a chance at having her own biological children, it brings her one step closer to being selected for the uterine transplant trial as well.
A diagram of a uterus with text.
The extraction required is more involved than a standard hysterectomy. Credit: The Feed

To carry a child

While some candidates for the trial are hoping for a live donor, there are some hoping to receive a uterus from a deceased donor too. Which raises some ethical questions.

“This is a unique example where the transplant is about creating new life rather than saving a life,” says Evie Kendal, bioethicist at Swinburne University of Technology.

“So we can't prioritise medical necessity or urgency … So it means that we will need to make some really difficult decisions about allocating this scarce resource,” she says.

There are some concerns surrounding live donors too.

“My main concern as an ethicist is avoiding any form of exploitation or coercion,” says Evie. “You might feel pressured, as a result of these sorts of social norms about, particularly motherhood, but parenthood more generally.”

While Dr Deans acknowledges there are some ethical considerations to be made, she also sees the transplant trial’s life-changing potential.
Two pregnant women posed with their bellies out.
There are just 12 spots available for what could be an Australian first. Credit: The Feed
“Not every woman, but some women have a deep desire to carry a child and that's unquestionable,” says Dr Deans. “It might talk to …what it is to be a woman.”

“So it's never been tested, but the brain wanders to what this could mean. I mean trans women may one day be able to have a child and carry a child as a result of this procedure,” she says.

For now there are just 12 spots available for what could be an Australian first. But Dr Deans says it won’t be long before the procedure is more widely available.

“This could become mainstream within our lifetimes,” she says.

In the meantime Kate and Kirsty are cautiously optimistic about what’s to come.

“When I do get a kid, and I know I'm gonna get a kid,” says Kate, “every single bloody day I'm gonna be so grateful for it.”

“I have to give this a go,” says Kirsty. “I want to carry another child. And this is my only option.”

You can find out more about the uterine transplant trial at

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7 min read
Published 24 May 2022 4:49pm
By Ninah Kopel
Source: SBS


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