# Uterine Transplantation for Absolute Uterine Factor Infertility: From Bench to Bedside

## TL;DR

Uterus transplantation is becoming a viable option for women who cannot conceive due to uterine infertility, with over 50 successful births reported.

## Contribution

This review provides a comprehensive translational overview of uterine transplantation's progress from research to clinical application.

## Key findings

- More than 90 uterine transplant procedures have resulted in over 50 live births globally.
- Advances in microsurgical techniques and immunosuppressive strategies have improved clinical outcomes.
- Persistent challenges include graft rejection and long-term immunosuppression effects.

## Abstract

Uterus transplantation (UTx) has emerged as a promising reproductive option for women with absolute uterine factor infertility, and this narrative review offers an integrated translational overview of its progression from experimental research to clinical practice based on a structured qualitative synthesis of the literature retrieved from PubMed/MEDLINE, Embase, and Scopus between 2000 and June 2025, including original studies, reviews, case reports, meta-analyses, and clinical guidelines while excluding grey literature, incomplete abstracts, and non-human studies. Without performing quantitative synthesis or meta-analysis, the review highlights key historical milestones, advances in microsurgical technique and vascular preservation, evolving immunosuppressive strategies, reported graft function, reproductive and neonatal outcomes, and ethical considerations related to donor safety and equitable access. The review also notes that more than 90 uterine transplant procedures worldwide have led to over 50 reported live births, thereby demonstrating growing clinical reliability, while underscoring persistent challenges, such as graft rejection, infectious risk, and the long-term effects of immunosuppression, as the field continues to mature toward broader clinical applicability.