Reproductive medicine has advanced rapidly, transforming infertility treatment. From the birth of the first IVF baby in 1978 to the growing use of assisted reproductive technologies (ART), alongside new options such as uterus transplantation, fertility treatments continue to expand for individuals and couples facing reproductive health challenges.
Today, IVF remains a cornerstone of fertility treatment, often combined with technologies such as intracytoplasmic sperm injection (ICSI), preimplantation genetic testing, and fertility preservation through egg or embryo freezing. Surrogacy, both traditional and gestational, offers another route to parenthood, though it is surrounded by legal, ethical, and financial complexities that vary widely across regions.
More recently, uterus transplantation has emerged as a novel solution for women with absolute uterine factor infertility (AUFI), a previously untreatable cause of infertility. As of 2025, over 130 uterus transplants have been performed worldwide, resulting in more than 70 live births.* In the United Kingdom, a significant milestone was achieved when a woman gave birth to a healthy baby girl in February 2025, following a uterus transplant from her sister in 2023, the country’s first successful case of its kind.*
While still considered experimental in some countries, these successes mark advancement in reproductive health options, offering new hope to individuals affected by AUFI and prompting ongoing discussions among clinicians and ethicists.
As reproductive technology advances, so do questions surrounding access, safety, and long-term outcomes. Last month, we asked over 2,400 physicians worldwide about their opinion on uterus transplantation. Check out the full results below.
What are your thoughts on modern reproductive medicine, including uterus transplantation? Share your perspective in the comments below.
Uterus Transplantation: Significance and Patient Impact
With clinical outcomes and global experience continuing to develop, uterus transplantation is prompting new discussions about its role within reproductive medicine. While its feasibility has now been demonstrated across multiple centres, the broader significance lies in how it reshapes fertility treatment pathways for individuals with absolute AUFI, particularly those who have not pursued or do not prefer alternatives such as surrogacy.
For patients, the decision to undergo uterus transplantation often reflects a specific desire to experience gestation, but it also requires weighing the risks associated with major surgery, immunosuppression, and long-term follow-up. From a clinical perspective, identifying suitable candidates for uterus transplantation involves assessing not only physiological eligibility but also psychosocial readiness and expectations.
As the procedure remains time and resource-intensive, its impact is also being evaluated in terms of health system capacity, cost-effectiveness, and long-term maternal and child health outcomes. Some centres have begun exploring standardised criteria for donor selection, surgical protocols, and postnatal care, though no international consensus has yet been established.
For physicians, uterus transplantation could represent both a technical achievement and a developing area of patient-centred care that requires ongoing evaluation, balancing reproductive autonomy with clinical safety and broader policy considerations.
Physician Perspectives: M3 Pulse Results on Uterus Transplantation
In our latest M3 Pulse survey, we asked 2,464 physicians worldwide for their views on uterus transplantation as a current option within reproductive medicine. Because this was a multiple-choice question, respondents could select more than one answer, and the percentages below reflect how many selected each statement.
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Nearly half of all respondents, 46.0%, considered uterus transplantation a valuable advancement in reproductive health and fertility medicine, highlighting its growing potential as an infertility treatment for individuals with AUFI.
39.2% believed that more clinical trials are needed to assess its long-term success, and 37.7% felt it should be used with caution due to medical risks, especially when compared to more established ART such as IVF and intracytoplasmic sperm injection (ICSI).
Ethical and educational concerns also emerged. 28.8% responded ethical considerations need more attention in clinical discussions, while 24.7% noted that patients often lack full understanding of the risks involved in uterus transplantation as a novel infertility treatment.
Additionally, 21.0% pointed to a lack of public awareness about this form of fertility treatment, and 20.2% believed the procedure is not yet viable in clinical practice due to complexity or cost. 16.6% stated that it should remain experimental for now.
These findings suggest that while uterus transplantation is increasingly recognised as an innovative development within the broader field of reproductive medicine, many physicians believe it still requires further validation, ethical guidance, and public education before becoming a standardised infertility treatment alongside existing ART methods like IVF and ICSI
Comparing Infertility Treatments: Uterus Transplants vs. Surrogacy & Other Options
Fertility treatment options vary significantly in terms of medical complexity, legal accessibility, and patient preference. For individuals with AUFI, uterus transplantation and gestational surrogacy are two pathways that can lead to a genetically related child. However, the differences between them are substantial.
Uterus transplantation offers the possibility of pregnancy within the recipient’s own body, but requires major surgery, long-term immunosuppression, and assisted conception via IVF. It is currently available in limited centres, often under research protocols, and access is constrained by donor availability, cost, and institutional capacity.
In contrast, surrogacy is legally permitted in some regions and more established in practice, though it is highly dependent on national and local legislation. It typically carries fewer medical risks for the intended parent but introduces complex legal, ethical, and relational considerations, especially regarding parental rights, compensation, and cross-border arrangements.
Other options, such as adoption or child-free living, remain valid alternatives but may not meet all personal or cultural expectations. Ultimately, the decision between treatments involves not only clinical suitability but also individual values, legal context, and psychosocial support. A shared decision-making approach remains essential in helping patients navigate these fertility treatment choices.
The Future of Reproductive Medicine: What’s Next?
The future of reproductive medicine is being shaped by rapid advancements in bioengineering, artificial gestation technologies, and evolving transplant policies.
Artificial wombs, such as the “EXTEND” system developed by researchers at the Children’s Hospital of Philadelphia, aim to support the development of extremely premature infants by mimicking the intrauterine environment. These systems have shown promise in animal models and are progressing toward human clinical trials.*
Bioengineering efforts are also focused on creating bioengineered uterine tissues. Researchers are exploring the use of stem cells and scaffolding techniques to develop functional uterine tissue that could potentially be used for transplantation, reducing the reliance on donor organs and minimising the need for immunosuppression.*
Policy discussions are keeping pace with these technological advancements. In Mexico, for instance, legal debates are underway regarding the permissibility of live uterus donations, highlighting the need for updated regulatory frameworks to address ethical and legal considerations in reproductive technologies.*
As these innovations continue to develop, they hold the potential to expand reproductive health options and improve outcomes for individuals facing infertility, while also prompting important discussions about accessibility, ethics, and long-term implications.
What are your thoughts on the future of reproductive medicine and uterus transplantation? Share your perspective in the comments below.
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