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Delhi Doc Plans Womb Transplant in Transwomen: Why Hasn’t It Worked Before?

Uterine transplant in transgender women has only been attempted once before in the world, unsuccessfully.

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A Delhi based surgeon says he's planning to attempt a uterine transplant in a transgender woman, reported Mirror.

According to reports, Dr Narendra Kaushik, will go through with the procedure by using a donated uterus from either a deceased person or someone who had a hysterectomy and chose to donate.

"And that’s our aim, to make it so that they live as normal a life as possible as a woman. We aim for an aesthetic ideal," Dr Narendra Kaushik was quotes as saying by Mirror.

Although uterine transplants have been done in cis women, it has never been attempted successfully in a transwoman (assigned male at birth) before.
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Uterus Transplant in Transwomen

Uterine transplants are complicated procedures in the most conducive of conditions, in the case of transwomen, the anatomical considerations make it a whole other ball game.

Along with the uterus, the procedure involves transplanting the cervix, a cuff of vagina, the surrounding ligamentous and connective tissues, as well as the major blood vessels to the level of the internal iliac vessels, making it all the more risky.

So far, there has only been one recorded case of uterus transplant in a transwoman in the world.

Danish actress Lili Elbe underwent the procedure in 1931, but unfortunately didn't survive it, passing away just a few months later from related.

The story of Lili Elbe is captured in the movie, 2015 Oscar-nominated film, The Danish Girl.

If such a procedure was to be successfully carried out, it must be noted that the woman still wouldn't be able to get pregnant naturally, and would have to go through the In Vitro Fertilization (IVF) route.

In spite of the high risk, many doctors are optimistic of the future of uterine transplants in transwomen.

"There are clearly anatomical boundaries when it comes to trans women, but these are problems that I believe can be surmounted and the transplant into a trans-female is essentially identical to that of a cis-female," Surgeon Christopher Inglefield, founder of the London Transgender Clinic, was quoted as saying by Mirror.

In these cases, the nerves are not transplanted, so the person, if they are able to carry the pregnancy to term, won't experience labour pains and the birth would have to be through a caesarian section.
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Uterus Transplant in India

The success rate of the surgery is low even in cis women. Of the over 100 cases recorded in the world so far, around 20 have been successful.

Although we have come a long way since the procedure was first performed in 2014, it is still considered a risky and experimental surgery.

Pune's Galaxy Hospital made news in 2017 for being the first clinic in India to perform uterine transplants.

FIT reported back then that upwards of 40 women had signed up for the procedure. Since then the clinic has performed over 3 successful transplants, where the women were able to get pregnant.

(written with inputs from the Mirror.)

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