ABSTRACT
Transplant medicine, including surgery and subsequent medical management postoperatively, has improved dramatically over its relatively short existence. There has been recent rapid progress in transplantation in gynecology, particularly in the field of ovarian and uterine transplantation. These advancements have arisen due to the significant number of women who suffer from absolute uterine factor infertility (AUFI). Such women are considered “unconditionally infertile,” due to either an absence of uterus or the presence of a nonfunctioning uterus. Women with absence of a uterus may have been born without such, as in Mayor-Rokitansky-Kuster-Hauser syndrome, or may have undergone hysterectomy following cancer or excessive hemorrhage. Those with a nonfunctioning uterus may have a uterine malformation, intrauterine adhesions, severe adenomyosis, fibroids, or have suffered radiation damage. Such women have historically had the options of adoption or surrogacy, both of which are associated with moral and ethical complications in addition to legal, cultural, and religious factors that can all interrelate to restrict couples’ options. The fact that surrogacy is prohibited in many areas of the world, including Italy, Germany, France, and Spain, signifies the difficulties women experience to have children and the associated heartache, pain, and confusion that it may cause. Uterine transplantation is the first treatment for AUFI that overcomes some of these dilemmas.
