You can donate your uterus to someone who cannot carry a pregnancy on their own, and more than 100 such transplants have been performed worldwide since the first successful case in Sweden in 2014. The procedure is still offered at a limited number of specialized centers, almost exclusively within research protocols, and the screening process is rigorous for both the donor and the recipient. Whether you are a living volunteer or have registered as an organ donor after death, the path to uterus donation involves medical imaging, psychological evaluation, and surgical planning that differ substantially from other forms of organ donation.
Who Qualifies as a Living Donor
The basic eligibility criteria for a living uterus donor are straightforward on paper but narrow in practice. In the largest published U.S. trial, donors had to be between 25 and 65 years old, have delivered at least one baby at full term, and be free of significant medical or psychological conditions.1JAMA. Uterus Transplant in Women With Absolute Uterine-Factor Infertility Having carried a pregnancy to term matters because it proves the uterus can support a fetus and that the blood supply developed normally. Programs vary somewhat in their age cutoffs and how many prior births they require, but the core idea is consistent: your uterus needs a demonstrated track record.
A large pool of women have expressed interest. One U.S. analysis of over 2,200 living donor applicants found a mean age of about 34, with most having had two or three children. Interestingly, nearly 40 percent of the people who applied had never given birth, which would disqualify them under the standard protocols.2PubMed Central. Awareness and Interest in Uterus Transplantation over Time: Analysis of Those Seeking Surgical Correction for Uterine-Factor Infertility in the US That gap between who wants to donate and who meets the criteria is one of the practical bottlenecks in the field.
Beyond pregnancy history, programs screen for conditions that could compromise either the organ or the donor’s own health during the surgery. Obesity, uncontrolled hypertension, diabetes, and certain clotting disorders can all be disqualifying. You also need to be someone who can safely undergo general anesthesia for a long operation and tolerate several weeks of recovery.
The Medical Screening Pipeline
If you pass the initial eligibility check, the next stage is a battery of imaging studies designed to map the blood vessels feeding your uterus. This is not a standard part of any routine gynecological workup, and it is the step that most often reveals deal-breakers. Programs typically start with CT angiography of the abdomen and pelvis, pelvic ultrasound with Doppler, and often a chest X-ray.3PubMed Central. DUETS Dallas UtErus Transplant Study The role of imaging in uterus transplantation The surgeons need to see the exact caliber and branching pattern of the uterine arteries, because those vessels will be carefully dissected out during surgery and reconnected in the recipient.
MRI with angiography is increasingly favored as the first-line imaging tool. One comparative study found that MRI can often display the uterine arteries well enough that the donor does not need additional radiation-based scans. If the arteries are not fully visible on MRI, the team steps up to CT angiography and, in select cases, a catheter-based angiogram.4PubMed Central. Imaging evaluation of uterine arteries in potential living donors for uterus transplantation: a comparative study of MRA, CTA, and DSA Vascular anatomy varies a lot between individuals, and an unfavorable pattern (arteries that are too small, too tortuous, or that branch in unusual ways) can rule out an otherwise healthy donor.
Standard blood work, cancer screening, and infectious disease panels round out the medical picture. Programs also evaluate your cervix, endometrium, and overall pelvic anatomy with ultrasound and sometimes hysteroscopy. The screening process from first contact to final approval can take many months, sometimes over a year.
Psychological Evaluation
Uterus donation is unusual among organ transplants because it is entirely elective and the organ is not life-sustaining. No one will die on a waitlist without a uterus. That changes the ethical calculus: the bar for confirming that a donor is making a fully informed, psychologically sound decision is arguably higher than for, say, a kidney donor who is helping a family member survive dialysis. Every program includes structured psychological assessment, and this is not a rubber stamp.
In the Dallas UtErus Transplant Study, nondirected donors (people who volunteered to donate to a stranger) were screened for depression, anxiety, post-traumatic stress, and overall quality of life. None met clinical thresholds for psychological distress, and their resilience and well-being scores were above population averages. The most common motivations were wanting to give another woman the chance to carry her own child and wanting to contribute to science.5PubMed. Motivations and Psychological Characteristics of Nondirected Uterus Donors From The Dallas UtErus Transplant Study A separate study of six nondirected donors at Baylor found similar patterns: high general well-being, no signs of distress, and the same core motivation of helping someone else experience pregnancy.6PubMed. Live nondirected uterus donors: Psychological characteristics and motivation for donation
That does not mean every applicant sails through. An Australian trial reported that some potential donors showed clinical levels of depression, anxiety, or stress during screening, and the researchers emphasized the need for ongoing psychological support rather than a single-point evaluation.7PubMed. Psychological Assessment and Motivations of Potential Donors Within the First Australian Uterine Transplant Trial Programs are looking for people whose decision to donate is stable, not impulsive, and not driven by pressure from a family member or a sense of obligation that could sour after the fact.
What the Surgery Looks Like for the Donor
Donating a uterus is a major operation. It is substantially more involved than a standard hysterectomy because surgeons must preserve long segments of the uterine arteries and veins, along with their connections to larger pelvic vessels, so the organ can be revascularized once it is placed in the recipient. The two main approaches are open surgery (a large abdominal incision) and robotic-assisted surgery.
Early cases were all done through open laparotomy, with operative times averaging roughly six hours. Robotic-assisted cases take longer in the operating room, with a median of about ten and a half hours in one Dallas series, but the trade-off is meaningful: donors who had robotic surgery lost less blood, spent fewer days in the hospital, and returned to work sooner.8PubMed. Dallas UtErus Transplant Study: Early Outcomes and Complications of Robot-assisted Hysterectomy for Living Uterus Donors None of the robotic cases had to be converted to an open procedure, and early graft function was equivalent between the two approaches. A clinical review of multiple centers confirmed the same pattern: robotic surgery had the longest operative times but the lowest blood loss and shortest hospital stays.9PubMed Central. Living-Donor Uterus Transplantation: A Clinical Review As more teams gain experience, operative times for robotic cases are expected to come down.10PubMed Central. Robotic live donor hysterectomy
Recovery from the donor surgery typically involves a few days in the hospital for the robotic approach and somewhat longer for open surgery. Full recovery to normal activities generally takes several weeks. The complication profile is comparable to other major pelvic surgeries: risks include bleeding, infection, urinary tract injury, and the general risks of prolonged anesthesia. Since the uterus is removed completely, the donor will no longer menstruate and cannot become pregnant afterward.
Long-Term Health After Donation
One concern that potential donors rightly raise is what happens to their physical and mental health in the years after giving up their uterus. A Swedish study followed uterus donors for two to three years postoperatively and found that their health-related quality of life, mood, and marital relationships were generally stable. Their scores on a standard quality-of-life questionnaire remained above population averages.11PubMed. Donors’ health-related quality-of-life and psychosocial outcomes 3 years after uterus donation for transplantation A few individuals showed slight dips, and the researchers noted these seemed connected either to older age or to disappointment when the recipient’s pregnancy did not succeed. That second point is worth thinking about: if you donate to a specific person and the transplant fails or the pregnancies do not work out, that can weigh on you psychologically even if your physical health is fine.
Unlike kidney donation, uterus donation removes a non-essential organ. You do not lose any metabolic or filtering capacity. The main permanent change is the loss of fertility and menstruation, which is why programs require that donors have already completed their own families. Hormonal function is unaffected because the ovaries stay in place.
Deceased Donor Uterus Transplants
Not all uterus transplants come from living donors. Several programs have performed transplants using uteri recovered from brain-dead or recently deceased donors, similar to how kidneys or livers are procured for transplant. The first transplant from a deceased donor took place in Turkey in 2011 and, after a long interval, resulted in a live birth in 2020.12Transplant International. Past, Present, and Future: A Review of Uterus Transplant Italy recently reported its first experience with deceased-donor uterus transplants, with donor ages between 25 and 43.13PubMed Central. Uterus Transplantation from Deceased Donors: First Italian Experience
The obvious advantage of deceased donation is that no living person undergoes a long, risky surgery. The disadvantage is cold ischemia time, the period between when the organ loses its blood supply and when it is reconnected in the recipient. Published data suggest the uterus can tolerate at least six hours of cold storage and still support a successful pregnancy.14PubMed Central. The Key Role of Warm and Cold Ischemia in Uterus Transplantation: A Review Researchers are working on machine perfusion techniques to extend that window, testing 12-hour preservation periods in preclinical models.15PubMed Central. Uterine Transplant Optimization From a Preclinical Donor Model With Controlled Cardiocirculatory Arrest If you are considering registering as an organ donor and want the uterus included, it is worth knowing that very few organ procurement organizations currently have protocols in place for uterine recovery. This is still an emerging capability.
Using deceased donors also introduces different ethical and regulatory questions. Who decides whether the uterus can be recovered? Does the donor’s family have any say in how the organ is used or any relationship with the resulting child? These questions remain largely unsettled in most legal systems.16PubMed Central. Uterus Transplantation: The Ethics of Using Deceased Versus Living Donors
What Happens on the Recipient’s Side
Understanding the recipient’s journey helps potential donors grasp the full picture of what their donation enables, and also why the screening is so demanding. Recipients are typically women of childbearing age with what doctors call absolute uterine-factor infertility, meaning they were born without a uterus (most often due to a condition called MRKH syndrome), lost it to cancer treatment, or have a uterus so damaged it cannot carry a pregnancy. Before the transplant can even be scheduled, the recipient must undergo IVF and bank frozen embryos.1JAMA. Uterus Transplant in Women With Absolute Uterine-Factor Infertility
After receiving the uterus, the recipient takes immunosuppressive drugs to prevent rejection, typically a combination of tacrolimus and another agent. In the Dallas series, most recipients did not need long-term steroids, and the regimens were well tolerated, though about a third experienced some degree of acute kidney stress from the medications. Sixteen rejection episodes occurred across ten recipients, but all responded to treatment and none led to graft loss.17PubMed. Immunosuppression in Uterus Transplantation: Experience From the Dallas Uterus Transplant Study
Of the 20 recipients in the published JAMA trial, 14 had a functioning graft and all 14 gave birth to at least one healthy baby with no congenital malformations.18PubMed Central. Uterus Transplant in Women With Absolute Uterine-Factor Infertility All deliveries in uterus transplant pregnancies are by cesarean section, and preterm birth is common, though an expanded single-center report found a median gestational age at delivery of 37 weeks, with all babies ultimately discharged home.19American Journal of Transplantation. Pregnancy Outcomes After Uterus Transplantation: An Expanded Single-Center Experience A systematic review did find higher-than-normal rates of placenta previa and preterm delivery compared to the general population.20PubMed Central. Maternal and perinatal outcomes of live births after uterus transplantation: A systematic review
The transplanted uterus is not permanent. Once the recipient has finished having children (usually one or two), the uterus is removed through a planned hysterectomy so she can stop taking immunosuppressive drugs. Examination of these explanted uteri has shown varying degrees of chronic inflammation, including vascular rejection in some cases, reinforcing that the organ was never meant to stay in indefinitely.21American Journal of Transplantation. Uterus transplantation: Histological findings in explants at elective hysterectomy
Cost and Access
Uterus transplantation is expensive, and insurance coverage is virtually nonexistent. A Swedish cost analysis estimated the mean total expense at roughly €75,000 (about $80,000), covering everything from preoperative workup and IVF through surgery, hospitalization, medications, and sick leave for both donor and recipient. In the United States, that figure is likely two to three times higher because of the price differential for assisted reproduction and surgical care.22PubMed Central. Uterus transplantation: from research, through human trials and into the future A Dutch estimate came in even higher, at roughly €94,000, and the authors questioned whether the procedure was financially feasible outside of dedicated research settings in their country.
Right now, the procedure is performed at only a handful of centers globally, most of them running formal clinical trials. In the U.S., Baylor University Medical Center in Dallas has the most published experience. Sweden’s University of Gothenburg pioneered the field. Programs in France, Italy, India, China, the Czech Republic, and a few other countries have performed cases, but availability is nowhere near routine. If you are interested in becoming a living donor, the practical first step is contacting one of these research programs directly; there is no central registry or organ procurement pathway for living uterus donation the way there is for kidneys.
The Question of Transgender Recipients
One of the most frequently asked questions about uterus transplantation is whether it could one day allow transgender women to carry pregnancies. Researchers have examined this possibility and concluded that there is no overwhelming clinical argument against performing the transplant as part of gender-affirming surgery, though several hurdles remain.23PubMed Central. Uterine transplantation in transgender women Among those hurdles: the pelvic anatomy is different, hormonal support would need to be entirely exogenous, the vaginal canal would be surgically created rather than naturally present, and there is no clinical experience yet on which to base protocols. No uterus transplant into a transgender woman has been attempted as of mid-2025, and the field is still debating the ethical, immunological, and obstetric questions that would need to be resolved first. For potential donors, it is worth knowing that the eventual pool of recipients could expand beyond cisgender women, though that remains theoretical for now.
Directed Versus Nondirected Donation
Living donors fall into two categories. A directed donor is someone who donates to a specific person, often a family member or close friend. Your mother, sister, aunt, or even an unrelated friend could be your donor, provided she meets the eligibility criteria. A nondirected (or altruistic) donor volunteers without a specific recipient in mind, much like a nondirected kidney donor. The Dallas program has published extensively on nondirected donors and found that they tend to be highly motivated, psychologically stable, and driven by altruism.5PubMed. Motivations and Psychological Characteristics of Nondirected Uterus Donors From The Dallas UtErus Transplant Study
The choice between directed and nondirected donation raises practical and emotional differences. A directed donor has a personal relationship with the recipient, which can be a source of support but also of complicated feelings if the transplant fails or the pregnancy does not work out. A nondirected donor avoids that entanglement but may never learn the outcome. Contact policies between donors, recipients, and any children born from the transplant are not standardized and vary by program.16PubMed Central. Uterus Transplantation: The Ethics of Using Deceased Versus Living Donors Some programs facilitate a meeting if both parties agree; others maintain strict anonymity. If the emotional dimension of knowing (or not knowing) what happens to your uterus matters to you, ask about the specific program’s policy before committing.
How This Got Started
The science behind uterus transplantation developed over decades of animal research before it reached humans. The first live birth from a transplanted uterus in any species was in a mouse model in 2003, and studies in rats, sheep, pigs, and non-human primates followed, working out the surgical technique, immunosuppression protocols, and rejection monitoring.24PubMed Central. The history behind successful uterine transplantation in humans The first human attempt, in Saudi Arabia in 2000, failed when the graft had to be removed three months later because of blood clots. A 2011 case in Turkey using a deceased donor initially seemed like only a partial success, but that recipient eventually delivered a baby in 2020, nine years after transplant. The proof of concept came in 2014, when a Swedish team delivered the first baby from a planned uterus transplant trial: a premature but healthy boy born to a woman with MRKH syndrome.12Transplant International. Past, Present, and Future: A Review of Uterus Transplant Since then, the field has grown steadily, with programs on several continents and a cumulative live birth count well into the dozens.