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According to a new study, trans women may soon carry pregnancies to term thanks to uterus transplants.
If the first case of uterus transplant dates back to 2014, in Sweden, this operation could soon be democratized among trans women, in France and elsewhere in the world, according to the authors of a study published in the journal Fertility and Sterility.
Trans women will need multiple surgeries
“As there are growing studies of high levels of depression, suicide among trans women, and the emotional impact of being unable to have children, we must consider the potential benefits of uterus transplant for trans women“, detail the authors of the study.
But if this surgery tends to become commonplace – a Frenchwoman transplanted in 2019 is now expecting her second child – it remains no less complex.
This transplant requires several surgeries: first an orchiectomy (surgical removal of testicles), then a vaginoplasty, that is to say a surgical operation aimed at constructing an artificial vagina and clitoris (composed of human tissue from other organs).
After a period of convalescence, the patient may benefit from a uterus transplant. But surgeons will need to have a healthy uterus – with the same blood group as the patient – in order to proceed with the implantation.
This uterus may come from a deceased woman or from a living donor. It will then be inserted and grafted into the trans woman’s body.
The scientists point out that the way in which this operation takes place varies: “Several vaginoplasty techniques exist and there are considerable nuances in the surgery as each surgeon makes their own modifications to the procedure.“.
The patient will not be able to get pregnant naturally
According to the researchers, this intervention, which could last more than ten hours, would take place almost in the same way as that of a biological woman.
However, the transplanted uterus cannot be connected to the fallopian tubes: the trans woman will therefore have to undergo in vitro fertilization (IVF) to hope to become pregnant. She will also need to take artificial hormones to mimic the hormonal system of the female body.
However, the authors point out that this operation remains “dangerous” for the patient and that the correct implantation of the graft is not 100% guaranteed.
They also state that “sperm conservation should be encouraged, allowing generation of embryos with a cis-female partner or egg donor“.