The idea that British trans women could one day carry a baby might soon be a reality, says prolific surgeon Christopher Inglefield, who explains that a successful 'womb transplant' has already resulted in a healthy pregnancy in Brazil. Just six weeks after the surgery, the Brazilian woman who received the womb also started menstruating.
Said case took place two years ago and saw the unnamed trans woman receive a womb that was donated from a deceased biologically female person. It was a major moment for fertility scientists, who were thought to be overjoyed at the birth of a healthy baby girl weighing in at 5.6lbs.
Mr Inglefield, founder of the London Transgender Clinic and a specialist in his field, told The Mirror, "This pioneering birth is extremely important for any trans female who would like to carry her own child. Because once the medical community accept this as a treatment for cis women with uterine infertility, such as congenital absence of a womb, then it would be illegal to deny a trans female who has completed her transition.
"There are clearly anatomical boundaries when it comes to trans women but these are problems I believe can be [overcome] and the transplant into a trans female is essentially identical to that of a cis female."
In terms of the legalities of a trans woman falling pregnant, The Human Fertilisation and Embryology Authority (HFEA) have confirmed that there are no rules or regulations that say trans women who have received a uterus transplant should be denied IVF treatment.
But how does the science side of it all actually work? "The most important step is the harvesting from the donor, as great care is required to avoid damage to the arteries and veins supplying the uterus," said Dr Inglefield. "The 'plumbing in' is straight forward: donor vessels are connected to the pelvic artery and veins which are the same in both males and females."
He went on to explain, "With a uterus transplant in a trans female, the neovaginal would be opened at the pelvic end to accept the donor womb, and the same procedure is used in a cis female transplant, with the donor uterus being attached to the native vagina."
Hormone supplements could be taken throughout the pregnancy to replicate the changes that occur in a biologically female body, however, Mr Inglefield says it's unlikely a trans woman would be able to give birth naturally – a Caesarian section would be the safest choice for both mother and baby.
This groundbreaking new transplant surgery also gives hope to cisgender females with Mayer-Rokitansky-Kuster-Hauser syndrome (which sees the body fail to develop a functioning uterus that could carry a child, or have a menstrual cycle). It's believed to affect around 1 in 4,500 women.
To date, there have been 39 womb transplants carried out across the world, resulting in the birth of 11 babies (the first being the earlier mentioned case in Brazil).
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