Transgender women should be entitled to womb transplant to enable them to have their own babies, according to a leading British surgeon.

Two years ago a woman in Brazil became the first mother to give birth to her child using a womb transplanted from a deceased donor to a woman.

It was a major breakthrough in fertility medicine when the little girl was born healthy and weighing 5.6lbs.

It comes just four years after the worlds first womb transplant baby from a live donor was born in Sweden in 2014.

Surgeon Christopher Inglefield, founder of the London Transgender Clinic, says a successful uterus implant into a trans-female is now achievable.

He says the procedure essentially identical to that of cis-women - aka females born in that gender.

Mr Inglefield, a specialist in gender confirmation surgery as well as facial and body feminisation, said: 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 that I believe can be surmounted and the transplant into a trans-female is essentially identical to that of a cis-female.

The Human Fertilisation and Embryology Authority (HFEA) confirm there are no regulations in place to prevent a trans woman who has received a uterus transplant from having IVF treatment.

And Mr Inglefield describes how a transplant would work.

He explained: "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.

"The actual plumbing in is straight forward.

"The donor vessels are connected to the pelvic artery and veins which are the same in both males and females.

"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.

Trans females have a much narrower pelvis than cis-women of the same height, but there would still be room for them to carry a child.

Supplemental hormones could be taken to replicate the changes that occur in the body when a woman is pregnant.

Meanwhile its highly unlikely that a trans female would give birth naturally, but would be delivered via Caesarian section in order to safeguard the child.

Other experts have also endorsed Mr Inglefields claims.

In November last year, Dr Richard Paulson, former president of the American Society for Reproductive Medicine, said there was no anatomical reason why a womb could not be successfully implanted into a transgender woman.

He added: "You could do it tomorrow. There would be additional challenges, but I dont see any obvious problem that would preclude it.

"I personally suspect there are going to be trans women who are going to want to have a uterus and will likely get the transplant.

Womb transplant surgery is being seen as a major cause for hope for those who suffer from Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome.

This is when a woman fails to develop a proper uterus and vagina yet has normal ovarian functions and normal external genitalia.

Women who have MRKH will still go on to develop breasts and pubic hair, but they will not have a menstrual cycle.

The syndrome is thought to affect around 1 in every 4,500 women.

But Mr Inglefield, who appeared in ITV's fly-on-the wall documentary Transformation Street, says the demand among trans women could be far greater.

He added: According to some estimates, the prevalence of transgender females in the UK could be as high as 1,000 per 100,000 persons, around 1 per cent of the population.

Just looking at the potential number of trans females who might seek uterine transplantation surgery and its abundantly clear it could become a vital medical service.

As it stands, trans women face a tricky pathway to motherhood, which is often achieved through surrogacy, adoption or fostering.

But those pathways are not without their own pitfalls and many would-be mothers simply long to carry their child, to be pregnant in the very real sense.

As womb transplant surgery is further improved and perfected, its vital trans women are not excluded from the conversation, at it could immeasurably improve a great many lives.

The Gender Recognition Act 2004 says that a trans female can apply for a Gender Recognition Certificate if they wish for their acquired gender to be legally recognised in the UK.

Applicants must go before a panel, documenting any treatments theyve had to change their sexual characteristics, such as hormone treatment or surgery.

They must have lived in their acquired gender for at least two years if single, or six years if married or in a civil partnership.

A spokesperson for the HFEA said: "I can confirm that to our knowledge there are currently no regulations in place which would prevent a person who has received a uterus transplant from having IVF treatment.

"The law, as it currently stands, does not require the person who is carrying a child to have obtained a GRC stating that they are female before having their fertility treatment.

And as stated in the Act the person who carries or has carried a child as a result of an embryo transfer, or artificial insemination, is considered as the mother of the child at birth."

The new test case, which has made headlines across the world, saw a 32-year-old woman born without a uterus given one taken from a 45-year-old donor who died from a brain haemorrhage.

The donor womb was implanted in a 10 hour surgery, which saw veins, arteries, ligaments and vaginal canals being connected.

And she then received fertilised eggs produced by IVF.

The birth took place in December 2017, but has only now been reported in journal The Lancet.

There have been 39 womb transplants across the world and of these, 11 babies born.

Until the Brazil transplant the surgery had failed 10 times.

The womb donor was a mum-of-three, who was in her mid-40s and died from bleeding on the brain.

Just six weeks after the surgery, the woman who received the womb started having periods.

Then, seven months later the eggs, which had been fertilised via IVF, were implanted in her womb.

Her baby was born by caesarean secion on December 15, 2017, and weighed 6lb.

Dr Dani Ejzenbery, from Hospital das Clicas in Sao Paulo, where the surgery was carried out, said: "The first uterus transplants from live donors were a medical milestone, creating the possibilty of childbirth for many infertile women with access to suitable donors and the needed medical facilities.

"However, the need for a live donor is a major limitation as donors are rare, typically being willing and eligible family members or close friends."

Imprial College London's Dr Srdjan Saso described the surgery as "extremely exciting".

The government equalities office estimates there are between 200,000 to 500,000 trans people in the UK.

Liz Armstrong, head of transplant development at NHS Blood and Transplant, said: No uterus transplant has yet been carried out in the UK.

"However if it was to go ahead, the donation and transplantation of a uterus would be carried out under the same regulatory framework in the UK as any other organ, whether from a living or deceased donor.

"The new opt out law in England, only applies to transplants which are already routinely carried out in this country specifically heart, lungs, liver, kidneys, pancreas and intestinal organs.

"It also covers certain tissue, including corneas, skin, blood vessels, bone, muscle and tendons.

"A uterus transplant would be classed as a novel transplant and would therefore only take place with the explicit permission from the donor or donors family.

"People have the option to state which routine organs they wish to donate, when recording an opt in decision on NHS Organ Donor Register.

"We would encourage everyone to speak with family and friends so they are clear on what you want to happen in the event of your death."

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Transgender women 'should be allowed womb transplants so they can have own babies' - Mirror Online

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