Uterus transplantation: historical evolution, clinical advances, and perspectives for latin america. a narrative review (2000–2025)

Abstract

Objective. To describe the evolution of uterus transplantation from its early experimental experiences to the most recent clinical outcomes (2000–2025), highlighting major advances, ethical and regulatory challenges, as well as perspectives for its implementation in Latin America, with emphasis on the Colombian context. Materials and Methods. A narrative review was conducted based on a non-systematic search in PubMed, Scopus, Embase, and SciELO up to October 2025, using the descriptors uterus transplantation, womb transplant, uterine factor infertility, and reproductive transplantation. Original articles, reviews, and institutional reports in English, Spanish, and Portuguese were included. Results. Globally, more than 140 uterus transplants have been reported, with approximately 70 live births. The most established programs are concentrated in Sweden, the United States, the Czech Republic, and Brazil. Major advances include the use of deceased donors, the incorporation of robotic surgery, and optimization of immunosuppressive management. In Latin America, Brazil leads successful cases, while Colombia is advancing in preclinical research. Ethical, logistical, and regulatory challenges persist, limiting regional implementation. Conclusions. Uterus transplantation represents an emerging paradigm for the treatment of absolute uterine factor infertility. Its development requires specific guidelines to ensure safety, quality of care, and scientific rigor. In Latin America, implementation demands strengthening institutional capacity, establishing clear regulatory frameworks, and evaluating cost-effectiveness according to the regional healthcare and socioeconomic context.