Uterine Transplantation for Absolute Uterine Factor Infertility: From Bench to Bedside

Uterus transplantation (UTx) has emerged as a promising reproductive option for women with absolute uterine factor infertility, and this narrative review offers an integrated translational overview of its progression from experimental research to clinical practice based on a structured qualitative synthesis of the literature retrieved from PubMed/MEDLINE, Embase, and Scopus between 2000 and June 2025, including original studies, reviews, case reports, meta-analyses, and clinical guidelines while excluding grey literature, incomplete abstracts, and non-human studies. Without performing quantitative synthesis or meta-analysis, the review highlights key historical milestones, advances in microsurgical technique and vascular preservation, evolving immunosuppressive strategies, reported graft function, reproductive and neonatal outcomes, and ethical considerations related to donor safety and equitable access. The review also notes that more than 90 uterine transplant procedures worldwide have led to over 50 reported live births, thereby demonstrating growing clinical reliability, while underscoring persistent challenges, such as graft rejection, infectious risk, and the long-term effects of immunosuppression, as the field continues to mature toward broader clinical applicability.