Hello Hugo! First UK birth following a uterus transplant from a deceased donor

In February 2026, the first birth following a uterus transplant from a deceased donor was announced by Womb Transplant UK (see BioNews 1329). Grace Bell gave birth to her son, Hugo, on 12 December 2025.

The first birth from a deceased donation occurred in 2017 in Brazil (see BioNews 979), and Hugo's birth is believed to be the third such birth in Europe, with a few others born in the USA.

Hugo's birth is a milestone in the journey of Womb Transplant UK and its ongoing efforts to provide uterus transplantation as a solution to women without a functioning uterus. These women are unable to gestate as they have congenital or acquired absolute uterine factor infertility (AUFI): either they were born without a uterus, have had their uterus removed, or have a non-functioning uterus. Uterus transplantation has emerged over the last decade as an innovative, though highly complex, reproductive technology for women with AUFI.

Clinical trials have been happening globally thanks to donations from both living and deceased donors. Womb Transplant UK have permission for two clinical trials, one involving living donors and the other with deceased donors. In February 2025, Grace Davidson gave birth to Amy, the first baby to be born in the UK following a uterus transplant from a living donor; in this case, the donation came from Grace’s elder sister (see BioNews 1285 and 1204). The safe arrival of Hugo has demonstrated that uterus transplantation with either a living or a deceased donor is now possible in the UK.

The aim of uterus transplantation is to enable women with AUFI to gestate and give birth, regardless of who the donor is. However, living and deceased donations raise distinct ethical questions, with debate about which is ethically preferable.

For living donors, there is a significant risk of harm due to the more radical hysterectomy that is required to successfully explant the uterus for subsequent implantation. This is heightened by the fact that living donors undergo a non-therapeutic surgery for the benefit of another person.

Furthermore, there is the potential for coercion and familial pressure to donate, where the living donor is known to the recipient. This risks the voluntariness of the donor’s consent, as emotional bonds between the living donor and recipient can complicate consent. One study in the USA is using living donors unknown to recipients, negating this risk of coercion (see BioNews 878). This is not yet an option for the UK clinical team, whose trials include known living donors or deceased donors.

Using deceased donors overcomes these concerns, including avoiding the significant risk of physical harm to the living donor. However, deceased donation is not without ethical issues.

Due to the unique symbolism of the uterus, procurement from a deceased donor requires sensitivity, and explicit permission to remove the uterus must be requested after permission for life-saving organs has been sought to reduce the risk of refusal to donate those life-saving organs. Religious beliefs may also impact the willingness of next-of-kin to give consent.

Consent is fundamental to organ donation; within the UK, an opt-out system applies, whereby consent to organ donation is presumed unless one has opted out. However, it is important to note that this only applies to those aged over 18 years old, and that people can choose to opt out of the presumed consent system. Not all organs are automatically included: presumed consent applies to life-saving organs such as the heart, lungs, kidneys, liver, pancreas and small bowel, with donation of tissue and corneas also permitted.

The uterus is explicitly excluded from presumed consent to organ donation, so explicit consent is required. The donor can consent before death, or someone in a qualifying relationship to the deceased can consent to the donation after death. It is important to recognise the role of families in deceased donation and the act of selflessness to donate at a time of grief to not only save lives, but also improve the quality of a recipient's life by giving them the opportunity to gestate.

There is considerable demand by potential recipients for uterus transplantation, such that demand outstrips the supply of available organs; it is therefore highly likely that living and deceased uterus transplantation programmes will continue to run side by side. While Womb Transplant UK have advocated for an expansion of selection criteria to increase the number of potential deceased donors, there will still be a shortage of suitable organs. This is seen in all areas of organ donation.

It is anticipated that a public awareness campaign would need to be conducted regarding the public's knowledge of uterus transplantation to increase the likelihood of someone consenting to donation prior to death or on behalf of a deceased family member.

Womb Transplant UK is a charity established to fund the cost of the uterus transplant operations at approximately £25,000 each. The medical and surgical teams are drawn from five different hospitals in London and Oxford, led by Professor Richard Smith and consultant transplant surgeon Miss Isabel Quiroga. They currently have permission for a total of 15 transplants across two trials.

Worldwide, over 100 transplants and over 70 babies have been born following uterus transplantation, and at least one centre in the USA is now offering uterus transplantation as a treatment for AUFI.

With this latest announcement from Womb Transplant UK, it appears that uterus transplantation is rapidly developing to the point of accepted treatment for women with AUFI. There will be many challenges in establishing this procedure as a treatment for AUFI in the UK, not least of which will be the availability of suitable organs for transplantation.

Amy and Hugo's births last year both demonstrate that living and deceased uterine donation can result in the gestation and birth of children to women previously unable to gestate. They are the happy proof of many years of dedication by the Womb Transplant UK team, the ongoing hope and perseverance of the recipients and their families, and the generosity of donors.