Two babies were born following uterine transplants at Tübingen University Hospital in Germany: one in March and the other in May. Both women were suffering from Müllerian agenesis, a rare malformation (1/4,500) that had caused them to be born without a uterus and vagina. They were both transplanted with their own mother's womb. A third German uterine transplant was performed in Tübingen in January, thus enabling this woman to have a baby from 2020 onwards given the mandatory one-year delay between transplantation and conception.
About forty uterine transplants have been performed worldwide, resulting in around ten births. Conception must necessarily be in-vitro (IVF) "because it would not be medically possible to transplant intact fallopian tubes and ensure that an egg lodges in the right place inside the uterus". Birth is necessarily by caesarean section "to protect the uterus and vagina", the latter being artificially constructed with surgery. There is "otherwise quite simply too great [...] a risk that the transplanted organ will be damaged". The cost of such an operation is "between what kidney and liver transplants cost", i.e. "less than €50,000". No less than 18 departments and 40 specialists in Tübingen were involved in these births.
It is possible to consider a second pregnancy once the uterus has healed properly.
In answer to the question "Will transgender women soon be able to have children?" the doctors in Tübingen reply that they do not think this possible. In particular, this is because "transgender patients do not have the ovaries and hormone production needed to maintain a healthy uterus in which a child can develop".
Deutsche Welle, Fabian Schmidt (23/05/2019) - Two children born in Germany for the first time after uterus transplant