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I was told that a transgender person, which I will define as anyone assigned male or female at birth that identifies opposite to that assignment, could never become pregnant conceptually, due to the lack of hormonal pathways present in cis-male / trans-female person.

Are there modern medical methods that would allow for someone born male and is now trans-female to ever become pregnant or is it the case that medical science is not, nor ever will be capable of allowing for this?

Edit: I would say this is a different question than the suggested duplicate because someone who has AIS or CAIS would have a different anatomy than men assigned at birth, although not by much.

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  • $\begingroup$ One thing I would point out in your question is that a female identifying as trans-male who has not undergone hormone replacement or reassignment can become pregnant, assuming there are no medical conditions that would prevent a pregnancy. It is only after they are trans-male that they would be incapable of becoming pregnant, unless of course their internal sexual organs were preserved. I think the bigger issue would be that as the person does not identify as female, they would probably not desire to become pregnant, either before or after reassignment. $\endgroup$ – AMR Jan 10 '16 at 3:06
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    $\begingroup$ Possible duplicate of Can androgen-insensitive genetic-males get pregnant? $\endgroup$ – AliceD Jan 10 '16 at 7:00
  • $\begingroup$ @Christiaan The question here is phrased differently. It asks whether or not current medical technology could allow a trans-female to ever become pregnant. With Uterus transplantation, carefully controlled hormone therapies, in vitro fertilization, and cesarean delivery, the answer could be yes rather soon, though there may be some ethical hurdles to overcome. $\endgroup$ – AMR Jan 10 '16 at 14:04
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Medical science has reached the point where it is able to consider performing uterine transplants in genetically female (cis-female) patients born without a uterus.

In the MedlinePlus report, First Uterus Transplant Planned in U.S. doctors at The Cleveland Clinic have plans to perform the first uterus transplant in the US sometime in 2016.

The article does however go on to state that the women will need to have been born with ovaries. The same matching process of blood and tissue typing that goes along with any organ transplant would still be in effect for this surgery.

It is also unlikely that the procedure would be open to women that lost their uterus due to cancer, as the recipients would be required to be on immunosuppression medication, and the risk of cancer recurrence would be too great.

As for your question about transplantation into Male-to-Female transgender patients, it is unlikely, at least with present technology that the person would be able to receive the transplant. There is a complex cascade of hormone signaling required for implantation of the embryo.

There could also be implications as to the formation of the placenta and how the person's body react to that. We have many examples of surrogacy, so we know that a woman can carry the embryo formed from the egg of another woman, but how the transgender person's somatic cells would react, given that they all have y-chromosomes is unknown.

According to a Yahoo! news article that interviewed Dr. Karine Chung, director of the fertility preservation program at the University of Southern California’s Keck School of Medicine and Dr. Christine McGinn, a New Hope, Pa., plastic surgeon who performs transgender surgeries on men and women, they foresee possibilities that this could happen in the future, however they do not cite any research that has been performed to date.

One of the issues would be the differing pelvic vasculature that a cis-male has to a cis-female, and what would need to be done to provide an adequate blood supply to sustain not only the uterus but the growing fetus as well.

...biological women have a leg up on biological males when it comes to accepting and nurturing a transplanted uterus. Women already have: vasculature needed to feed the uterus with blood, pelvic ligaments designed to support a uterus, a vagina and cervix, and natural hormones that prepare the uterus for implantation and support the pregnancy.

Men have none of those support systems — naturally — but none are impossible to create. “Male and female anatomy is not that different,” says Chung. “Probably at some point, somebody will figure out how to make that work.” (2)

The article does go on to point out that

  1. Hormone therapy can shut off testosterone and introduce progesterone and estrogen needed to prepare the uterus for pregnancy.

  2. Even though males do not have uterine veins and arteries needed to nurture the womb, it’s possible to attach a branch of a large vessel, like the internal iliac, to the uterus. “It’s doable, it just hasn’t been done,” Chung says.

  3. Although it’s preferable for a vagina to support the uterus, it’s possible to attach a transplanted uterus to other ligaments in the pelvis.

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  • $\begingroup$ So if I understand correctly we can not emulate the hormonal signals at all or well enough to allow for the formation of a placenta in a possible successfully transplanted uterus in a Male to Female transgender person? Is research being done in this regard or no? $\endgroup$ – Ro Siv Jan 10 '16 at 2:14
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    $\begingroup$ I am not familiar with what is being done beyond the information contained in the article, and one or two others I have read with basically the same information. I would have to assume that to clear their Medical Ethics committee and gain approval for the procedure, the doctor's would have needed to limit the study to only women born without uteri. I do not know if they would have even gone so far as to consider the possibility of performing this procedure in the transexual population. As for what is being done elsewhere, this is the first I have heard of the procedure, so I cannot say. $\endgroup$ – AMR Jan 10 '16 at 2:22
  • $\begingroup$ The point of the ovaries is likely two-fold. First is likely hormonal, and the second is likely practical. If the woman has no ovaries, then she would not be able to give birth to a child that was genetically her's, so I would think that ethicists would weigh the risks versus the benefits as far too great to allow the procedure to proceed for the purpose of giving the person the ability to have the experience of being pregnant. $\endgroup$ – AMR Jan 10 '16 at 2:25
  • $\begingroup$ @RoSiv This article from Yahoo! news interviews doctors that feel that it may be possible within the next five to ten years, but here, they are guessing. yahoo.com/health/… $\endgroup$ – AMR Jan 10 '16 at 2:36

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