New analysis shows that uterus transplants help women achieve successful pregnancies

The once impossible surgical procedures, pioneered and refined at Penn Medicine, have led to fewer rates of organ rejection and more births of healthy babies

University of Pennsylvania School of Medicine

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PHILADELPHIA – A decade of uterus transplantation in the United States has resulted in dozens of healthy births and steadily improving surgical outcomes, according to a new national review led by researchers from the Perelman School of Medicine at the University of Pennsylvania. The study found that 70 percent of uterus transplant recipients achieved at least one live birth (or were still pregnant beyond 20 weeks when the study closed), demonstrating that the procedure has matured from an experimental intervention into a replicable clinical therapy for women born without a uterus or those whose uteruses cannot support pregnancy.

 

The findings, published in Obstetrics & Gynecology, [EH1] summarize outcomes from 60 uterus transplants performed between 2016 and 2025 at the four U.S. centers that have offered the procedure. The analysis represents nearly the entire U.S. experience with uterus transplantation and includes surgical, reproductive, neonatal, and early childhood developmental outcomes.

 

"One of the reasons I went into obstetrics was to help give more women opportunities to start a family, and I’m proud of the work my colleagues and I have done at Penn to advance this treatment," said senior study author Kathleen E. O'Neill, MD, MSTR, an assistant professor of Obstetrics and Gynecology at Penn and the director of the Penn Uterus Transplant Program. "The data from this analysis show that uterus transplant is an effective way for women to achieve pregnancy and have children. It should be part of the conversation alongside adoption and gestational surrogacy, and these data give patients and their doctors the information they need to decide whether it's the right path for them."

 

Absolute uterine factor infertility—the absence of a uterus either from birth or after hysterectomy—affects roughly 3 percent of women. Most transplant recipients in the study had Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, a congenital condition in which the uterus does not develop. Others had undergone hysterectomy or had a uterus unable to support pregnancy.

 

Penn pioneers uterus transplantation

Under the leadership of O’Neill, Penn’s first birth from a uterus transplant happened in November 2019 with the arrival of baby Benjamin Gobrecht. His mother, born without a uterus, received a new organ from a deceased donor through the Gift of Life as part of Penn’s UNTIL uterus transplant trial.

Since then, Penn has had eight babies born from seven transplants, mostly from living donors. And three of those transplant recipients, all of whom have delivered a healthy baby, are trying to get pregnant again.

 

Success rates rise as surgical outcomes improve

Researchers found that 51 of the 60 transplanted uteruses survived beyond the critical first 30 days after surgery. Among the women who received those organs, more than 82 percent ultimately achieved at least one live birth or were still pregnant at 20 weeks or later when the study closed. And since 2020, only one surgical graft failure has occurred among 31 transplants performed nationwide, reflecting major improvements in surgical techniques and patient care.

 

Across the study period, 48 babies were born to uterus transplant recipients in the United States. Nine recipients delivered two children, demonstrating that transplanted uteruses can support multiple pregnancies before the organ is removed.

 

Among living donors, major complications requiring additional intervention declined from 33 percent in 2016-2017 to 8 percent in 2024-2025, and no recipient or living donor experienced a life-threatening complication or death related to the procedure.

 

Children thrive as obstetric challenges persist

While reproductive outcomes were encouraging, pregnancy after uterus transplantation remains complex. More than half of babies, 58 percent, were born prematurely, and pregnancy complications such as preeclampsia, gestational diabetes, and hypertension were relatively common.

 

Researchers also tracked the health and development of children born following uterus transplantation. All children demonstrated normal development at hospital discharge and at six months of age. Among 29 children evaluated at age 3, researchers observed normal growth and no cases of failure to thrive. Two children had been diagnosed with autism spectrum disorder, while no other developmental disorders were identified.

 

Both recipients and babies will continue to be followed, said O’Neill, and research is being done to better understand why pregnancy complications are occurring.

 

Researchers call for wider access

The authors noted that access remains one of the field's greatest challenges. Uterus transplantation is available at only a handful of centers nationwide, including Penn, and is generally not covered by insurance, making treatment inaccessible for many eligible patients.

 

“I hope this analysis does show insurance companies, and those who can invest in making this procedure more widely available, that we have a technique that has allowed more women to be able to become moms,” said O’Neill. “Women deserve access and options when it comes to how to start a family.”

 

 

 

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About Penn Medicine 

Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, excellence in patient care, and community service. 

The organization consists of the University of Pennsylvania Health System and Penn’s Raymond and Ruth Perelman School of Medicine, founded in 1765 as the nation’s first medical school.

The Perelman School of Medicine is consistently among the nation's top recipients of funding from the National Institutes of Health, with more than $588 million awarded in the 2024 fiscal year. Home to a proud history of “firsts,” Penn Medicine teams have pioneered discoveries that have shaped modern medicine, including CAR T cell therapy for cancer and the Nobel Prize-winning mRNA technology used in COVID-19 vaccines.

The University of Pennsylvania Health System cares for patients in facilities and their homes stretching from the Susquehanna River in Pennsylvania to the New Jersey shore. UPHS facilities include the Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, Chester County Hospital, Doylestown Health, Lancaster General Health, Princeton Health, and Pennsylvania Hospital—the nation’s first hospital, chartered in 1751. Additional facilities and enterprises include Penn Medicine at Home, GSPP Rehabilitation, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.

Penn Medicine is a $13.7 billion enterprise powered by more than 50,000 talented faculty and staff.  

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Journal

Obstetrics and Gynecology

Subject of Research

People

 

How straw is returned to soil can make a major difference in nitrous oxide emissions

Pelletized straw cut nitrous oxide emissions by up to 45.7% in saline-alkali soil, while also reshaping key ammonia-oxidizing bacterial communities

Shenyang Agricultural University Collaborative Journals

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Straw return methods differentially mitigate N2O emissions with reduced AOB amoA abundance and shifted community composition in N-fertilized saline-alkali soils

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Credit: Zhen Li, Huimin Dong, Wenshuo Liu, Yaqi Yu, Marcela Hernández, Yanhong Lou, Haojie Feng, Hui Wang, Quangang Yang, Hongjie Di, Yuping Zhuge & Hong Pan

Returning crop straw to farmland is widely used to recycle nutrients and improve soil quality. But new research shows that the way straw is returned to soil can strongly influence how effectively it limits emissions of nitrous oxide, a potent greenhouse gas.

Researchers compared several straw management strategies in nitrogen-fertilized saline-alkali soil and found that pelletized straw produced the strongest reduction in nitrous oxide, or N₂O, emissions. Under low nitrogen conditions, pelletized straw reduced cumulative emissions by 45.7% compared with soil receiving no straw, while the reduction remained 43.2% under high nitrogen input.

“Our results suggest that straw return should not be treated as a single management practice,” said corresponding author Yuping Zhuge of Shandong Agricultural University. “The physical form and processing pathway of straw can alter microbial nitrogen cycling, which in turn affects how much nitrous oxide is released from soil.”

The study focused on saline-alkali soils, which are often characterized by high pH, elevated salt levels and relatively low soil organic carbon. Farmers commonly rely on nitrogen fertilizer to sustain crop production in these soils, but added nitrogen can also stimulate microbial processes that generate N₂O.

The researchers conducted a 90-day incubation experiment using soil collected from a saline-alkali land improvement demonstration site in Weifang, Shandong Province, China. Two nitrogen application rates, equivalent to 120 and 240 kilograms per hectare, were tested. The team compared soil receiving no straw with four straw-derived treatments: crushed straw, pelletized straw, composted cattle manure derived from straw-fed livestock, and carbonized straw biochar.

Higher nitrogen input increased cumulative N₂O emissions by an average of 41.6%. However, all four straw treatments reduced emissions relative to the no-straw control. Pelletized straw consistently produced the lowest cumulative emissions, whereas carbonized straw was generally less effective. The timing of emissions also changed. In soil without straw, N₂O emissions peaked around day 30, while straw-amended soils showed a delayed peak around day 60.

The researchers then examined the microorganisms involved in nitrogen cycling. They found that N₂O emissions were closely associated with the abundance of the amoA gene in ammonia-oxidizing bacteria, or AOB. Among the functional genes studied, AOB amoA showed the strongest relationship with cumulative N₂O emissions. Straw application generally reduced its abundance.

Straw addition also changed the composition of the ammonia-oxidizing bacterial community. The relative abundance of Nitrosovibrio increased, while Nitrosospira declined, indicating that straw management affected not only the number of ammonia oxidizers but also which groups dominated the community.

The findings highlight an important distinction for agricultural greenhouse gas management: returning crop residues can help reduce N₂O emissions, but the size of that benefit depends strongly on how the straw is processed and applied.

The authors conclude that pelletized straw may be particularly effective for suppressing AOB-associated N₂O production in nitrogen-fertilized saline-alkali soils. Field studies will be important for determining how these effects translate from controlled incubation conditions to working agricultural systems.

 

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Journal Reference: Li Z, Dong H, Liu W, Yu Y, Hernández M, et al. 2026. Straw return methods differentially mitigate N2O emissions with reduced AOB amoA abundance and shifted community composition in N-fertilized saline-alkali soils. Nitrogen Cycling 2: e027 doi: 10.48130/nc-0026-0014  

https://www.maxapress.com/article/doi/10.48130/nc-0026-0014  

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About Nitrogen Cycling:
Nitrogen Cycling (e-ISSN 3069-8111) is a multidisciplinary platform for communicating advances in fundamental and applied research on the nitrogen cycle. It is dedicated to serving as an innovative, efficient, and professional platform for researchers in the field of nitrogen cycling worldwide to deliver findings from this rapidly expanding field of science.

Follow us on Facebook, X, and Bluesky. 

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Journal

Nitrogen Cycling

DOI

10.48130/nc-0026-0014

Method of Research

Experimental study

Article Title

Straw return methods differentially mitigate N2O emissions with reduced AOB amoA abundance and shifted community composition in N-fertilized saline-alkali soils

Article Publication Date

24-Sep-2026

 

European researchers set out EU innovation reforms in Science

Science Policy Forum proposes a clearer route from discovery to market, stronger support for high-risk ideas and better incentives for academic entrepreneurs

Politecnico di Milano

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Europe could turn more of its scientific discoveries into new technologies, products and businesses by changing the way it funds innovation and supports researchers, according to a new Policy Forum published in Science.

The paper, Enhancing Europe’s Competitiveness by Empowering Researchers as Innovators, calls for a more continuous route from fundamental research to commercialisation, simpler funding procedures and greater recognition of entrepreneurship within universities. It argues that persistent institutional and funding barriers prevent scientific excellence from generating its full economic and societal impact.

The work is an initiative of INPACT!, a network launched in 2023 that brings together more than 120 scientist-innovators from over 20 countries in the European research area, mainly European Research Council grantees. It combines researchers’ direct experience with economic analysis of European funding programmes to identify reforms that could strengthen Europe’s ability to translate research into innovation.

Connecting research and innovation

The analysis focuses on Horizon Europe, the European Union’s research and innovation programme for 2021–2027. The authors argue that funding remains fragmented and that discoveries with commercial potential can encounter administrative gaps between European Research Council (ERC) Proof of Concept grants, which help researchers explore practical applications, and European Innovation Council (EIC) programmes supporting technology development and business growth.

One of the main proposals is to bring ERC Proof of Concept grants under EIC governance, creating a more continuous pathway from scientific discovery to technology development and commercialisation. According to the authors, this could reduce repeated evaluations, simplify transitions between programmes and make support more predictable for researchers and investors.

“Europe has extraordinary scientific talent, but too often we lose momentum between discovery and application. We need a more continuous pathway that allows promising ideas to move from fundamental research towards technologies, companies and solutions capable of generating economic and societal impact,” says Dario Polli, Professor at Politecnico di Milano and one of the lead authors of the Policy Forum.

The Policy Forum also calls for stronger support for early-stage, high-risk innovation. Combined annual funding for the EIC Pathfinder and Transition programmes is currently approximately €500 million, while their programme-management capacity remains limited compared with advanced research agencies in the United States. The authors recommend reallocating resources towards breakthrough innovation and giving independent programme managers greater authority to guide promising projects.

“Europe is caught in a middle-technology trap: we specialise in mature industries such as automotive and industrial machinery, while frontier sectors such as AI and biotechnology remain too small. To strengthen Europe’s competitiveness and strategic autonomy, we must rebuild the pipeline from scientific discovery to market-funding the best ideas and enabling researchers and innovators to turn today’s breakthroughs into tomorrow’s high-tech industries,” says Giorgio Presidente, researcher at Institute for European Policymaking at Bocconi University.

Simpler applications and support for excellent unfunded projects

The authors also argue that European funding applications should be shorter and assessed more directly on the substance of the idea and its potential use.

They propose that national funding agencies make multi-year commitments to support excellent projects that successfully pass European evaluation but cannot be financed from the available EU budget, extending the approach already used through the Seal of Excellence.

 

Universities must recognise researchers as innovators

Reforming European funding alone will not be enough, the authors argue. Universities and technology transfer offices also need to create conditions in which researchers can pursue innovation without being forced to choose between an academic career and entrepreneurship.

The Policy Forum recommends greater recognition of entrepreneurship in academic careers, improved intellectual-property management and clearer routes to patents, industrial partnerships and spin-offs, together with better access to mentoring and entrepreneurial expertise.

These reforms, the authors stress, would not by themselves resolve Europe’s wider constraints in venture capital, regulation and business expansion. However, a more coherent system linking scientific research, technology development and entrepreneurship could help Europe capture more of the economic and societal value generated by its research base.

“To translate more scientific discoveries into new technologies, products, and services that reach the market, we would benefit from a clearer pathway in our institutions, with well-defined steps, predictable timelines, and streamlined procedures. Making the entire process easier to navigate could empower more of us to transform knowledge into solutions for society. I strongly believe that embracing innovation can give new momentum to our careers, reshape how we approach our work, and enable us to play a strategic role in strengthening Europe’s global competitiveness while addressing unmet societal needs.” says Amanda Silva Brun, Director of research at the CNRS and one of the lead authors of the Policy Forum.

About the Policy Forum

Enhancing Europe’s Competitiveness by Empowering Researchers as Innovators is published as a Policy Forum in Science. The article underwent external peer review and revision before acceptance.

The paper is an initiative of INPACT!, a European network of scientist-innovators established to share experience, identify barriers to research commercialisation and contribute proposals to strengthen Europe’s research and innovation ecosystem.

https://doi.org/10.1126/science.ady2388

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Journal

Science

DOI

10.1126/science.ady2388

Method of Research

Commentary/editorial

Subject of Research

Not applicable

Article Title

Enhancing Europe’s competitiveness by empowering researchers as innovators

Article Publication Date

24-Sep-2026

 

RESEARCH: Climate overshoot will leave lasting impacts even after global temperatures fall

Accounting for these accumulated effects could help governments better assess climate risks and plan adaptation measures, Concordia researchers say

Concordia University

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Returning global temperatures to a climate target does not necessarily undo the damage caused by exceeding it, new Concordia-led research finds.

The study shows that temporarily overshooting warming targets such as 1.5°C or 2°C can leave lasting changes in the oceans, permafrost and other parts of the climate system, even if temperatures eventually fall back to below these targets.

The researchers used the University of Victoria Earth System Climate Model to compare 42 pairs of climate scenarios. In each pair, one scenario temporarily exceeded its warming pathway before returning to it, while the other stayed below the threshold.

The researchers measured overshoot using “degree-years” — a measure that combines how much temperatures exceed a target with how long they remain above it. They found that degree-years were a strong predictor of lasting changes in several climate variables.

Some variables were found to be much more susceptible to warming than others. Permafrost, for instance, showed almost no recovery of lost carbon when temperatures returned to baseline levels. Changes to sea-level rise, ocean warming and ocean oxygen levels also largely persisted after overshoot.

The findings suggest that the peak level of warming alone does not tell the whole story. The length of time spent above a target can also determine how much lasting change occurs.

For policymakers, this means climate goals should not be viewed simply as temperature levels that can eventually be reached after limits are breached. The pathway to those temperatures matters. Accounting for the accumulated effects of overshoot could help governments better assess climate risks and plan adaptation measures.

The study was published in Nature Communications Earth and Environment. It was written by Concordia postdoctoral fellow Mitchell Dickau; Damon Matthews, professor, Geography, Planning and Environment; and Kirsten Zickfeld, professor, Geography, Simon Fraser University.

Read the paper: “Irreversible climate changes driven by degree-years of temperature overshoot”

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Journal

Communications Earth & Environment

DOI

10.1038/s43247-026-03761-z

Method of Research

Computational simulation/modeling

Subject of Research

Not applicable

Article Title

Irreversible climate changes driven by degree-years of temperature overshoot

 

Study finds alpine peaks are greening in Northeast U.S., Canada

Satellite imagery shows the impact of wind above the tree line

Dartmouth College

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Alpine plants, including grass-like sedges and rushes, and low-growing shrubs called heaths, on the rocky summit of Algonquin Peak, located in the Adirondack Mountains in upstate New York. 

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Credit: Photo by Jonathan Chipman.

In northeastern North America, a 500-mile-long stretch of mountains runs from the Adirondacks in New York to the Gaspé Peninsula in eastern Quebec.

Nearly 70 million people live within a day's drive of one of the alpine zones, the area above tree line where trees don't grow due to the harsh conditions.

The ecological habitats, which include the alpine zones in the Green Mountains and the White Mountains, are home to many rare species of flowering plants, making the areas hotspots for biodiversity. However, with climate change and rising temperatures, the alpine zones are impacted by declining snow cover, atmospheric nutrient deposition, and high-impact outdoor recreation where invasive species may be tracked in by hikers, hunters, bikers, skiers, and others enjoying the mountain terrain.

While prior research has examined greening in regions such as the Alps, the Rocky Mountains, and the Arctic, in relation to climate warming and other processes, Jonathan Chipman '90, director of the Citrin Family GIS/Applied Spatial Analysis Laboratory at Dartmouth, noticed that a regional-scale assessment of what's been happening above tree line in northeastern North America was lacking.

Given that Dartmouth is home to remote sensing and technical expertise in processing satellite imagery and time series data, and the Appalachian Mountain Club has a huge amount of alpine ecology expertise on the ground from fieldwork and citizen science projects, Chipman teamed up with co-author Jordon Tourville, a terrestrial ecologist at the Appalachian Mountain Club, to research the topic further.

"This study was a perfect collaboration between a university and a nongovernmental organization in the region, as we don't just want to be doing this research in the abstract, but we want to help land managers, other stakeholders, and the public understand what is happening in the region," says Chipman.

In a new study led by Chipman using hundreds of satellite images over 40 years, the team provides the first regional analysis of greening trends in the northern Appalachian region.

Published in Ecosphere, the results show that 69% of the alpine zones studied have experienced significant increases in vegetation, representing 88% of the alpine area in the region.

"In other regions such as in the Alps, as an area near the top of the mountain warms, the tree line advances, growing higher up the mountain, but the situation here is quite different," Chipman says. "Our results show that significant greening and shrubification, in which alpine plants are being replaced by shrubs, is occurring inside the alpine zone, not just where the tree line is advancing."

This was especially evident for the Presidential Range in New Hampshire and Katahdin in Maine, where greening was prominent within the alpine zone at higher elevations. Increases in vegetation were observed, including in: cliff plants that grow out of rocky outcrops; cushion-tussock, a dense dome-shaped plant; and sedge meadows, a hardy grass-like plant.

However, according to the co-authors, this acceleration of growth may not necessarily be positive if rare alpine plants start getting crowded out by more aggressive flora.

"While these ecological changes are affected by a number of factors—the overall warming trend, the landscape such as the steepness of the slope and sun exposure, snow cover, soil chemistry, and nitrogen deposition from power plant emissions—what's notable in this region is the effect of wind," says Chipman.

All the mountains in the region have very high winds, especially in the winter. Mount Washington, in New Hampshire's White Mountains, has the highest recorded wind speed by a staffed weather station of 231 miles per hour.

"The wind causes the alpine zones to start lower than they would be elsewhere at this latitude," says Chipman. "What we're seeing is that this greening trend on mountains in the Northeast is kind of being held back on the windy side of the mountains, but there's this kind of growth that is being unleashed on the more sheltered sides, where it's occurring faster."

The results show that the region is warming due to climate change, but the observed greening trends don't necessarily match the expected pattern. The researchers suspect that other factors are adding to the impact of warming. "In the late 20th century these mountains were being doused with nitrogen from Midwestern power plant emissions, which acted as a fertilizer for some plant species more than others," says Chipman. "After the 1990 Clean Air Act amendments, these emissions were reduced, but it takes time for the ecosystem to adjust." So climate warming plus other factors makes for a pattern of greening that varies over space and time.

Using Landsat satellite imagery from 1984 to 2024, the researchers defined the alpine zones on every site south of the St. Lawrence River that were large enough to monitor from satellites, which totaled 50 square miles. They identified 35 major alpine zones and modeled the greenness of the landscape over time. They looked at where the greening is occurring regionally and within individual mountains.

One of the challenges of working with satellite imagery from the region is the cloud cover, resulting in fewer clear-sky days for imagery as compared to other regions. Furthermore, given the sparsity of data from the past, this creates the risk for "observation frequency bias," where it may appear as if there's a trend due to the limited amount of older data from the 1980s to 1990s when that may not be the case. To deal with this problem, the team came up with a method that takes every sparse observation in the past and turns it into the best possible predictor of what the data was at that time.

The pilot version of this work was conducted by co-author Irene Ko '27, a Women in Science Project intern in 2024 and a Citrin Lab research assistant from 2024 to 2025, who examined 22 alpine zones, demonstrating that the topic was something to study further.

The co-authors hope that their regional analysis of alpine greening in northeastern North America can be used to help inform future land and ecological management and stewardship practices.

Funding for this research was provided by Dartmouth's Women In Science Program, the William H. Neukom Institute for Computational Science, and the Jeffrey and Rona Citrin family.

Chipman is available for comment at: Jonathan.W.Chipman@dartmouth.edu.

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A color heatmap illustrates the greening rates for

Mount Washington and the Presidential Range in

New Hampshire from 1984 to 2024.

Credit

Illustration by Jonathan Chipman.

Diapensia lapponica, a slow-growing evergreen cushion plant on Mount Washington in New Hampshire's White Mountains, is a cold- and wind-adapted plant found in alpine zones.

 

Credit

Photo by Jonathan Chipman.

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Journal

Ecosphere

DOI

10.1002/ecs2.70765

Article Title

Long-term trends in greenness in the alpine zone of northeastern North America from remote sensing

Article Publication Date

25-Sep-2026