Reproductive Endocrinology · Mayer-Rokitansky-Küster-Hauser syndrome

Biological Children and Family Planning with MRKH

At a Glance

Individuals with MRKH can have biological children because their ovaries function normally and produce healthy eggs. The two primary paths to biological parenthood are gestational surrogacy and uterine transplantation, both of which require In Vitro Fertilization (IVF) to retrieve eggs.

While MRKH means that you cannot become pregnant naturally, it does not mean that having biological children is impossible ^[1]. Because your ovaries are present and function normally, they still produce eggs that can be used to create a baby that is 100% genetically yours ^[2].

Today, there are two primary paths to biological parenthood for individuals with MRKH: gestational surrogacy and the emerging field of uterine transplantation [3PKDBJV2]^[3]. It is important to know upfront that both paths carry significant financial and medical hurdles.

Egg Retrieval and IVF

The first step for either path is In Vitro Fertilization (IVF), where eggs are retrieved from your ovaries and fertilized with sperm in a lab [5MX0F8J2]. In MRKH, your ovaries may be ectopic—meaning they are located higher up in the pelvis than usual because there is no uterus to hold them in the standard spot ^[4]^[5].

Because of this, your doctor will likely use an MRI to “map” exactly where your ovaries are before beginning a cycle [4AFK8QWC]. While most egg retrievals are done through the vagina, some MRKH patients may require a different approach, such as a transabdominal or laparoscopic retrieval, to safely reach the eggs [5MX0F8J2].

Path 1: Gestational Surrogacy

Surrogacy is the most established and common option for building a family with MRKH [3PKDBJV2]. A gestational carrier is a person who carries the pregnancy for you using an embryo created from your egg and your partner’s (or a donor’s) sperm [3JPEFDGU].

Success Rates: The success rates for surrogacy are very high, and the medical risks to the baby are no different than any other IVF pregnancy [3JPEFDGU]^[6].
Considerations: Surrogacy and complex IVF are often astronomically expensive, presenting high financial barriers ^[7]. Laws regarding surrogacy vary greatly depending on where you live, so working with a specialized agency and a reproductive lawyer is essential [C5JL9MU2]^[8].

Path 2: Uterine Transplantation (UTx)

For many years, carrying a pregnancy was not an option for someone with MRKH. Today, uterine transplantation has achieved successful live births ^[3]^[9]. However, it is vital to have realistic expectations: UTx is highly specialized, limited to a small number of medical centers globally, and carries heavy physical and financial burdens ^[10]^[11].

The Process: It involves a major operation to transplant a uterus from a living or deceased donor ^[9]. You will need to take powerful immunosuppressant drugs to prevent your body from rejecting the organ, which carries long-term health risks ^[12]. Once a baby is born (usually via C-section), the uterus is typically removed so that you can stop taking those medications ^[13].
The Outcome: This is currently the only way for a person with MRKH to experience pregnancy personally [84WNY0QS]. While it is a complex and medically intense journey, hundreds of successful live births have been recorded globally ^[9]^[14].

Other Ways to Build a Family

Beyond biological options, many people with MRKH find that adoption or foster-to-adopt are the right paths for them ^[1]. Every family-building journey is deeply personal, and there is no “right” way to become a parent. Discussing these options early with a reproductive endocrinologist can help you understand the landscape and feel empowered as you look toward your future ^[15]^[11].

Common questions in this guide

Can I have biological children if I have MRKH syndrome?

Yes, you can have biological children. Because your ovaries are present and function normally, your eggs can be retrieved through IVF and used to create embryos that are genetically yours. These embryos can then be carried by a gestational surrogate or by you if you undergo a uterine transplant.

How does egg retrieval work for someone with MRKH?

Since individuals with MRKH do not have a standard uterus, their ovaries are sometimes located higher up in the pelvis, known as ectopic ovaries. Your doctor will likely use an MRI to map their exact location before deciding whether to retrieve the eggs vaginally, transabdominally, or laparoscopically.

What is a uterine transplant and how does it work for MRKH?

A uterine transplant is a specialized surgery where a uterus from a donor is transplanted into your body, allowing you to experience pregnancy. This process requires taking powerful immunosuppressant drugs to prevent organ rejection, and the uterus is typically removed after the baby is delivered via C-section.

Do I have to get a uterine transplant to have a biological child?

No, surrogacy is the most established and common option for building a biological family with MRKH. A gestational carrier is a person who carries the pregnancy for you using an embryo created from your egg and your partner's or a donor's sperm.

Curated prompts to bring to your next appointment.

1.Based on my imaging, where are my ovaries located, and would they be easy to reach for egg retrieval?
2.What experience does your clinic have with egg retrieval for patients with MRKH?
3.Can you explain the long-term health risks of taking immunosuppressant drugs if I were to consider a uterine transplant?
4.Which hospitals or programs in my region are currently participating in uterine transplant clinical trials or clinical care?
5.Do you have a reproductive lawyer or specialized social worker you recommend for navigating surrogacy laws?

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References (15)

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How do women with Rokitansky syndrome and healthcare professionals reflect on the provision of uterine transplantation? Insights from an interview study in France, Norway, and Sweden.
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Acta obstetricia et gynecologica Scandinavica 2025; (104(3)):502-513 doi:10.1111/aogs.15016.
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Mayer-Rokitansky-Kuster-Hauser Syndrome: From Radiological Diagnosis to Further Challenges-Review and Update.
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14
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15
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This page provides educational information about family planning for individuals with MRKH. Always consult a reproductive endocrinologist or specialized healthcare provider for personalized medical and fertility advice.

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