Except perhaps in rare cases of intersex individuals, transgender women are born without a female reproductive system. While sex reassignment surgery can create a functional vagina for these women, the option of a uterus is currently unavailable to them, meaning they cannot carry a pregnancy and would need to take other routes to parenthood, whether it be a more traditional approach involving coitus or an alternative one such as adoption, egg donation, or a gestational carrier. General interest in uterine transplants for transgender women has waned in recent decades, due to the success and subsequent widespread availability of assisted reproductive technology, and being transgender has become virtually synonymous with being infertile. Nonetheless, at least one uterine transplant for a trans woman occurred, for the Danish artist Lili Elbe (1882–1931), in one of the medical field's first attempts to treat the needs of transgender patients. Hoping to have children with her fiance, she underwent a uterine transplant in 1931, in conjunction with vaginoplasty, in Germany at the age of 48. However, she developed an postsurgical infection and died from cardiac arrest just three months later. Elbe's medical records were destroyed during World War II, so little is known about the goals of the surgeons or the techniques they utilized, nor the origin of the uterus, and as Elbe died so suddenly following the surgery, there is no way to determine whether or not the surgeries could have resulted in a successful pregnancy.