The Future of Uterus Transplantation: Cost, Regulations, and Outcomes

Abstract

Uterus transplantation (UTx) has evolved rapidly since technical success was first demonstrated, and is now practiced worldwide, using both living and deceased donors. As UTx transitions from an experimental to widely available standard clinical procedure, new challenges and questions are becoming more urgent. These include issues of cost and coverage, the establishment of guidelines and registries to ensure quality of care and monitor outcomes, regulatory oversight (including for the allocation organs from deceased donors), and the extent to which indications for UTx should be expanded.

Children after uterus transplantation: 2‐year outcomes from the Dallas UtErus Transplant Study (DUETS)

“…Ccentiles of the Centers for Disease Control and Prevention clinical growth chart for 0–36 months were used and created by using the PediTools Universal Bulk Growth Calculator. Age (in months) at measurement was corrected based on gestational age and sex for each child for accurate assessment 23,65 …”

“…These favourable results are reassuring and represent meaningful information to establish UTx as an accepted solution for absolute uterine‐factor infertility. Further efforts are required to pool existing and future data from other centres where UTx is performed and incorporate children's data to allow women to make a fully informed decision and to ensure quality of care 65 …”

“…Further efforts are required to pool existing and future data from other centres where UTx is performed and incorporate children's data to allow women to make a fully informed decision and to ensure quality of care. 65…”

Evolving clinical challenges in uterus transplantation

“…When UTx becomes a mainstream clinical practice, it remains to be seen whether the costs will be covered by public health, national/private health insurance systems or directly by the patient (Polk et al, 2022). The question must be asked of whether it is justified to divert funding from healthcare systems to support the high costs of this non-vital transplantation procedure, particularly in settings of limited medical financial resources.…”

Doppler Flow Indices and Prediction of Embryo Transfer Success and Pregnancy Outcome in Uterus Transplant Recipients

“…15 The UTx field is undergoing rapid acceptance as a treatment for absolute uterine factor infertility. 16,17 There are no studies describing UtA or UmbA Doppler velocimetry indices in UTx recipients. Studies are needed to establish how blood flow dynamics of the pregnant transplanted uterus compare with pregnancies in women with a native uterus.…”