UK criteria for uterus transplantation: a review

Abstract

Absolute uterine factor infertility is the final hurdle for assisted reproductive treatments. Uterus transplant trials are happening worldwide; to advance the debate around uterine transplantation (UTx), this article considers selection criteria for clinical trials from a UK perspective and makes recommendations for future selection criteria for UTx treatment. Recommendations advanced include the use of donor eggs, access for single women and women in same‐sex relationships, prohibiting participation of women who are already mothers, and a preference for deceased donors and bioengineered uteri. With UTx treatment on the horizon, it is important to proactively consider future selection criteria. Tweetable abstract Review of UK selection criteria for clinical trials for uterus transplantation; recommendations for the future.

Uterine Transplantation Using Living Donation: A Cross-sectional Study Assessing Perceptions, Acceptability, and Suitability

“… 14 - 16 This has led many to conclude that DD is preferable provided that there are sufficient donor uteri, similar success rates, and that retrieval does not threaten the viability of lifesaving organs for transplant. 17 - 19 When these conditions are not met, however, the use of LDs may be justified provided that the donor provides informed and voluntary consent, the risks are proportionate to potential benefits and fall below an acceptable absolute threshold, and risks to the donor are minimized. 17 This is similar to the approach adopted in other solid organ transplants that use LD such as kidney and liver lobe transplantation.…”

Uterus Transplantation with Live Donors: Screening Candidates in One French Center

“…Transfusions and history of previous pregnancy increase, however, the risks of rejection. The fact that the R already has children should be discussed as a possible exclusion factor because of the current risks involved in UTx [46], but, in the Baylor trial, more than 50% of interested potential recipients had children [26]. Finally, RUFI could be included.…”

Options for acquiring motherhood in absolute uterine factor infertility; adoption, surrogacy and uterine transplantation

“…81 Moreover, potential recipients with a previous history of cancer must have been in remission for at least 5 years, owing to the risk of recurrence during this high-risk period 82 when immunosuppression is commenced. Ethical and legal reasons mean it is likely that many of these selection criteria will be alleviated following transition into clinical practice; 83,84 nevertheless, the selection criteria utilised to optimise success and safety will continue to restrict UTx availability among potential recipients.…”