Uterus transplantation: Perspectives of Australian women with absolute uterine factor infertility regarding desirability and utility

Abstract

Background: Uterus transplantation is an emerging surgical innovation offering the option of genetic and gestational motherhood to women with absolute uterine factor infertility. More than 15 centres worldwide have now commenced clinical trials, but the procedure has not been performed in Australia. Aim:To explore the awareness, attitudes and perceptions regarding uterus transplantation among Australian women with absolute uterine infertility. Materials and Methods:An online survey targeting Australian women with absolute uterine factor infertility was performed. Data collected included demographic data, infertility circumstances, considered motherhood options and wellbeing, followed by specific questions regarding uterus transplantation. In total, the participants completed 50 items.Results: All 57 respondents (90% response rate) indicated awareness of uterus transplantation. Of the women who desired parenthood, more than two-thirds indicated a strong desire to carry their own child, with an even higher number (80%) endorsing the need for the procedure to be an option in Australia. Which donor model is preferred (deceased or live), requires further exploration. Conclusion:This study indicates that uterus transplantation is desired by the majority of Australian women with absolute uterine factor infertility. Clinical introduction of uterus transplantation in Australia has strong support from the women who would benefit from the procedure. K E Y W O R D S absolute uterine factor infertility, motherhood, quality of life, transplantation, uterus transplantation Not important 8 (19.5) Age Wald χ 2 (1) = 1.905, P = 0.167 1.046 (0.955-1.146) Education Wald χ 2 (1) = 1.341, P = 0.247 0.488 (0.115-1.743) AUFI cause Wald χ 2 (1) = 5.266, P = 0.022 9.778 (1.395-68.57) Previous children Wald χ 2 (1) = 4.728, P = 0.030 0.123 (0.20-0.778) Awareness of UTx worldwide (Q1) Wald χ 2 (1) = 5.902, P = 0.015 0.114 (0.020-0.658) 3. Is there a need a need for UTx in Australia? Responses Yes definitely 24 (60) Yes, but more a desire than a need 8 (20) Unsure 5 (12.5) No 3 (7.5) Age Wald χ 2 (1) = 4.100, P = 0.043 0.878 (0.774-0.996) Education Wald χ 2 (1) = 0.088, P) = 0.767 0.806 (0.194-3.357) AUFI cause Wald χ 2 (1) = 0.109, P) = 0.292 0.333 (0.043-2.579) Previous children Wald χ 2 (1) = 1.786, P) = 0.180 0.197 (0.018-2.119) I have no preference on donor type 12 (36.4) Age Wald χ 2 (1) = 0.663, P = 0.416 0.960 (0.869-1.060) Education Wald χ 2 (1) = 2.015, P = 0.156 2.837 (0.672-11.972) AUFI cause Wald χ 2 (1) = 0.108, P = 0.742 1.333 (0.240-7.421) Previous children Wald χ 2 (1) = 01.056 P = 0.304 2.358 (0.459-12.111) 6. Do you have a potential donor? Responses Yes (friend or relative) 14 (35.9%) No but I would hope for an anonymous donor 13 (33.3%) No but I would consider a deceased donor option. 6 (15.4) Not interested 6 (15.4) Age Wald χ 2 (1) = 7.260, P = 0.205 0.907 (0.780-1.060) Education Wald χ 2 (1) = 1.088 P = 0.297 0.582 (0.210-1.610) AUFI cause Wald χ 2 (1) = 5.791, P = 0.052 1.333 (0.443-4.336) Previous children Wald χ 2 (...

Uterus transplantation and pregnancy induction: Approved protocol at the Royal Prince Alfred Hospital

“…Monitoring includes cervical biopsies to monitor signs of rejection 6 1,7 . The current literature shows that more than 15000 babies have been born with no increased risks of malformations 6,7 .…”

“…The immunosuppression protocol has been based on other solid‐organ transplantations and has proven to be safe during pregnancy 1,7 . The current literature shows that more than 15000 babies have been born with no increased risks of malformations 6,7 . Furthermore, cases in the USA and Sweden have reported minimal and usually asymptomatic rejection episodes detected by cervical biopsies, indicating that the immunosuppression used is optimal 6,7 …”

“…In September 2014, the first baby born following a uterus transplant in Sweden was announced 5,6 . A recent study published by Pittman et al found that the majority of Australian women felt a high desire for uterus transplant trials to be undertaken in Australia and believed the trials were highly warranted as a potential treatment option 7 . Uterus transplant programs are conducted in several countries, with over 70 transplants reported worldwide and currently 18 live births reported 8 .…”

Treatment of Pernicious Placenta Previa with Ergonoxine and Spiral Suture of Lower Uterine Segment

“…Statistical software, statistical package for the social sciences (SPSS) 22.0 was used to analyze the data. Measurement data conforming to normal distribution were expressed as mean standard deviation (χ±s), and t test was used for comparison between groups.…”

“…The placenta is attached to the lower uterine segment, which is often accompanied by penetration of placental implantation, and a large number of angiotensed vessels can be seen in the lower uterine segment during the operation [10] . without affecting the implementation of supplementary hemostatic programs such as balloon placement and uterine artery ligation [22,23] . The difficulty of this surgical plan is that for parturients with thin anterior wall of the lower uterus or severe adhesion of the uterine bladder, the suture may penetrate the bladder mucosa and cause bladder damage.…”