INvestigational Study Into Transplantation of the Uterus (INSITU): a cross-sectional survey among women with uterine factor infertility in the UK assessing background, motivations and suitability.

Autor:	Jones BP; Lister Fertility Clinic, The Lister Hospital, London, UK benjamin.jones@nhs.net.; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.; Imperial College Healthcare NHS Trust, London, UK., Vali S; Imperial College Healthcare NHS Trust, London, UK.; Department of Surgery and Cancer, Imperial College London, London, UK., Kasaven LS; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.; Imperial College Healthcare NHS Trust, London, UK., Mantrali I; Imperial College Healthcare NHS Trust, London, UK.; Department of Surgery and Cancer, Imperial College London, London, UK., Saso S; Imperial College Healthcare NHS Trust, London, UK., Bracewell-Milnes T; Lister Fertility Clinic, The Lister Hospital, London, UK.; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK., Nicopoullos J; Lister Fertility Clinic, The Lister Hospital, London, UK.; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK., Thum MY; Lister Fertility Clinic, The Lister Hospital, London, UK.; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK., Diaz-Garcia C; IVI London, IVIRMA Global, London, UK., Quiroga I; Oxford University Hospitals NHS Trust, Oxford, UK., Yazbek J; Imperial College Healthcare NHS Trust, London, UK.; Department of Surgery and Cancer, Imperial College London, London, UK., Smith JR; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.; Imperial College Healthcare NHS Trust, London, UK.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2023 Dec 09; Vol. 13 (12), pp. e073517. Date of Electronic Publication: 2023 Dec 09.
DOI:	10.1136/bmjopen-2023-073517
Abstrakt:	Importance: The study summarises the selection prescreen criteria currently used in the UK for a uterus transplant and highlights the number of women who are suitable to proceed. Objectives: To assess the demographics, motivations, reasons and suitability among women with absolute uterine factor infertility (AUFI) to undergo uterine transplantation (UTx). Design: A cross-sectional survey. Setting: An electronic questionnaire was sent via email to women with AUFI who had previously been referred to the UTx research team or approached the Womb Transplant UK Charity. The questions assessed suitability to undergo UTx based on demographic information, perceptions to adoption and surrogacy and reasons why UTx was preferable. Responses were assessed against the study selection criteria. Participants: Women with AUFI. Results: 210 women completed the questionnaire. The most common aetiology of AUFI in our cohort was Mayer-Rokitansky-Küster-Hauser (68%; n=143) whereas 29% (n=62) had previously undergone hysterectomy. 63% (n=132) of the cohort had previously considered adoption, 5% (n=11) had attempted it and 2 (1%) had successfully adopted. The most common reason cited to undergo UTx over adoption was to experience gestation (n=63; 53%), while 37% (n=44) wanted a biologically related child. 76% (n=160) of participants had previously considered surrogacy, 22 (10%) had attempted it and 2 (1%) had successfully become mothers using a surrogate. The most common reason to undergo UTx over surrogacy was to experience gestation (n=77; 54%). 15% (n=21) were concerned about the legal implications, 14% (n=20) identified the financial cost as a barrier and 8% (n=12) could not consider it due to religious reasons. On adhering to the selection criteria, 65 (31%) women were suitable to proceed with the trial. Conclusion: The study demonstrates that implementing commonly used selection criteria for a UTx led to an attrition rate of more than two-thirds of women who requested to initially undergo the process. As more studies present outcomes following UTx, critical assessment of the selection criteria currently used is warranted to ensure potential recipients are not being unnecessarily excluded. Trial Registration Number: NCT02388802. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu