The Interest of Women with Mayer–Rokitansky–Küster–Hauser Syndrome and Laparoscopic Vecchietti Neovagina in Uterus Transplantation

Chmel, Roman; Nováčková, Marta; Pastor, Zlatko; Froněk, Jiří

doi:10.1016/j.jpag.2018.04.007

Cited by 25 publications

(23 citation statements)

References 19 publications

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“…8,9 In vitro fertilization (IVF) treatments using the long gonadotropin-releasing hormone (GnRH) agonist protocol preceded UTx. The recipients underwent meticulous examination before UTx, including examination of quality of their sexual life and a 4-stage screening process with an explanation of the risks and benefits regarding the entire experimental treatment for AUFI.…”

Section: Recipientsmentioning

confidence: 99%

“…The recipients underwent meticulous examination before UTx, including examination of quality of their sexual life and a 4-stage screening process with an explanation of the risks and benefits regarding the entire experimental treatment for AUFI. 8,9 In vitro fertilization (IVF) treatments using the long gonadotropin-releasing hormone (GnRH) agonist protocol preceded UTx. The protocol was initiated with downregulation using depot GnRH agonist in the absence of a growing follicle.…”

Section: Recipientsmentioning

confidence: 99%

“…10.7 days(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). The mean surgical time for the UTx was 245 minutes (210-300 minutes).…”

mentioning

confidence: 99%

“…The mean postoperative hospital stay was 8 days(6)(7)(8)(9)(10)(11), and the mean surgical time for graft procurement was 356 minutes (320-430). The mean postoperative hospital stay was 8 days(6)(7)(8)(9)(10)(11), and the mean surgical time for graft procurement was 356 minutes (320-430).…”

mentioning

confidence: 99%

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Revaluation and lessons learned from the first 9 cases of a Czech uterus transplantation trial: Four deceased donor and 5 living donor uterus transplantations

Chmel

Nováčková

Janoušek

et al. 2019

American Journal of Transplantation

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115

213

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Although uterus transplantation is still in the experimental stage, it has promising potential as a treatment for women with absolute uterine factor infertility based on the childbirths from living donor trials conducted in Sweden and the United States. We report the main characteristics and perioperative and postoperative courses of both recipients and donors following 4 deceased donor and 5 living donor uterus transplantations. Three main priorities differentiate this study from the previously reported uterus transplantations. First, clinical experience with the largest worldwide group of deceased donor uterine transplants is described. Second, in the majority of living donor uterine recipients, only 2 ovarian veins were used for venous blood outflow. All of these recipient procedures were surgically successful, and follow-up posttransplant ultrasound examinations revealed normal uterine blood supply and outflow. Third, in only one living and one deceased donor recipient, the transplanted uterus relied on only 2 uterine veins for venous outflow with a 50% surgical success rate. In all other recipients, 2 uterine and 2 ovarian veins were utilized. Although a successful pregnancy has not yet been achieved, the presented surgical and functional results of our trial are promising.

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Section: Recipientsmentioning

confidence: 99%

Section: Recipientsmentioning

confidence: 99%

“…10.7 days(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). The mean surgical time for the UTx was 245 minutes (210-300 minutes).…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Revaluation and lessons learned from the first 9 cases of a Czech uterus transplantation trial: Four deceased donor and 5 living donor uterus transplantations

Chmel

Nováčková

Janoušek

et al. 2019

American Journal of Transplantation

Self Cite

115

213

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“…This study was registered as a clinical trial under http://clinicaltrials.gov (NCT03277430) and was approved by the Ethics Committee and assigned the Institutional Review Board approval number 2044/15 (NM‐15‐01). A detailed description of our four‐step process of recipient recruitment was previously published . Informed consent was provided by the research participants, and all potential recipients with Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome and Vecchietti laparoscopic neovagina were questioned regarding their sexual satisfaction .…”

Section: Introductionmentioning

confidence: 99%

Clinical pregnancy after deceased donor uterus transplantation: Lessons learned and future perspectives

Chmel

Pastor

Nováčková

et al. 2019

J of Obstet and Gynaecol

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Aim: To describe our first clinical pregnancy following a uterus transplant from a brain-dead donor and to discuss current issues with deceased donor uterus transplantation as they relate to obstetrical success. Methods: In August 2016, a 26-year-old woman with Mayer-Rokitansky-Küster-Hauser syndrome was the fourth person worldwide to receive a uterine transplant from a deceased donor and was the second in our trial. in vitro fertilization treatments using the long gonadotropin-releasing hormone agonist protocol preceded the transplantation procedure. Frozen embryo transfers were performed in months 12, 13, 16, 19 and 23 after transplant. Results: Recovery of the uterus of a 24-year-old brain-dead nulliparous donor and the transplant procedure itself was uncomplicated. No abnormalities were revealed on Pap smears, which were performed every 6 months during the post-transplant period, and cervical biopsies showed no epithelial dysplasia. The fifth frozen embryo transfer resulted in a clinical pregnancy. Three weeks after embryo transfer, an intrauterine gestational sac containing an embryo with a heartbeat was detected. One week later, signs of a missed abortion were revealed by ultrasound. Two weeks later, spontaneous bleeding occurred, and an ultrasound examination performed a week later confirmed an empty uterine cavity. Conclusion: In light of present research, both deceased donor uterine procurement and transplantation surgeries are technically feasible; however, more experience is needed to determine the pregnancy success rate associated with this method. Thus, additional trials of deceased donor uterine transplantation should be performed in the future to continue research related to this promising concept for the treatment of absolute uterine factor infertility.

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Perceptions and Motivations for Uterus Transplant in Transgender Women

et al. 2021

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IMPORTANCE Uterus transplant has been demonstrated to be a viable fertility-restoring treatment for women categorized as female at birth with absolute uterine factor infertility. Recent advancements, as well as considerations of fairness and equality in reproductive care, have now led to the possibility of uterus transplant being undertaken in transgender women. OBJECTIVE To investigate the reproductive aspirations of transgender women and their perceptions of uterus transplant. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional survey study used a 27-item electronic questionnaire to investigate the reproductive aspirations of 182 transgender women older than 16 years, including their perceptions of and motivations for uterus transplant, between May 1 and November 1, 2019. MAIN OUTCOMES AND MEASURES Perceptions of and motivations for uterus transplant, including perceived significance of the ability to gestate, menstruate, and have a physiologically functioning vagina. RESULTS A total of 182 transgender women completed the questionnaire; most women (109 [60%]) were aged 20 to 29 years. Most did not have children prior to transitioning (167 [92%]) and expressed a desire to have children in the future (171 [94%]). In addition, most respondents agreed or strongly agreed that the ability to gestate and give birth to children (171 [94%]) and menstruate ( 161[88%]) would enhance perceptions of their femininity. Similarly, high proportions strongly agreed or agreed that having a transplanted, functioning vagina would improve their sexual experience ( 163[90%]), improve their quality of life (163 [90%]), and help them to feel like more of a woman ( 168[92%]). Nearly all respondents (180 [99%]) believed that uterus transplant would lead to greater happiness in transgender women. More than three-quarters of the respondents (140 [77%]) strongly agreed or agreed that they would be more inclined to cryopreserve sperm if uterus transplant became a realistic option. CONCLUSIONS AND RELEVANCEThis study provides insights into the reproductive aspirations of transgender women and reports on their multifaceted motivation to undergo uterus transplant. The survey responses suggest that transgender women would choose to have female physiologic experiences, such as menstruation and gestation, as well as potentially having a physiologically functioning transplanted vagina. If proven feasible and safe in this setting, uterus transplant may facilitate the achievement of reproductive aspirations, improve quality of life, and further alleviate dysphoric symptoms in transgender women.

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The Interest of Women with Mayer–Rokitansky–Küster–Hauser Syndrome and Laparoscopic Vecchietti Neovagina in Uterus Transplantation

Cited by 25 publications

References 19 publications

Revaluation and lessons learned from the first 9 cases of a Czech uterus transplantation trial: Four deceased donor and 5 living donor uterus transplantations

Revaluation and lessons learned from the first 9 cases of a Czech uterus transplantation trial: Four deceased donor and 5 living donor uterus transplantations

Clinical pregnancy after deceased donor uterus transplantation: Lessons learned and future perspectives

Perceptions and Motivations for Uterus Transplant in Transgender Women

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