Psychological Issues Associated With Absolute Uterine Factor Infertility and Attitudes of Patients Toward Uterine Transplantation

• Published in: Progress in transplantation (Aliso Viejo, Calif.) Calif.), 2016-03, Vol.26 (1), p.28-39
• Main Authors: Saso, Srdjan, Clarke, Alex, Bracewell-Milnes, Timothy, Saso, Anja, Al-Memar, Maya, Thum, Meen-Yau, Yazbek, Joseph, Priore, Giuseppe Del, Hardiman, Paul, Ghaem-Maghami, Sadaf, Smith, J. Richard
• Format: Article
• Language: English
• Subjects: 46, XX Disorders of Sex Development - complications; 46, XX Disorders of Sex Development - psychology; 46, XX Disorders of Sex Development - surgery; Adult; Congenital Abnormalities - psychology; Congenital Abnormalities - surgery; Female; Health Knowledge, Attitudes, Practice; Humans; Hysterectomy; Infertility, Female - etiology; Infertility, Female - psychology; Infertility, Female - surgery; Middle Aged; Mullerian Ducts - abnormalities; Mullerian Ducts - surgery; Nursing; Organ Transplantation - psychology; United Kingdom; Uterine Diseases - psychology; Uterine Diseases - surgery; Uterus - transplantation; Young Adult
• ISSN: 1526-9248; 2164-6708
• DOI: 10.1177/1526924816634840

Context: Uterine transplantation (UTx). Objective: To explore patients’ knowledge of and attitudes toward UTx before and after a short educational intervention via a video and question and answer (Q&A) session. Design: Large, in-depth survey investigating patients’ motivations, aims, and beliefs on UTx. Setting: Imperial College London. Participants: Women diagnosed with absolute uterine factor infertility (AUFI) who were seeking information on UTx and had already volunteered to participate in the study. Intervention: A semistructured interview involving a brief baseline questionnaire before a Q&A session and a 20-minute video exploring the main risks and benefits for UTx. Main outcome measures: Attitudes of self-referred patients with AUFI toward UTx before and after education focusing on UTx. Rank order of importance of key UTx-related issues. Results: Forty women were interviewed. Following the video presentation and Q&A session, 97.5% (n = 39) would undergo UTx ahead of surrogacy and adoption in full knowledge that the latter 2 options would be ultimately safer for their own well-being and the fact that the graft could fail even prior to conception. All felt that UTx should take place, and 92.5% saw UTx as achievable. Conclusion: The study demonstrates a keen interest in UTx, partly because other options seem difficult to access. It is worth noting that people appear to be distancing themselves from the risk. This requires careful assessment in any clinical program. This study is the first to demonstrate a qualitative relationship between patients with AUFI and their curiosity and desire for UTx. It paves the way for forming the introduction into the psychological assessment of a potential patient.