Perspectives of 281 patients with Mayer-Rokitansky-Küster-Hauser Syndrome on uterine transplantation
The results of our analysis demonstrate individuals with Mayer-Rokitansky-Kuster-Hauser syndrome are extremely interested in pursuing uterine transplantation, and raise concern for the potential vulnerability of this patient population.
Nicole Fischer, M.P.H., Helen Xun, B.S., Amy Lossie, Ph.D., Darya Fadavi, B.S., Halley Darrach, M.D., Pooja Yesantharao, B.S., M.S., Franca Kraenzlin, M.D., Bhuchitra Singh, M.D., M.P.H., M.S., Justin M. Sacks, M.D., M.B.A., FACS, James H. Segars, M.D.
To investigate the personal, ethical, and financial perspectives of individuals with Mayer−Rokitansky−Küster−Hauser syndrome (MRKH), a congenital uterine factor infertility condition, regarding uterine transplantation (UTx).
Cross-sectional, quantitative survey.
A 60-item anonymous electronic questionnaire was disseminated via social media sites.
International members of the Beautiful You MRKH Foundation.
Main Outcome Measures
The survey contained UTx educational materials followed by questions assessing participants’ baseline knowledge, global perceptions, financial concerns, and ethical considerations regarding UTx.
We received 281 responses, with a mean participant age of 28.2 ± 9.8 years. After reviewing the education material, most participants considered receiving a UTx (73%), believed that it should be an option for all women with uterine factor infertility (86%), and believed that it should be covered by health insurance (78%). Respondents perceived the benefits of the procedure to outweigh the risks (67%) and considered it to be an ethical procedure (82%). Almost one-half (49%) were willing to spend more than $10,000 out of pocket to receive the procedure. When asked to rank the risk of UTx to self, donor, and fetus in order of personal importance, 21% ranked their own safety last.
There is a profound desire in the MRKH community for UTx to become more widely available and affordable. MRKH patients may represent a vulnerable population requiring special considerations for informed consent and rigorous evaluation for UTx. Providers caring for MRKH patients should be prepared to provide education about UTx and to thoughtfully engage with news and media outlets to communicate evidence-supported information.
Editorial Office, American Society for Reproductive Medicine
Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.