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The journey from infertility to uterus transplantation: A mixed-methods study of the perspectives of participants in the Dallas Uterus Transplant Study (DUETS)
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  • Anji Wall,
  • Liza Johannesson,
  • Monica Sok,
  • Ann Marie Warren,
  • Elisa Gordon,
  • Giuliano Testa
Anji Wall
Baylor University Medical Center

Corresponding Author:[email protected]

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Liza Johannesson
Baylor University Medical Center at Dallas
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Monica Sok
Baylor University Medical Center
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Ann Marie Warren
Baylor University Medical Center at Dallas
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Elisa Gordon
Northwestern University Feinberg School of Medicine
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Giuliano Testa
Baylor University Medical Center at Dallas
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Abstract

Objective: To study the impact of absolute uterine factor infertility (AUFI) and uterus transplantation (UTx) on women, and UTx recipients’ perceptions of Utx and reproductive autonomy Design: Convergent mixed-methods study. Setting: UTx program in a large academic medical centre in the United States. Population/Sample: 20 Utx recipients Methods: A medical chart review was conducted to collect patient demographic information, and clinical outcomes. Semi-structured interviews collected information regarding participants’ experience. Main Outcome Measure(s): The outcomes of interest were participants’ experience of infertility, experience with UTx, and general perceptions of UTx. Results: 7 participants were pregnant (one with a second child), 6 had experienced early graft failure and removal, 5 had delivered a healthy baby, and 4 had a viable graft and were awaiting embryo transfer. The primary themes identified were: the negative impact of AUFI diagnosis on psychological wellbeing, relationships, and female identity; the positive impact of UTx on healing the emotional scars of AUFI, female identity, and value of research trial participation; and the perception of UTx as an expansion of reproductive autonomy. All participants reported Utx was worthwhile, regardless of individual outcome. On bivariate analysis, disease aetiology, having a child after uterus transplantation, experiencing graft failure and current pregnancy were not significantly associated with the impact of AUFI or of UTx on participants’ identities. Conclusion: AUFI has a negative impact on women from a young age, affects multiple relationships, and challenges female identity. UTx helps reverse this impact, transforming women’s life narrative of infertility and enhancing female identity.
30 Aug 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
01 Sep 2021Submission Checks Completed
01 Sep 2021Assigned to Editor
13 Sep 2021Reviewer(s) Assigned
25 Sep 2021Review(s) Completed, Editorial Evaluation Pending
17 Oct 2021Editorial Decision: Revise Major
05 Nov 20211st Revision Received
09 Nov 2021Submission Checks Completed
09 Nov 2021Assigned to Editor
09 Nov 2021Review(s) Completed, Editorial Evaluation Pending
22 Nov 2021Editorial Decision: Accept