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Experiences of a multistep process with medical and psychological interventions for patients with congenital uterine aplasia to achieve motherhood: the Gothenburg-Tubingen collaboration

Journal article
Authors S. Y. Brucker
F. A. Taran
K. Rall
D. Scholler
Pernilla Dahm-Kähler
Niclas Kvarnström
Stina Järvholm
S. Nadalin
A. Konigsrainer
D. Wallwiener
Mats Brännström
Published in Facts Views and Vision in Obgyn
Volume 11
Issue 2
Pages 121-126
ISSN 2032-0418
Publication year 2019
Published at Institute of Clinical Sciences, Department of Surgery
Institute of Clinical Sciences, Department of Obstetrics and Gynecology
Pages 121-126
Language en
Keywords congenital uterine and vaginal aplasia, laparoscopic-assisted neovagina, MRKH-Syndrome, Vecchietti, allogeneic uterus transplantation, vaginal agenesis, rat, pregnancy, anastomosis, recipients, donors
Subject categories Surgery, Obstetrics and gynaecology

Abstract

Congenital uterine aplasia, also known as Mayer-Rokitansky-Kuster-Hauser syndrome (MRKHS) is a condition associated to a non-functional uterus in the presence of functional ovaries. In a setting where surrogacy is illegal (or not accepted) and adoption is the only alternative, neovaginoplasty and subsequent uterus transplantation (UTx) can provide a route to motherhood for women with MRKHS. This review article describes a multistep process by which patients with MRKHS can achieve motherhood with their own biological child. This process involving a careful clinical diagnosis, psychological counselling, assessment of eligibility for neovagina creation and UTx, the surgical treatment, fertility treatment, and long-term follow-up was developed at the Tubingen University Hospital and in close collaboration with Sahlgrenska Academy, University of Gothenburg, Sweden, where the basic experimental and clinical groundwork for UTx was laid and the first-ever UTx procedure was performed.

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