Uterine Transplant- Perspectives of Malaysian women with absolute uterine factor infertility: A questionnaire-based study

Study objectiveUterine transplantation gives women with absolute uterine factor infertility an opportunity to conceive their biological children. To date, there are more than 15 centers worldwide offering this surgical innovation. In Malaysia, as an Islamic country, surrogacy is prohibited. A small study has demonstrated that Malaysian women with absolute uterine factor infertility welcome the idea of uterine transplant. However, many were unaware of the risk and complications of uterine transplant (1)DesignWe conducted a questionnaire-based study to describe the level of awareness, attitudes and perceptions regarding uterus transplantation among women with absolute uterine infertility in Malaysia. The ethical approval was provided by the Research Ethics Committee, The National University of Malaysia.A questionnaire consisting of 6 questions adapted from Pittman et al (2020) (2) was distributed live online during a patients-closed-group webinar entitled “Mayer-Rokitansky-Kuster-Hauser (MRKH) Webinar”. The webinar consists of a series of lectures on various topics relevant to women with MRKH. Only women diagnosed with Mullerian agenesis or MRKH syndrome were invited to attend the webinar. The questionnaires were distributed at the end of the lecture titled ‘Uterine Transplantation. The lecture briefly describes the transplant procedure, cost, its related risk and live birth success rate. Women who agreed to participate were asked to complete the questionnaire forthwith. The data was collected immediately before the next lecture. The data generated from this questionnaire were analyzed.ResultsA total of 59 women agreed to participate and completed the questionnaire. The mean age of the participants was 29.1 + 8.3 with more than half being married or in a stable relationship (48%). A third of these participants were using or had used vaginal dilators (n=22) and six had undergone vaginoplasty. The majority (n =42, 71.2%) were aware of the existence of uterus transplantation in other countries. More than half considered the procedure extremely or very important in terms of having the option of carrying their child. Almost 60 % (n=34) of our participants agreed that there was a need for this service in Malaysia. The participants did not have a specific preference for the type of uterine donor (live or deceased, known or unknown) (Table 1)ConclusionMalaysian women with absolute uterine factor infertility have strong desires for uterine transplantation to be able to conceive their genetic offspring. Thus, uterine transplantation initiatives in Malaysia are warranted to benefit these women and their partners. Uterine transplantation gives women with absolute uterine factor infertility an opportunity to conceive their biological children. To date, there are more than 15 centers worldwide offering this surgical innovation. In Malaysia, as an Islamic country, surrogacy is prohibited. A small study has demonstrated that Malaysian women with absolute uterine factor infertility welcome the idea of uterine transplant. However, many were unaware of the risk and complications of uterine transplant (1) We conducted a questionnaire-based study to describe the level of awareness, attitudes and perceptions regarding uterus transplantation among women with absolute uterine infertility in Malaysia. The ethical approval was provided by the Research Ethics Committee, The National University of Malaysia. A questionnaire consisting of 6 questions adapted from Pittman et al (2020) (2) was distributed live online during a patients-closed-group webinar entitled “Mayer-Rokitansky-Kuster-Hauser (MRKH) Webinar”. The webinar consists of a series of lectures on various topics relevant to women with MRKH. Only women diagnosed with Mullerian agenesis or MRKH syndrome were invited to attend the webinar. The questionnaires were distributed at the end of the lecture titled ‘Uterine Transplantation. The lecture briefly describes the transplant procedure, cost, its related risk and live birth success rate. Women who agreed to participate were asked to complete the questionnaire forthwith. The data was collected immediately before the next lecture. The data generated from this questionnaire were analyzed. A total of 59 women agreed to participate and completed the questionnaire. The mean age of the participants was 29.1 + 8.3 with more than half being married or in a stable relationship (48%). A third of these participants were using or had used vaginal dilators (n=22) and six had undergone vaginoplasty. The majority (n =42, 71.2%) were aware of the existence of uterus transplantation in other countries. More than half considered the procedure extremely or very important in terms of having the option of carrying their child. Almost 60 % (n=34) of our participants agreed that there was a need for this service in Malaysia. The participants did not have a specific preference for the type of uterine donor (live or deceased, known or unknown) (Table 1) Malaysian women with absolute uterine factor infertility have strong desires for uterine transplantation to be able to conceive their genetic offspring. Thus, uterine transplantation initiatives in Malaysia are warranted to benefit these women and their partners.