Huet S, Tardieu A, Filloux M, Essig M, Pichon N, Therme J F, Piver P, Aubard Y, Ayoubi J M, Garbin O, Collinet P, Agostini A, Lavoue V, Piccardo A, Gauthier T
Department of Obstetrics-Gynecology, Hôpital Mère-Enfant, CHU Limoges, av Dominique Larrey, 87000 Limoges, France.
Department of Immunology, CHU Limoges, 87000 Limoges, France.
Eur J Obstet Gynecol Reprod Biol. 2016 Oct;205:7-10. doi: 10.1016/j.ejogrb.2016.08.027. Epub 2016 Aug 12.
Uterine infertility (UI), which can be caused by a variety of congenital or acquired factors, affects several thousand women in Europe. Uterus transplantation (UTx), at the current stage of research, offers hope for these women to be both the biological mother and the carrier of their child. However, the indications of UTx still need to be defined. The main aim of the study was to describe the different etiologies of UI and other data as marital and parental status from women requesting UTx who contacted us in the framework of a UTx clinical trial. Secondarily, we discussed the potential indications of UTx and their feasibility.
This is an observational study.
Of a total of 139 patients with UI, 105 patients (75.5%) had uterine agenesis, making it the leading cause of UI in this sample. Among the patients with uterine agenesis, 25% had a solitary kidney and 44.7% had undergone vaginal reconstruction. Peripartum hysterectomy, hysterectomy for cancer, and hysterectomy for benign pathologies accounted for 9.4%, 7.2% and 5% of cases, respectively. Less common causes of UI included complete androgen insensitivity syndrome (2.2% of patients) and prenatal diethylstilbestrol exposure (0.7%). Approximately 14% of the women already had at least one child and 66% were in a couple living together for at least 2 years.
UTx is still under evaluation and further research is under way. Nulliparous patients with no major medical or surgical history and with normal ovarian function, who meet the legal criteria for medically assisted reproduction, represent the best indications for UTx at this stage of its development.
子宫性不孕（UI）可由多种先天性或后天性因素引起，在欧洲影响着数千名女性。在当前研究阶段，子宫移植（UTx）为这些女性成为自己孩子的生物学母亲和孕育者带来了希望。然而，UTx的适应症仍有待明确。本研究的主要目的是描述UI的不同病因以及在UTx临床试验框架下联系我们的UTx需求女性的婚姻和生育状况等其他数据。其次，我们讨论了UTx的潜在适应症及其可行性。
这是一项观察性研究。
在总共139例UI患者中，105例（75.5%）患有子宫发育不全，使其成为该样本中UI的主要原因。在子宫发育不全的患者中，25%有单肾，44.7%接受过阴道重建。产后子宫切除术、癌症子宫切除术和良性病变子宫切除术分别占病例的9.4%、7.2%和5%。UI较不常见的原因包括完全雄激素不敏感综合征（占患者的2.2%）和产前己烯雌酚暴露（0.7%）。约14%的女性已经至少有一个孩子，66%处于同居至少2年的伴侣关系中。
UTx仍在评估中，进一步的研究正在进行。在现阶段，符合医学辅助生殖法律标准、无重大内科或外科病史且卵巢功能正常的未生育患者是UTx的最佳适应症。
