Chmel Roman, Pastor Zlatko, Nováčková Marta, Matěcha Jan, Čekal Miloš, Zámečníková Renata, Froněk Jiří
Cas Lek Cesk. 2017 Winter;156(7):374-378.
Uterus transplantation is a life-giving and quality-of-life enhancing transplantation. Life with transplanted uterus is a transitional phase of life for both recipients and their partners. Six deliveries of healthy children from five transplanted mothers out of 9 uterus transplantations in Sweden may encourage untimely hopes of thousands of women with absolute uterine factor infertility worldwide. Psychological evaluation might be included into all trials regarding new treatment methods and treatment procedures. Main psychological issues connected with the infertility treatment in women with absent uterus are clearly defined (especially in vitro fertilization, uterus transplantation, compliance with immunosuppressive treatment, ultrasound examinations of uterine vascular perfusion, rejection signs surveillance, embryo transfer, pregnancy, cesarean section, preterm delivery risk, puerperium, hysterectomy and immunosuppressive treatment termination). The role of psychological evaluation of participants before the admission to complicated treatment process is to choose those who will be able to cope all mentioned difficulties and unexpected complications including potential failure of the whole treatment without serious negative impact on their psychological situation. Up to now experience with psychological stability of our 7 uterus recipients and 3 uterus living donors are good although post-transplant period is especially in recipients connected with everyday psychological adaptation on the significant life changes. We are aware that psychological evaluation of our study participants will require further 3 years of follow up with publication of our results.
子宫移植是一种赋予生命并提高生活质量的移植手术。对于接受者及其伴侣来说,拥有移植子宫的生活是人生的一个过渡阶段。在瑞典的9例子宫移植手术中,5位接受移植的母亲诞下了6名健康婴儿,这可能会让全球数千患有绝对子宫因素不孕症的女性燃起过早的希望。在所有关于新治疗方法和治疗程序的试验中,都可能需要进行心理评估。与无子宫女性的不孕症治疗相关的主要心理问题已得到明确界定(特别是体外受精、子宫移植、免疫抑制治疗的依从性、子宫血管灌注的超声检查、排斥迹象监测、胚胎移植、妊娠、剖宫产、早产风险、产褥期、子宫切除术以及免疫抑制治疗的终止)。在参与者进入复杂治疗过程之前进行心理评估的作用是挑选出那些能够应对所有上述困难和意外并发症的人,包括整个治疗可能失败,且不会对其心理状况产生严重负面影响。到目前为止,我们的7例子宫接受者和3例子宫活体捐赠者的心理稳定性情况良好,尽管移植后的时期,尤其是对于接受者来说,与对重大生活变化的日常心理适应有关。我们意识到,对我们研究参与者的心理评估还需要进一步随访3年,并公布我们的结果。