Department of Obstetrics & Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Anesthesia and Intensive Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Hum Reprod. 2020 Aug 1;35(8):1855-1863. doi: 10.1093/humrep/deaa143.
How is a women's self-image affected by uterus transplantation (UTx)?
Women experienced receiving a uterus in both positive and negative ways, but in general, their self-image was positively affected; regardless of whether they have given birth to a child or not, recipients describe themselves as being 'back to normal' after the hysterectomy to remove the transplanted uterus.
UTx has repeatedly proved to be a successful treatment for absolute uterine factor infertility. However, there has been no previous qualitative long-term research into the self-image of women undergoing UTx.
STUDY DESIGN, SIZE, DURATION: This complete, prospective cohort study included the nine recipients of the first UTxs performed in Sweden mostly in 2013. Interviews took place in the 5 years following surgery.
PARTICIPANTS/MATERIALS, SETTING, METHODS: Eight out of the nine recipients had congenital absence of the uterus, a characteristic of Mayer-Rokitansky-Küster-Hauser syndrome, and one recipient lacked a uterus after a radical hysterectomy due to cervical cancer. The mean age of participants was 31.5 years at inclusion and at this time they all lived in stable marital relationships. Post-transplantation, interviews were performed annually for 5 years, comprising a total of 43 interviews. The interview followed a semi-structured guide. All interviews (median duration of around 25 minutes) were recorded, transcribed verbatim and then analysed by thematic approach.
The joys and frustrations of becoming a 'complete' woman are seen as a master theme, which influences the three underlying subthemes, a changed self-perception, a changed body and a changed sexuality. Each of these subthemes have three underlying categories.
LIMITATIONS, REASONS FOR CAUTION: The small sample size is a limitation.
The results provide information that will be helpful in pre-operative screening procedures and in the psychological support offered both to women who experienced successful and unsuccessful outcomes following UTx.
STUDY FUNDING/COMPETING INTEREST(S): Funding was received from the Jane and Dan Olsson Foundation for Science; the Knut and Alice Wallenberg Foundation; an ALF grant from the Swedish state under an agreement between the government and the county councils; the Swedish Research Council; a Ferring Pharmaceuticals scholarship in memory of Robert Edwards; and the Iris Jonzén-Sandblom and Greta Jonzén Foundation. The authors have no competing interests.
NCT01844362.
子宫移植（UTx）如何影响女性的自我形象？
女性以积极和消极的方式体验到接受子宫，但总的来说，她们的自我形象受到积极影响；无论她们是否生育过孩子，接受者在切除移植子宫的子宫切除术之后都描述自己“恢复正常”。
UTx 已多次被证明是治疗绝对子宫因素不孕的成功方法。然而，以前没有对接受 UTx 的女性的自我形象进行过定性的长期研究。
研究设计、规模、持续时间：这项完整的前瞻性队列研究包括 2013 年在瑞典进行的第一批 UTx 的九名接受者。手术后 5 年内进行了访谈。
参与者/材料、地点、方法：九名接受者中有八名患有先天性子宫缺失，这是 Mayer-Rokitansky-Küster-Hauser 综合征的特征，一名接受者因宫颈癌行根治性子宫切除术而缺乏子宫。参与者的平均年龄为纳入时的 31.5 岁，此时她们都处于稳定的婚姻关系中。移植后，每年进行一次 5 年的随访，共进行了 43 次访谈。访谈遵循半结构化指南。所有访谈（持续时间约 25 分钟）均进行录音、逐字转录，然后进行主题分析。
成为“完整”女性的喜悦和挫折被视为一个主要主题，它影响着三个潜在的子主题，即自我认知的改变、身体的改变和性的改变。这些子主题中的每一个都有三个潜在的类别。
局限性、谨慎的原因：样本量小是一个限制。
结果提供了有助于术前筛选程序和提供给经历 UTx 成功和不成功结果的女性的心理支持的信息。
研究资金/竞争利益：资金来自简和丹·奥尔森基金会科学；库特和爱丽丝·沃伦伯格基金会；瑞典政府与郡理事会之间协议下的 ALF 赠款；瑞典研究委员会；费林制药奖学金，以纪念罗伯特·爱德华兹；和 Iris Jonzén-Sandblom 和 Greta Jonzén 基金会。作者没有竞争利益。
NCT01844362。
