a:1:{s:5:"en_US";s:115:"Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, University of Palermo, 90146 Palermo, Italy";}.
Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, University of Palermo, 90146 Palermo, Italy.
Acta Biomed. 2022 May 11;93(2):e2022138. doi: 10.23750/abm.v93i2.12868.
Absolute uterine factor infertility (AUFI) is a form of infertility whereby conception and/or maintenance of pregnancy is impossible as a result of uterine absence or its completed dysfunction. It affects 1/500 women of reproductive age while the incidence is about 8% of infertile couples. Uterus transplantation (UTx) has been gaining ground as a viable option to enable women with AUFI to have biological children and as an alternative to surrogacy, a highly controversial practice still banned in many countries.
The authors have set out to strike a reasonable balance between UTx benefits and the still numerous risks, whether clinical or ethical, associated with such an innovative form of transplant, which is not life-saving, requires immunosuppression throughout pregnancy and the organ to be removed right after childbirth.
While still far from achieving mainstream status, considerable strides have been made in UTx outcomes, with many live births already recorded. Procedures from living donor are reportedly more effective in terms of success rates. Organ tissue engineering has been explored and developed with promising results.
UTx entails various risks and ethical quandaries which have to do with reproductive autonomy and rights. New human attempts and clinical trials of UTx should be performed to further optimize the procedure in relation to safety and effectiveness. Techniques such as tissue engineering could lead in the medium-long term to a wholly bioengineered uterus to be used for transplantation, relying on scaffolds from decellularized organs or tissues that can be recellularized by several types of autologous somatic/stem cells. Such advances hold promise in terms of solving UTx-related complications and organ supply difficulties.
完全性子宫因素不孕（AUFI）是一种不孕形式，由于子宫缺失或完全功能障碍，妊娠的发生和/或维持成为不可能。它影响了 1/500 名育龄妇女，而不孕夫妇的发病率约为 8%。子宫移植（UTx）作为一种可行的选择，已经越来越受到关注，使 AUFI 妇女能够拥有生物学上的孩子，并作为代孕的替代方案，代孕在许多国家仍然是一项极具争议的做法，被禁止。
作者旨在在 UTx 的益处与仍然存在的许多风险之间取得合理的平衡，这些风险无论是临床风险还是伦理风险，都与这种非救命的创新移植形式有关，这种移植形式需要在整个怀孕期间进行免疫抑制，并且器官需要在分娩后立即移除。
尽管 UTx 仍远未达到主流地位，但在 UTx 结果方面已经取得了相当大的进展，已经有许多活产记录。据报道，来自活体供体的程序在成功率方面更有效。器官组织工程已经得到探索和发展，并取得了有希望的结果。
UTx 带来了各种风险和伦理困境，涉及生殖自主权和权利。应该进行新的人类尝试和 UTx 的临床试验，以进一步优化该程序的安全性和有效性。组织工程等技术可能会在中短期内在移植中使用完全生物工程化的子宫，依靠脱细胞化器官或组织的支架，这些支架可以被多种类型的自体体细胞/干细胞重新细胞化。这些进展有望解决 UTx 相关的并发症和器官供应困难。
