Facts, Views & Vision
in ObGyn

Journal of the European Society for Gynaecological Endoscopy

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Experiences of a multistep process with medical and psychological interventions for patients with congenital uterine aplasia to achieve motherhood: the Gothenburg–Tübingen collaboration

S.Y. Brucker 1 , F-A Taran 1 , K. Rall 1 , D. Schöller 1 , P. Dahm-Kâhler 2 , N. Kvarnström 4 , S. Järvholm 2 , S. Nadalin 5 , A. Königsrainer 5 , D. Wallwiener 1 , M. Brännström 2,3

1 Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany;
2 Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden;
3 Stockholm IVF, Stockholm, Sweden;
4 Department of Transplantation, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden;
5 Department of General, Visceral and Transplant Surgery, University of Tübingen, Tübingen, Germany.

Keywords:

congenital uterine and vaginal aplasia, laparoscopic-assisted neovagina, MRKH-Syndrome, Vecchietti, uterus transplantation


Published online: Oct 03 2019

Abstract

Congenital uterine aplasia, also known as Mayer–Rokitansky–Küster–Hauser syndrome (MRKHS) is a condition associated to a non-functional uterus in the presence of functional ovaries. In a setting where surrogacy is illegal (or not accepted) and adoption is the only alternative, neovaginoplasty and subsequent uterus transplantation (UTx) can provide a route to motherhood for women with MRKHS. This review article describes a multistep process by which patients with MRKHS can achieve motherhood with their own biological child. This process involving a careful clinical diagnosis, psychological counselling, assessment of eligibility for neovagina creation and UTx, the surgical treatment, fertility treatment, and long-term follow-up was developed at the Tübingen University Hospital and in close collaboration with Sahlgrenska Academy, University of Gothenburg, Sweden, where the basic experimental and clinical groundwork for UTx was laid and the first-ever UTx procedure was performed.