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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

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          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.

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          Most cited references 36

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          Livebirth after uterus transplantation.

          Uterus transplantation is the first available treatment for absolute uterine infertility, which is caused by absence of the uterus or the presence of a non-functional uterus. Eleven human uterus transplantation attempts have been done worldwide but no livebirth has yet been reported.
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            Clinical pregnancy after uterus transplantation.

            To present the first clinical pregnancy after uterus transplantation. Case study. Tertiary center. A 23-year-old Mayer-Rokitansky-Kuster-Hauser syndrome patient with previous vaginal reconstruction and uterus transplantation. Eighteen months after the transplant, the endometrium was prepared for transfer of the thawed embryos. Implantation of embryo in an allografted human uterus. The first ET cycle with one day 3 thawed embryo resulted in a biochemical pregnancy. The second ET cycle resulted in a clinical pregnancy confirmed with transvaginal ultrasound visualization of an intrauterine gestational sac with decidualization. We have presented the first clinical pregnancy in a patient with absolute uterine infertility after uterus allotransplantation. Although the real success is the delivery of a healthy near-term baby, this clinical pregnancy is a great step forward and a proof of concept that the implantation phase works. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
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              First live birth after uterus transplantation in the United States


                Author and article information

                Facts Views Vis Obgyn
                Facts Views Vis Obgyn
                Facts, Views & Vision in ObGyn
                Universa Press (Wetteren, Belgium )
                June 2019
                3 October 2019
                : 11
                : 2
                : 121-126
                Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
                Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
                Stockholm IVF, Stockholm, Sweden
                Department of Transplantation, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
                Department of General, Visceral and Transplant Surgery, University of Tübingen, Tübingen, Germany
                Author notes
                Correspondence at: Prof. Dr. med. Sara Brucker, Department of Obstetrics and Gynecology, University of Tübingen, Calwerstrasse 7, 72076 Tübingen, Germany, Email: sara.brucker@ 123456med.uni-tuebingen.de
                Copyright © 2019 Facts, Views & Vision

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.



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