Abstract
Key content Following the diagnosis of absolute uterine factor infertility (AUFI), women may experience considerable psychological harm as a result of a loss of reproductive function and the realisation of permanent and irreversible infertility.Adoption enables women with AUFI, and their partners, to experience social and legal parenthood, also often providing benefits for the adopted child.Surrogacy offers the opportunity to have genetically related offspring. Outcomes are generally positive in both surrogates and the children born as a result.Uterine transplantation is the only option to restore reproductive anatomy and functionality. While associated with considerable risk, it allows the experience of gestation and the achievement of biological, social and legal parenthood. Learning objectives To gain an understanding of the routes to parenthood available for women with AUFI experiencing involuntary childlessness, such as adoption, surrogacy and, most recently, uterine transplantationTo consider a suggested management plan to facilitate counselling in women with AUFI who experience involuntary childlessness. Ethical issues In the UK, while the number of children requiring adoption continues to increase, the number being adopted from care is decreasing.Some cultures may hold ethical or religious beliefs that surrogacy is unacceptable, and its legal position in many jurisdictions is problematic.Restrictive selection criteria and high costs may limit future availability of uterine transplantation
Highlights
This review explores the options available for women with absolute uterine factor infertility (AUFI) to acquire motherhood, discusses the advantages and disadvantages of each option and provides a suggested management algorithm for women with AUFI who experience involuntary childlessness, based on individual reproductive aspirations
In particular, demonstrated that more than one-third (35%) of surrogate mothers had such difficulties, this reduced to 6% after 12 months.[46]
Pre-operative evaluation to determine suitability, including extenstive physical and psychological evaluation
Summary
The Obstetrician & Gynaecologist [Manuscript title] Options for acquiring motherhood in absolute uterine factor infertility; adoption, surrogacy and uterine transplantation [Running title] Motherhood in uterine factor infertility [Author names and post nominal initials] Benjamin P Jones BSc (Hons) MRCOG,a,* Niccole Ranaei-Zamani BSc (Hons),b Saaliha Vali BSc,c Nicola Williams BA MA PhD,d Srdjan Saso PhD MRCS MRCOG,e Meen-Yau Thum MRCOG MD,f Maya Al-Memar MRCOG PhD,g Nuala Dixon RCN,h Gillian Rose FRCOG,i Giuliano Testa MD FACS MBA,j Liza Johannesson MD PhD,k Joseph Yazbek MRCOG MD,l Stephen Wilkinson MA DPhil,m J Richard Smith MD FRCOG.n a Clinical Research Fellow, Department of Surgery and Cancer, Imperial College London, Du Cane Road, London W12 0NN, UK b Clinical Research Fellow, Department of Surgery and Cancer, Imperial College London, Du Cane Road, London W12 0NN, UK c Specialty Trainee in Obstetrics and Gynaecology, Queen Charlotte’s & Chelsea Hospital, Imperial College NHS Trust, London W12 OHS, UK d Research Associate in Ethics, Department of Politics, Philosophy and Religion, Lancaster University, Lancaster LA14YQ, UK e Gynaecology Oncolology Subspecialty Trainee, Hammersmith Hospital, Imperial College NHS Trust, London W12 OHS, UK f Fertility Specialist, The Lister Fertility Clinic, London SW1W 8RH, UK g Specialty Trainee in Obstetrics and Gynaecology, Queen Charlotte’s & Chelsea Hospital, Imperial College NHS Trust, London W12 OHS, UK h Clinical Nurse Specialist, Queen Charlotte’s & Chelsea Hospital, Imperial College NHS Trust, London W12 OHS, UK i Consultant Gynaecologist, Queen Charlotte’s & Chelsea Hospital, Imperial College NHS Trust, London W12 OHS, UK j Transplant Surgeon, Baylor University Medical Center, Dallas, Texas 75246-2088, USA k Gynaecology Oncology Surgeon and Medical Director of Uterus Transplant, Baylor University Medical Center, Dallas, Texas 75246-2088, USA l Consultant Gynaecologist, Hammersmith Hospital, Imperial College NHS Trust, London W12 OHS, UK m Professor of Bioethics, Department of Politics, Philosophy and Religion, Lancaster University, Lancaster LA14YQ, UK n Consultant Gynaecologist, Hammersmith Hospital, Imperial College NHS Trust, London W12 OHS, UK
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
