Abstract
To assess the psychosocial outcomes of recipients and their partners 2 and 3 years after entering this first clinical uterus transplantation study. Prospective observational study. University hospital. Nine women with absolute uterine factor infertility and their male partners participated. Psychosocial evaluations using questionnaires focusing on health-related quality-of-life, mood, relationship, and fertility-related quality-of-life were conducted at 2- and 3-year follow-up after transplantation. Scores were obtained on the validated questionnaires 36-Item Short Form Survey (SF-36), Hospital Anxiety and Depression Scale, Dyadic Adjustment Scale, and Fertility Quality of life measuring health-related quality-of-life, mood, relationship, and infertility-associated life quality, respectively. There was a reversible decrease (at year 2) in the physical component of SF-36 concerning recipients, but not in partners. Negative deviations in the mental component of SF-36 were seen in four recipients, and in two of their partners at year 3, possibly related to the fact that live birth had not been achieved yet among three of these women. Childlessness also seemed to be related to reporting elevated anxiety scores. Most recipients and partners stated high satisfaction with marital relationship both at inclusion and at follow-up. The results of the present study show that even if the baseline psychosocial characteristics of the women to undergo transplantation and their partners were stable and equal or better compared with norm populations, graft failure and failure to achieve parenthood will pose psychological strains on couples in the period up to 3 years after transplantation. Psychological counseling should be offered past 3 years for recipients and their partners. NCT01844362.
Highlights
The summary score for the mental part (MCS) and for the physical part (PCS) was calculated based on the formula designed for the Swedish population, with a normative Swedish population having a mean score of 50 with a standard deviation (SD) of 10 [16], higher scores indicating better healthrelated quality-of-life
The summary scores on SF-36 were calculated based on the formula designed for the Swedish population [25] and the scores are mean of 50 with a SD of 10, in a normative population
The individual values of SF-36, regarding physical component summary (PCS) and mental component summary (MCS), for recipients and partners are shown in Figures 1 and 2
Summary
To assess the psychosocial outcomes of recipients and their partners 2 and 3 years after entering this first clinical uterus transplantation study. We have reported previously the 1-year psychological outcome of the recipients and their partners of this first UTx trial [13] with data from baseline, 3, 6, and 12 months after UTx. The results of that study were that the participants showed psychological stability at baseline, compared with norm populations. The latter publication [13] did not cover the psychologically sensitive period of pregnancy attempts and possible pregnancy because we initiated embryo transfers from the earliest at 1 year after UTx. In the present study, we report the 2- and 3-year outcomes of the participants of the initial UTx trial concerning healthrelated quality-of-life, mood, relationship, and fertility quality-of-life. The patient cohort is unique because it includes the world’s first UTx patients, with long-term follow-up
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