Exploring Divergent Views: A Comparative Study Of Uterus Transplantation Perceptions Among Transplant And Obstetrics/Gynecology Providers

Abstract

Research Question: What are the perceptions of uterine transplantation (UTx) among OB/GYN attending the 2023 ACOG conference? What are the perceptions of UTx among transplant physicians attending the 2023 American Transplant Congress? What are the similarities and differences between perceptions of OB/GYNs and transplant physicians regarding UTx?

Background and Significance: Uterus transplantation (UTx) is a procedure that provides women with absolute uterine-factor infertility (AUFI) the opportunity to carry their own pregnancy and deliver a child. There are multiple ethical and medical concerns associated with UTx. It is important to investigate the opinions of healthcare providers involved in diagnosing patients with AUFI and performing the transplantation, for UTx to move into regular clinical practice. The last survey evaluating the perception of UTx among OB/Gyns, transplant surgeons, internists, and family medicine practitioners in the United States was performed in 2018. Since then, there have been additional reports of successful transplantations and pregnancies. This study aims to identify and understand the perception of UTx among providers who are generally involved in the diagnosis of AUFI and on the transplant team. The second aim of this study is to compare these perceptions to each other and evaluate how opinions have changed since previous surveys were conducted. Addressing these aims will help us understand knowledge gaps among providers and determine what barriers must be overcome for UTx to be used in general clinical practice.

Materials and Methods: This study was a survey study conducted via REDCap surveys. Study subjects included OB/GYN physicians recruited at the 2023 American College of Obstetrics & Gynecology (ACOG) conference and transplant physicians recruited at the 2023 American Transplant Congress (ATC). Participants were recruited by medical student volunteers. Potential participants were asked if they would be interested in reading an introduction pertaining to uterus transplantation and then answering a short survey. Physicians interested in participating were asked to sign an online consent form and then proceed to the survey on an iPad.

Results: 200 physicians completed the survey between the ACOG and ATC conferences. Overall, 42% of providers from ACOG reported that they agreed to have medical concerns related to UTx compared to 22% of the providers from ATC. Survey responses for all participants showed that 76% of participants agreed that UTx should be an option for patients with congenital AUFI.

Conclusion: Ultimately, this study further elucidates the perception of uterine transplantation among Ob/Gyns and transplant physicians regarding UTx. We found greater support for the procedure among providers compared to results from previous studies.