title: Uterus transplantation in France: for which patients?
abstract: OBJECTIVE
  Uterine infertility (UI), which can be caused by a variety of congenital or acquired factors, affects several thousand women in Europe. Uterus transplantation (UTx), at the current stage of research, offers hope for these women to be both the biological mother and the carrier of their child. However, the indications of UTx still need to be defined. The main aim of the study was to describe the different etiologies of UI and other data as marital and parental status from women requesting UTx who contacted us in the framework of a UTx clinical trial. Secondarily, we discussed the potential indications of UTx and their feasibility.
  
  
  METHODS
  This is an observational study.
  
  
  RESULTS
  Of a total of 139 patients with UI, 105 patients (75.5%) had uterine agenesis, making it the leading cause of UI in this sample. Among the patients with uterine agenesis, 25% had a solitary kidney and 44.7% had undergone vaginal reconstruction. Peripartum hysterectomy, hysterectomy for cancer, and hysterectomy for benign pathologies accounted for 9.4%, 7.2% and 5% of cases, respectively. Less common causes of UI included complete androgen insensitivity syndrome (2.2% of patients) and prenatal diethylstilbestrol exposure (0.7%). Approximately 14% of the women already had at least one child and 66% were in a couple living together for at least 2 years.
  
  
  CONCLUSIONS
  UTx is still under evaluation and further research is under way. Nulliparous patients with no major medical or surgical history and with normal ovarian function, who meet the legal criteria for medically assisted reproduction, represent the best indications for UTx at this stage of its development.
authors.affiliation: Department of Obstetrics-Gynecology, Hôpital Mère-Enfant, CHU Limoges, av Dominique Larrey, 87000 Limoges, France.
authors.forename: S
authors.initials: S
authors.lastname: Huet
authors.affiliation: Department of Obstetrics-Gynecology, Hôpital Mère-Enfant, CHU Limoges, av Dominique Larrey, 87000 Limoges, France.
authors.forename: A
authors.initials: A
authors.lastname: Tardieu
authors.affiliation: Department of Immunology, CHU Limoges, 87000 Limoges, France.
authors.forename: M
authors.initials: M
authors.lastname: Filloux
authors.affiliation: Department of Nephrology, Hemodialysis, Transplantation, CHU Limoges, 87000 Limoges, France; Department of Pharmacology, Toxicology and Pharmacovigilance, Inserm, UMR-s850, CHU Limoges, 87000 Limoges, France.
authors.forename: M
authors.initials: M
authors.lastname: Essig
authors.affiliation: Hospital Organ Retrieval Network, CHU Limoges, 87000 Limoges, France.
authors.forename: N
authors.initials: N
authors.lastname: Pichon
authors.affiliation: Department of Psychiatry, CH Esquirol, 87000 Limoges, France.
authors.forename: J F
authors.initials: JF
authors.lastname: Therme
authors.affiliation: Department of Obstetrics-Gynecology, Hôpital Mère-Enfant, CHU Limoges, av Dominique Larrey, 87000 Limoges, France; Department of Pharmacology, Toxicology and Pharmacovigilance, Inserm, UMR-s850, CHU Limoges, 87000 Limoges, France.
authors.forename: P
authors.initials: P
authors.lastname: Piver
authors.affiliation: Department of Obstetrics-Gynecology, Hôpital Mère-Enfant, CHU Limoges, av Dominique Larrey, 87000 Limoges, France; Department of Pharmacology, Toxicology and Pharmacovigilance, Inserm, UMR-s850, CHU Limoges, 87000 Limoges, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Aubard
authors.affiliation: Department of Gynecology, Foch Hospital, 92150 Suresnes, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Ayoubi
authors.affiliation: Department of Gynecology, pôle de gynécologie obstétrique des Hôpitaux universitaires de Strasbourg, site du cmco, 67091 Strasbourg, France.
authors.forename: O
authors.initials: O
authors.lastname: Garbin
authors.affiliation: Gynecology Clinic, Hôpital Jeanne de Flandre, CHRU Lille, 59037 Lille cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Collinet
authors.affiliation: Department of Gynecology Obstetric - Gynécologie CHU de Marseille - Hôpital de la Conception, 13385 Marseille, France.
authors.forename: A
authors.initials: A
authors.lastname: Agostini
authors.affiliation: Department of Gynecology, CHU de Rennes, 35000 Rennes, France; Université de Rennes 1, France.
authors.forename: V
authors.initials: V
authors.lastname: Lavoue
authors.affiliation: Department of Vascular Surgery and Transplantation, CHU Limoges, 87000 Limoges, France.
authors.forename: A
authors.initials: A
authors.lastname: Piccardo
authors.affiliation: Department of Obstetrics-Gynecology, Hôpital Mère-Enfant, CHU Limoges, av Dominique Larrey, 87000 Limoges, France; Department of Pharmacology, Toxicology and Pharmacovigilance, Inserm, UMR-s850, CHU Limoges, 87000 Limoges, France. Electronic address: tristan.gauthier@chu-limoges.fr.
authors.forename: T
authors.initials: T
authors.lastname: Gauthier
mesh_terms: D000328:Adult; D005260:Female; D005602:France; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000601:surgery*; D017533:Marital Status; D018579:Patient Selection; D016896:Treatment Outcome; D014564:Urogenital Abnormalities / Q000150:complications / Q000601:surgery*; D014599:Uterus / Q000002:abnormalities* / Q000601:surgery / Q000637:transplantation*
keywords: Hysterectomy; Infertility; Rokitansky; Transplantation; Uterus