Follow along as we live tweet the @FertStert journal club. What do you think about #uterinetransplant? #ASRM2019
Send your questions via Twitter to ask the panel! #ASRM2019
Largest cohort of #uterinetransplant recipients: Swedish trial with 7 surgically successful transplants (recipients started menstruating). #EmbryoTransfer performed 12 months after transplant. Thus far, 8 babies born. #ASRM2019
Multidisciplinary team including #gynecologists, reproductive medicine, obstetricians, transplant medicine, #psychologists and #ethics cared for the donors and recipients enrolled in the trial. #ASRM2019
Criticisms of early #uterinetransplant was lack of oversight. Trials in Sweden and @ClevelandClinic changed this paradigm with data safety monitoring boards and ethics committees. #ASRM2019
@ClevelandClinic Prior to #uterinetransplant in humans, 15 years of research in animal models performed in Sweden. #translationalresearch #ASRM2019
@ClevelandClinic The first surgeries for #uterinetransplant lasted 10-13 hours for removing the uterus and 4 hours to transplant. #ASRM2019
@ClevelandClinic Surgeries are faster now, and Baylor has done their last 5 transplants using #robotic surgery. Will this be the best route going forward? #ASRM2019
@ClevelandClinic With a living #donor, you must consider the risk- helping one person but potentially harming the donor. #ASRM2019
@ClevelandClinic Using a #deceased donor negates the donor risk, but screening may be incomplete. The next of kin may not know health history including abnormal pap tests, obstetric history. This could impact the #recipient. #ASRM2019
@ClevelandClinic Do you think living or deceased donor models are best for #uterinetransplant?
@ClevelandClinic Right now demand in the #USA appears to be exceeding the supply of centers with ongoing trials. Dr. Flyckt notes we have an "epidemic of women with hysterectomy" #ASRM2019
@ClevelandClinic Cost estimates for #uterinetransplant for donor and recipient in #USA ranges from $200,000 - 1 million. In #Sweden, charges are covered by government and are estimated to be $60,000. #ASRM2019
@ClevelandClinic We know the #uterus does NOT age in terms of receptivity. Many donors are the mothers of #uterinetransplant recipients. #ASRM2019
@ClevelandClinic If a #uterinetransplant occurs, should we only implant a #euploid embryo? #ASRM2019
@ClevelandClinic Baylor requires #euploid embryos to enter #uterinetransplant trial. @Penn, @ClevelandClinic and University of Gothenburg in #Sweden do NOT require PGT-A. #ASRM2019
@ClevelandClinic @Penn Dr. De Ziegler suggests we perform all #embryotransfer after #uterinetransplant in a natural cycle. Recent studies suggest risk of #preeclampsia is lower with a corpus luteum. #ASRM2019
@ClevelandClinic @Penn Dr. Flyckt cautions that we should not have "conversations on women and what they can and cannot do with their bodies among a group that does not include these women" #ASRM2019
@ClevelandClinic @Penn Arguments FOR #uterinetransplant include choice, privacy, and control. Read this @elliottrichards paper to hear from women who have uterine factor infertility. #ASRM2019
tandfonline.com/doi/abs/10.108…
tandfonline.com/doi/abs/10.108…
@ClevelandClinic @Penn @elliottrichards Arguments against #uterinetransplant: concern for prolonged immune suppression, epigenetic changes, risks of the procedure may not be known until we do several thousand cases
@ClevelandClinic @Penn @elliottrichards Dr. Kate O'Neill advocates for increasing #choice. Provide the patient with information about all options (adoption, gestational carrier, #uterinetransplant) and let them make an informed decision. #ASRM2019
@ClevelandClinic @Penn @elliottrichards Tell us what you think! Let's continue the conversation on #uterinetransplant! Thanks to Interactive Associate @dremilybarnard for this recap. #ASRM2019
