Psychological evaluation of women with absolute uterine infertility prior to the introduction of uterus transplantation

Background: Uterus transplantation may offer women with absolute uterine infertility the chance for gestational motherhood. Infertility treatment can be associated with psychological distress and the absolute nature of infertility in these women could heighten the risk. While uterus transplantation is promising the potential repercussion of graft failure and organ availability could have repercussions on these families. Understanding the baseline psychological well-being prior to uterus transplant is needed to support these women. Aim: Explore baseline psychological scores in women with acquired and congenital uterine absence. Method: A survey including demographic data and two-validated tools, DASS21 and FertiQOL was given to two groups, women with congenital uterine absence and those with acquired (hysterectomy). Data was compared between groups for DASS21, and against Boivin et al. ¹ normative data for women with infertility (FertiQOL). Results: The study included 41 women, (average age 32.6yrs ± 10.4). As a collective only moderate depression, mild anxiety, and mild stress scores were reported however in the congenital uterine absence group 10.5% reported extremely severe anxiety and 5.3% extreme depression. Mean FertiQOL score was 57.76, 3.16 points higher than Boivin's average. Women with hysterectomy scored on average 15.36 points lower than those with congenital uterine absence. Conclusion: In this study, women with congenital uterine infertility appeared to experience significantly higher levels of depression and anxiety than women post-hysterectomy. The opposite was seen in infertility scores where women with congenital absence reported higher quality of life scores than both the normative values and those post-hysterectomy. It is essential robust psychological screening and support is offered to these women prior to inclusion into a uterus transplant program.