Background: A uterine transplantation (UTx) is a feasible fertility-restoring intervention for women with absolute uterine factor infertility (AUFI). Whereas AUFI affects one in 500 women of childbearing age, there is limited data on demand and suitability to undergo UTx in this population. The aim of this study was to gauge interest amongst women with AUFI, characterise their background demographics, and determine their reasons for considering UTx over adoption and surrogacy.  

Methods: A cross-sectional survey utilising a questionnaire amongst women with AUFI who have enquired about UTx.  

Results:210 women participated. The most common aetiology of AUFI was MRKH (68%; n=143) whereas 29% (n=62) had previously undergone hysterectomy. 48% (n=30) were undertaken because of cancer, the most common of which was cervical cancer (n=22; 73%). In those undertaken for benign disease (n=32), the most common indications massive obstetric haemorrhage (n=13; 41%). 16% (n=33) of women were parous. 63% (n=132) of the cohort had previously considered adoption, 5% (n=11) had attempted it, and two (1%) had successfully adopted. The most common reason cited to undergo UTx over adoption was to experience gestation (n= 63; 53%), while 37% (n=44) wanted a biologically related child. 76% (n=160) of participants had previously considered surrogacy, 22 (10%) had attempted it and two (1%) had successfully become mothers using a surrogate. The most common reason to undergo UTx over surrogacy was to experience gestation (n=77; 54%).15% n=21) were concerned about the legal implications, 14% (n=20) identified the financial cost as a barrier and 8% (n=12) could not consider it due to religious reasons.  

Conclusions: This is the largest and most detailed screening analysis of women with AUFI who have expressed interest inUTx. Our findings highlight important novel insights into such women, including their perceptions toward UTx and alternative options to acquire motherhood.