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Absolute Uterine Factor Infertility (AUI)

Definition - What does Absolute Uterine Factor Infertility (AUI) mean?

Absolute uterine factor infertility is an inability to conceive at all because of factors affecting the uterus. The condition affects about one in 500 women who until recently had no option to have a child other than adoption or using another woman to carry their embryo (a procedure known as gestational surrogacy). However, with new advancements and technologies, a total of 17 worldwide cases of human uterus transplantations have been successfully performed today to address the issue of absolute uterine factor infertility.

FertilitySmarts explains Absolute Uterine Factor Infertility (AUI)

Absolute uterine factor infertility (AUFI) may be present from birth because of malformations of the ducts in the fetus that form the uterus and other reproductive organs, or due to an absence of the uterus. More commonly, the condition is acquired by factors affecting the uterus such as uterine tumors (called fibroids), scarring of the uterus such as from repeated D&C (Asherman’s syndrome), or surgical removal of the uterus (hysterectomies). These conditions interfere with the implantation of the embryo or the ability to carry a pregnancy to term.

An experimental treatment for AUFI is uterus transplantation. It is a complex process. It should also be noted that in all the trials, the recipient (the woman with AUFI who will be the genetic mother) woman’s ovaries are not tied to the transplanted uterus, and in vitro fertilization (IVF) has still been required to conceive. This means that prior to the transplantation procedure, embryos have been created using the recipient woman’s eggs and the genetic father's sperm. After finding a suitable donor, the uterus is then surgically removed from that living or deceased donor and transplanted into the recipient. The entire process of uterus transplantation takes around 10 to 14 hours.

The major drawbacks associated with the grafted uterus have been rejection, clot formation, and infection — complications that call for immediate interventions. It is alos necessary that the recipients take toxic anti-rejection medications. Thus, in order to avoid further toxicity and side effects, the transplanted uterus has usually been removed after at least two successful pregnancies.

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