Survey of Attitudes toward Uterus Transplantation among Japanese Women of Reproductive Age: A Cross-Sectional Study

<div><p>Objective</p><p>Uterus transplantation (UTx) is a potential option for women with uterine factor infertility to have a child, but there has been no large-scale survey of the views on UTx in women of reproductive age in Japan. The present study was aimed to clarify the views of Japanese women of reproductive age on UTx for uterine factor infertility.</p><p>Methods</p><p>A questionnaire on UTx was conducted by an Internet research company in December 2014 as a cross-sectional study in 3,892 randomly chosen women aged 25 to 39 years old. Responses were analyzed from 3,098 subjects (mean age 32.1±4.2 years old), after exclusion of inappropriate respondents in screening.</p><p>Results</p><p>Of the respondents, 62.1%, 34.7% and 18.1% favored adoption, UTx and gestational surrogacy, respectively. In contrast, 7.0%, 21.9% and 63.3% opposed adoption, UTx and gestational surrogacy, respectively. In choices of candidates for UTx based on highest priority, deceased persons (33.8%) and mothers (19.0%) were favored as donors, and women with congenital absence of the uterus (54.4%) and hysterectomy due to a malignant uterine tumor (20.0%) as recipients. Regarding societal acceptance of UTx, the answer rates were 15.7% for "UTx should be permitted", 77.6% for "UTx should be permitted with discussion", and 6.7% for "UTx should not be permitted, even with discussion". Regarding personal opinions on UTx, 44.2% were in favor, 47.5% had no opinion, and 8.3% were against.</p><p>Conclusion</p><p>Our results suggest that many Japanese women of reproductive age feel that UTx is socially and individually acceptable, but that concerns requiring further discussion remain among these women. There was also a tendency for UTx to be viewed more favorably than gestational surrogacy.</p></div

Characteristics of respondents.

<p>Characteristics of respondents.</p

Screening of respondents to the questionnaire.

<p>Screening of respondents to the questionnaire.</p

Support for treatment options for uterine factor infertility.

<p>(Multiple answers allowed).</p

Reasons for not wanting UTx.

<p>A. Transplant should be performed only for vital organs, and not for having a child. B. I am afraid of the surgery itself. C. I am worried about the effect of immunosuppressants on a child (anomaly). D. Immunosuppressants are needed. E. I do not want pregnancy and delivery to be risks for myself and the donor. F. Hope should not be easily given to women who have lost their uterus. G. Other reasons.</p

Reasons for wanting UTx.

<p>A. We want a child with genes inherited from us. B. There are no ethical problems because the sperm and ovum are ours, even though the uterus is not. C. If the uterus is eliminated after delivery, immunosuppressants are transiently administered. D. Pregnancy and delivery improve maternal feelings, in contrast to gestational surrogacy and adoption. E. Women suffering from uterine factor infertility will have the hope to have a child. F. We want a child by self-delivery who is recognized as ours (the couple's) in the Japanese Civil Code. G. Other reasons.</p