Experiences of Women and Clinicians During the Introduction of Uterine Transplantation to the UK: A Qualitative Case Study

Objective:

To explore the experiences of women and clinicians during the introduction of uterine transplantation (UTx) to the UK.

Design:

A qualitative study utilising prospective case study methodology (interviews and observations) over 6 years.

Setting:

In the UK, five uterine transplants have been completed to date—two using living donors and three using deceased donors. In addition, three deceased donor retrievals were undertaken but did not proceed to implantation.

Sample:

Data included 18 audio-recorded consultations with potential recipients and clinicians, 22 interviews with seven clinicians and eight follow-up interviews with women.

Methods:

Data were synthesised using thematic analytical methods.

Results:

The first theme, ‘Emotional and ethical dimensions of UTx decision-making’, explores how women and clinicians navigated uncertainty, risk and hope, including dilemmas around living versus deceased donation. The second, ‘Building and refining a UK UTx programme’, reflects on bridging disciplines, managing initial cases and iteratively improving protocols through teamwork and reflection. The third, ‘Living through the unknowns after transplantation’, captures recipients' post-operative experiences, their collaboration with clinicians, and uncertainties surrounding recovery, embryo transfer and pregnancy.

Conclusion:

Prospective qualitative research enabled surgeons to reflect on their practice while generating insights to optimise uterine transplant delivery in the UK and internationally. Findings offer practical guidance for navigating uncertainty and risk when introducing new procedures and highlight ways to strengthen support for women throughout the process. Overall, this study demonstrates how prospective qualitative methods can provide crucial insights into the technical, ethical and emotional dimensions of innovative procedures like UTx.