16 September 2024.
Role-players:
|
59 |
Role-play. |
|
60 |
Viva. |
|
61 |
Viva. |
|
62 |
EMQ. Uterine transplant |
59. Candidate instructions will be
emailed shortly before the tutorial.
60 & 61. The
topics will be revealed during the tutorial.
61. Uterus transplant.
Abbreviations.
ET: embryo transfer.
UT: uterine transplant
Scenario 1.
When was the 1st. human uterus transplant
performed?
|
A |
2000 |
|
B |
2010 |
|
C |
2015 |
|
D |
2020 |
|
E |
none
of the above |
Scenario 2.
When was the 1st. human uterus transplant
performed in the UK?
|
A |
2000 |
|
B |
2014 |
|
C |
2019 |
|
D |
2023 |
|
E |
none of the above |
Scenario 3.
When was the 1st. livebirth after human
uterus transplant?
|
A |
2011 |
|
B |
2012 |
|
C |
2014 |
|
D |
2015 |
|
E |
2017 |
Scenario 4.
Approximately how many live births had occurred
worldwide after UTb2021?
|
A |
<
5 |
|
B |
5 -
10 |
|
C |
11
- 20 |
|
D |
21
- 50 |
|
E |
51
- 100 |
|
F |
>
100 |
Scenario 5.
For which of the following conditions is UT a possible
treatment?
|
A |
Androgen
Insensitivity syndrome. AIS. |
|
B |
Congenital
adrenal hyperplasia. CAH. |
|
C |
Kallmann’s
syndrome. KS. |
|
D |
Mayer-Rokitansky-Küster-Hauser
syndrome. MRKH. |
|
E |
McCune-Albright
syndrome. MCAS. |
|
F |
Swyer’s
syndrome. SS. |
|
G |
Turner’s
syndrome. TS. |
Scenario 6.
Which, if any, of the following are commonly used for
donor selection?
|
A |
absence
of adenomyosis |
|
B |
absence
of fibroids |
|
C |
age
< 65 years |
|
D |
good
general health |
|
E |
negative
cervical smear and no high-risk HPV |
|
F |
no
cancer in past 5 years |
|
G |
parous |
|
H |
vaginal
length > 7 cm. |
Scenario 7.
Has successful transplant occurred using a dead donor?
|
A |
No |
|
B |
Yes |
Scenario 8.
What is the rate of graft survival at 1 year, failure
being the need for hysterectomy?
|
A |
<
10% |
|
B |
11
– 20% |
|
C |
21
– 30% |
|
D |
31
– 40% |
|
E |
41
– 50% |
|
F |
51
– 60% |
|
G |
>
60% |
|
H |
the
figure is unknown |
Scenario 9.
Which of the following statements is correct?
|
A |
donor
surgery is more extensive than recipient surgery |
|
B |
donor
surgery is less extensive than recipient surgery |
|
C |
donor
surgery is as extensive as recipient surgery |
Scenario 10.
What are the main risks for the recipient in addition to the usual ones of bleeding, infection,
haematoma and thrombosis? There is no option list.
Scenario 11.
What are the risks to the donor in addition to the
usual ones of bleeding, infection, haematoma and thrombosis? There is no option
list.
Scenario 12.
Which condition has been the reason for recipients
needing uterus transplant and which complication is more likely in addition to
the usual ones of bleeding, infection, haematoma and thrombosis? There is no
option list.
Scenario 13. When
is IVF and cryopreservation of eggs done?
|
A |
before
uterus transplantation |
|
B |
at
the time of uterus transplantation |
|
C |
12
months after uterus transplantation to ensure graft rejection does not occur |
|
D |
when
the recipient chooses |
|
E |
none
of the above |
Scenario 14.
Which maintenance therapy was used immediately before
embryo transfer in the first case resulting in livebirth?
|
A |
azathioprine
+ corticosteroids + tacrolimus |
|
B |
azathioprine
+ ciclosporin + corticosteroids + mycophenolate mofetil |
|
C |
azathioprine
+ corticosteroids + mycophenolate mofetil + tacrolimus |
|
D |
azathioprine
+ corticosteroids + tacrolimus |
|
E |
ciclosporin
+ corticosteroids + mycophenolate mofetil + tacrolimus |
|
F |
ciclosporin
+ mycophenolate mofetil + tacrolimus |
|
G |
corticosteroids
+ mycophenolate mofetil + tacrolimus |
|
H |
corticosteroids
+ tacrolimus |
Scenario 15.
What are the main complications of pregnancy after UT?
There is no option list.
Scenario 16.
What are the main risks for the fetus after UT? There
is no option list.
CPD Questions for Jones – see “Abbreviations”. These are open
access, hence reproduced here.
With regard to uterine
transplantation.
10. around
one-quarter of the procedures have resulted in emergent hysterectomy. False/True
11. spontaneous
conception has been reported following the procedure. False/True
12. more than 70
live births have been reported following the procedure False/True
13. rejection is
assessed by histological assessment of cervical biopsies. False/True
14. lifelong
immunosuppression is essential after. False/True
15. the cost has
been estimated to be almost €100,000. False/True
16. potential
recipients with a previous history of cancer need to be in remission for at
least 10 years before being considered for the procedure. False/True
17. Cs is the
recommended approach to delivery following a successful pregnancy. False/True
Regarding management of women with
absolute uterine factor infertility.
18. those with
congenital causes, such as MRKHs, should be managed in tertiary referral
centres.
False/True
19. vaginal
restoration techniques such as the Vecchietti procedure create a
physiologically functioning mucosal vagina. False/True
20. MRKHs is
inherited in an autosomal recessive pattern. False/True
