Coping with Sociopsychological Challenges in MRKH: Progress in Uterine Transplantation and Uterus Tissue Engineering Approaches

Abstract

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a disorder of sex development affecting 1 in 5000 cisgender females with a typical female karyotype (46, XX). MRKH is characterized by the absence or underdevelopment of the uterus and upper portion of the vagina, and it poses significant challenges to affected individuals seeking to conceive and lead fulfilling lives. This literature review first navigates the multifaceted dimensions of MRKH research, addressing diagnostic intricacies, genetic and molecular insights, clinical implications, available treatments, and the profound psychosocial impacts on quality of life. Furthermore, the review critically analyses the heterogeneity in psychological results observed in MRKH studies, discussing the varied impacts on mental well-being. The review also incorporates qualitative data derived from interviews conducted with individuals who have personal or professional connections to the MRKH condition. Then, the review delves into the complexities surrounding vaginal reconstruction procedures, ethically evaluating Uterine Transplantation (UTx) and uterine Tissue Engineering (TE) studies, emphasizing the need for a comprehensive understanding of the psychological implications of these interventions. Hence, through a holistic examination of the clinical, psychological and ethical aspects, this review aims to contribute to a more comprehensive understanding of MRKH syndrome and paves the way for improved interventions and support for those navigating its challenges.