The uterus is the reproductive organ where the embryo formed by the fertilization of the sperm and egg settles and continues its development until birth. Absolute uterine factor infertility affects 3% to 5% of infertile women of reproductive age globally. With the transition of uterus transplantation from experimental studies to clinical trials and starting to have babies in this way, uterus transplantation offers a solution that can enable these women to have children genetically on their own and grow them in their wombs. Uterine transplant is a procedure that combines both assisted reproductive technology and organ transplantation due to the necessity of in vitro fertilization and embryo freezing pre-procedure and thus represents a new level of cooperation between the two. With the transition of uterus transplantation from an experimental clinical procedure to clinical trials and its positive early results, ethical discussions applicable to each of the stakeholders in this study will be reviewed with bioethical principles and major theories.
Uterine transplants are not life-saving, but life-enhancing transplants. In this context, uterus transplantation is accepted as a type of composite tissue transplantation included in the Organ and Tissue Transplant Services Regulation. However, uterus transplantation is also different from composite tissue transplantations in which it is included. By the definition of "donor" in the Composite Tissue Transplant Centers Directive in the Turkish legal system, it is accepted that living persons cannot be obliged to donate composite tissue. In this case, it is concluded that uterus transplantation is also included in the scope of composite tissue, and according to our legal order, it can only be done from a dead donor. In addition, in the Composite Tissue Transplantation Directive, uterine transplantation is not mentioned among the medical indications for such transplantations. Even this legal uncertainty points out that uterus transplants should be handled with a separate arrangement from the composite tissue transplant umbrella.
