The Ethics of Uterus Transplantation

Abstract

Human uterus transplantation (UTx) is currently under investigation as a treatment for uterine infertility. Without a uterus transplant, the options available to women with uterine infertility are adoption or surrogacy; only the latter has the potential for a genetically related child. UTx will offer recipients the chance of having their own pregnancy. This procedure occurs at the intersection of two ethically contentious areas: assisted reproductive technologies (ART) and organ transplantation. In relation to organ transplantation, UTx lies with composite tissue transplants such as face and limb grafts, and shares some of the ethical concerns raised by these non-life saving procedures. In relation to ART, UTx represents one more avenue by which a woman may seek to meet her reproductive goals, and as with other ART procedures, raises questions about the limits of reproductive autonomy. This paper explores the ethical issues raised by UTx with a focus on the potential gap between women's desires and aspirations about pregnancy and the likely functional outcomes of successful UTx.

Ethics in Uterine Transport: Values and Principles

“…Üçün-cüsü, nakil sonrası hamilelik gerçekleşirse, infertilite tedavisinin tıbbi amacı ile bağdaşmayan, rejeksiyon ve diğer komplikasyonların önemli riskleri vardır. 39 UN komplike bir işlem olması nedeniyle alıcı sadece tıbbi uygunluk açısından değil, aynı zamanda psikososyal uygunluk açısından da taranmalıdır. UN'deki greft damarları diğer nakillere göre daha küçük çaptadır ve anastomozlar bilateral olarak yapılır.…”

“…Çünkü uterus anne ve fetüs arasındaki fiziksel ve duygusal bir köprüdür. 39 Alıcı tarafından UN için kilit motivasyon faktörü, genetik olarak çocuk sahibi olma arzusu gibi görünmektedir. 39 Bu arzunun gücü birkaç faktör-den kaynaklanabilir.…”

Should Deceased Donation be Morally Preferred in Uterine Transplantation Trials?

“…65 Caplan holds too that the use of living donors increases the risk of coercion and adds: There could also be potential problems if a family member initially consents to being a uterus donor and then changes her mind. 66 Catsanos et al echo such sentiments but suggest not all forms of living uterus donation are equally risky, holding that altruistic donation by strangers and those already undergoing a hysterectomy can reduce concerns over coerced consent, 67 although without the immunological benefits associated with living related donation.…”

Ethics Criteria for Uterine Transplants: Relevance for Low-Income, Pronatalistic Societies?

“…This is not a radical question as uterine transplants are not an essential, life-saving procedure [48].…”

“…It should be noted that the transplanted uterus will not be enervated, meaning that the recipients will not be able to feel the pregnancy. It has also been proposed that, at least initially, prophylactic caesarean sections would be performed on recipients of uterine transplants, effectively diminishing the experience of pregnancy [48].…”