Korean J Transplant.  2022 Nov;36(Supple 1):S18. 10.4285/ATW2022.F-0949.

Ethical issues for uterine transplant donation

• Kendal E

• KMID: 2535134
• DOI: http://doi.org/10.4285/ATW2022.F-0949

Abstract

Absolute uterine factor infertility accounts for approximately 3% of the global burden of infertility in cis-gendered women (Koplin and Kendal 2020). Uterine transplantation is currently the only intervention that would allow these women to gestate a pregnancy themselves, rather than engaging a surrogate or starting a family through adoption. Although still in its experimental phase, there have been increasing numbers of successful live and cadaveric uterus donations around the world, with the first live birth using a transplanted womb achieved in Sweden in 2014. However, there are significant ethical concerns regarding the procurement and allocation of scarce organs for transplant, as the usual methods for determining which potential recipient has the greatest need or best prognosis do not apply (Arora and Blake 2014). Uterine transplantation is unique among organ transplants, as it is neither life-sustaining nor lifesaving, but rather "life-propagating" (Olausson et al. 2014). As such, justifications for organ harvesting that rely on saving lives are not relevant in the case of uterine transplantation. There are also significant societal pressures regarding reproduction that might diminish informed consent for donors and recipients that require urgent attention before this intervention passes into routine clinical care. This talk will consider these issues with a particular focus on protecting the rights and dig-nity of potential donors and their families. Sources: Arora KS, Blake V. Uterus transplantation: ethical and regulatory challenges. J Med Ethics 2014;40:396-400; Koplin JJ, Kendal E. Ethical issues in uterine transplantation. Korean J Transplant 2020;34:78-83; Olausson M et al. Ethics of uterus transplantation with live donors. Fertility and Sterility 2014;102:403.