Ethical aspects of uterus transplantation
Authors:
Roman Chmel 1,2; Marta Nováčková 1,2; Zlatko Pastor 1; Jan Matěcha 1; Miloš Čekal 1,3; Jiří Froněk 1,2
Authors‘ workplace:
Gynekologicko-porodnická klinika 2. LF UK a FN Motol v Praze
1; Klinika transplantační chirurgie IKEM, Praha
2; Centrum reprodukční medicíny Gest, Praha
3
Published in:
Čas. Lék. čes. 2017; 156: 36-42
Category:
Review Article
Overview
Uterus transplantation is an experimental treatment method with an ambition to become accepted treatment modality for women with absolute uterine factor infertility. The only legal alternative for these women to get parenthood is adoption which is accepted by most world societies and countries. Surrogate pregnancy is connected with many medical, ethical, legal, religious and social controversies in the great part of the world.
Donors (in living donation), recipients, partners and also unborn children must be incorporated into the analysis of ethical risks and benefits of uterus transplantation. The main ethical risks for the recipient are surgery, immunosuppression, pregnancy and delivery. All the potential recipients have to be advised about further ethical issues like organ rejection, infection, side effects of the drugs, unsatisfactory fertilization and different complications during pregnancy.
Uterus procurement in donor takes longer time than in standard hysterectomy due to preparation of uterine arteries and veins. Vessels with 2 mm diameter and their anatomical collision with ureter are connected with higher peroperative risk of uneventful surgical complications. Ethical issues might be connected with the uterus procurement in dead brain donors identically.
The deliveries after uterus transplantation are fruitful but the risk of preterm delivery and immaturity of the newborns cannot be underestimated as well.
Keywords:
ethics, infertility, uterus transplantation, absolute uterine factor infertility, efficacy, safety
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Journal of Czech Physicians
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