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The complicated ethics of womb transplants

The delivery of a baby born to a woman who received a uterus transplant at Baylor University Medical Center.
The delivery of a baby born to a woman who received a uterus transplant at Baylor University Medical Center in Dallas. Photo: Baylor University Medical Center at Dallas

The first baby has been born to a mother in the United States from a transplanted uterus as part of a clinical trial conducted at Baylor University Medical Center in Dallas, TX.

Why it matters: Although it may mean more options for parents who can’t have children due to medical reasons or complications, it also raises some ethical questions.

The concerns:

  • The procedure is complicated, risky, and still experimental. It may be difficult to explain that risk adequately to women in order to receive informed consent for the procedure. But that shouldn’t halt progress on it, the trial's principal investigator Giuliano Testa argued on NPR this week.
  • There are also potential risks to the baby in a procedure that is still experimental. One is the use of strong immunosuppresive drugs in the mothers. Liza Johannesson, who pioneered the procedure in Sweden where eight babies have been born to mothers with transplanted uteruses in recent years and who has now joined the Baylor team, tells NPR: “Females have been giving birth after kidney and liver transplants for many, many years on immunosuppressive drugs. So we know what the effect of immunosuppressive drugs has on pregnancies, on babies, on recipients.”
  • The cost: Testa estimates $200,000 - $250,000, which could limit who can receive the procedure. And, there are other safe and less costly options including surrogacy and adoption. “We have other options that are safer for the fetus and the would-be mom. I’m not ready to say ‘Don’t do it,’ but you have to really proceed with caution here," bioethicist Arthur Caplan from the New York University School of Medicine told STAT in 2016, after the first uterus transplant in the U.S.
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