Ethical debate ensues over proposed uterine transplant

When news spread that physicians at New York Downtown Hospital were ready to perform the country's first uterine transplant in a woman, several leading experts expressed their reservations. Why? "The debate brings together two of the most controversial areas of medicine, organ transplantation and reproductive technology," reported American Medical News (2/19/2007).

On the one hand, the New York physicians, led by ob/gyn and gynecologic oncologist Giuseppe Del Priore, hope to provide a woman with the ability to carry a child to term. Their plan, partly outlined in January's Obstetrics & Gynecology, involves transplanting a uterus into a female recipient and, after waiting 3 months to ensure that the organ is functioning properly, transferring a frozen embryo. Assuming the pregnancy goes well, the child would be delivered via cesarean section and the uterus would be removed. While a human uterine transplant has not been performed in the United States, Del Priore's team has successfully executed the procedure in rats, pigs, rabbits, and rhesus monkey.

However, leading experts believe that more animal research is necessary to ensure that the risks are low for the transplant recipient and child. In addition, several ethical issues have not yet been addressed. For example, what should be done if the transplant recipient's life is in danger yet she insists that doctors save her child? Or, if the child is injured, could he claim that he was wronged by the risky and experimental procedure?