Since the beginning of our research we have been constantly aware of the ethical considerations surrounding womb transplantation. The ethics of womb transplantation are fundamentally based on patient care requirements as they are in the use of any innovative surgical procedures.
Womb transplantation is not unique as an example of the ever-enlarging group of transplanted organs that are not life saving. Transplantations of these organs, including voice box, face, hand, and ovary, are now possible because the risks of transplantation have been greatly reduced. Whilst not life saving, transplantation of the organs involved in reproduction is clearly done for the purpose of enhancing the patient’s quality-of-life. In other words, it certainly makes a positive and important difference in the life of a woman or couple who are unable to have a child by any other method. The balance between risk and benefit appears to be improving every year.
Interestingly, the concept of womb transplantation covers many aspects of medical ethics, the so-called pillars of: autonomy, beneficence and justice. Womb transplantation offers all of these three qualities to a patient suffering from Absolute Uterine Factor Infertility. The application of the pillar: primum non nocere (first do no harm) cannot be made here as is the case with much of modern medicine. Most importantly, that ever-elusive life goal of eudaimonia (human flourishing), an Ancient Greek concept of the highest form of human goodness and happiness, can be attained by couples for whom the concept of family was always an impossibility.
The question of safety for the developing baby exposed to immunosuppressive regimens has been answered by experience with over 50 years of successful pregnancies in other solid organ transplant recipients. So far over 50 babies have been born to women with transplanted wombs and there have been no congenital nor developmental abnormalities reported.
Other ethical issues, particularly related to the question of informed consent, are fully addressed with the involvement of, an Independent Assessor from the Human Tissue Authority is involved with all living donation womb transplant surgeries to ensure the requirements of the Human Tissue Act 2004 (The HT Act) and associated Regulations are met.
Womb Transplant UK Statement/Fact sheet on the Potential for Operations for Transgender Women
Womb Transplant UK cannot and will not be involved research into uterine transplantation for women who were not assigned female at birth, for the foreseeable future.
We have legally binding permissions for two programmes of operations for women assigned female at birth, the first for five uterine transplants where the donor is a living relation of the recipient and the second, a clinical trial of ten operations, where the donor is deceased and not related to the recipient. All patients were assigned female at birth and suffer from absolute uterine factor infertility.
Some of the recipients of donated wombs will have been born without a functioning womb and others will have lost their womb as a result of serious medical conditions including endometriosis and cancer.
These two approved series of operations, which follow over 25 years of ethically approved and exhaustive clinical research, must be completed and then carefully evaluated, and peer reviewed, strictly in line with the provisions of our permissions.
The UK Womb Transplant Research Team is fully aware and respectful of the 2010 Gender Equality Act that mandates equal care for transgender women, assuming technical feasibility. However it is abundantly clear from all recent experience and research that technical feasibility for a safe and successful operation for a transgender female, together with the possibility of sustaining a successful pregnancy, does not currently exist and that many years of detailed medical research will be required before this might become a viable and safe option.
Furthermore, we believe that those commentators who claim that such transgender operations are already, or may soon be, possible, risk causing considerable distress among transgender women by raising false hopes of such an operation being available any time soon.