The Ethics of Uterus Transplantation

Thousands of women experience uterine factor infertility (UFI).1 Some are born without a womb (Müllerian agenesis)2; others have had a hysterectomy for a myriad of uterine-related pathologies. Many of these women, whether suffering from congenital or acquired uterine infertility, retain a strong desire to be able to bear their own biological child.3 Currently, the only clinically tested option to motherhood for women without wombs is gestational surrogacy, an immoral procedure in which eggs from the infertile woman and sperm from her husband are fertilized in vitro and then transferred to the womb of a surrogate for gestation. Now, however, transplantation of the uterus—an alternative treatment for UFI—is on the medical horizon. Here I will assess the ethics of two proposed models of human uterus transplantation (UT) to determine whether either approach is a morally superior alternative to gestational surrogacy. In what follows, I will defend my conclusion that the first approach, the Del Priore model,4 developed by Dr. Guiseppe Del Priore and his transplant team at New York Downtown Hospital (New York City), is immoral. But the second approach, the Brännström model5 emerging from the research efforts of Dr. Mats Brännström and his colleagues at Göteborg University (Gothenburg, Sweden), could be moral.