Impact of uterus transplant on fetuses and resulting children: a response to Daar and Klipstein

In assessing the safety of uterine transplant, the effects of gestation on mother, fetus, and resulting child need close attention. Data from current and future clinical studies should provide helpful information about those concerns. Unless the risks to mother and child are acceptable, uterus transplant will not become an accepted procedure for uterine infertility. Professor Judith Daar and Dr Sigal Klipstein in a trenchant yet generously toned comment critique my article on uterus transplant (and those of previous commentators) for a lack of focus on those risks.1 They argue that the safety record of gestational surrogacy2 in the United States is so much better than the vascular and teratogenic problems that are likely to arise with uterus transplants that women have an obligation to use surrogacy rather than transplant.3 I am very grateful for their Comment (as should be others working on uterus transplant) for they raise important questions about the effects of gestation in a donor uterus thatneedansweringduring the current experimental phaseof uterus transplant.4 If their empirical suspicions stand, uterine transplantmay notmeet the high standards of safety and efficacy required to become a routine therapy.