Uterine transplantation: Legal and regulatory implications in the UK

Uterus transplantation (UTx) is fast evolving from an experimental to a clinical procedure, combining solid organ transplantation with assisted reproductive technology. The commencement of the first human uterus transplant trial in the UK leads us to examine and reflect upon the legal and regulatory aspects closely intertwined with UTx from the process of donation to potential implications on fertility treatment and the birth of the resultant child. As the world’s first ephemeral transplant, the possibility of organ restitution requires consideration and is discussed herein. Public funding of fertility treatments pertaining to UTx remains variable and warrants review.

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A meta-analysis on uterine transplantation: Redefining the limits of reproductive surgery

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.62.05.474 ◽

2016 ◽

Vol 62 (5) ◽

pp. 474-477 ◽

Cited By ~ 3

Author(s):

Ana Flávia Garcia Silva ◽

Luiz Fernando Pina Carvalho

Keyword(s):

Meta Analysis ◽

Solid Organ Transplantation ◽

Reproductive Potential ◽

Scientific Progress ◽

Human Reproduction ◽

Solid Organ ◽

New Era ◽

Uterus Transplantation ◽

Uterine Transplantation ◽

History Of

SUMMARY In September 2014, the first baby grown in a transplanted uterus was born, which represented an astonishing scientific progress that will mark the history of human reproduction. The recipient was a 32-year-old woman with Rokytanski syndrome who became pregnant after a successful embryo transfer and had an uneventful pregnancy, giving birth to a healthy newborn and marking the beginning of a new era. Patients who do not have a uterus or have a dysfunctional uterus now have the chance of dreaming with pregnancy and motherhood. Combining principles of solid organ transplantation and techniques of human reproduction, uterus transplantation is the first ephemeral transplant performed in order to promote reproductive potential of women and may be removed after successful pregnancy. Worldwide, 11 uterine transplantations were performed in patients. Of these, seven maintained their reproductive potential, with viable transplanted uteri and regular menstrual cycles.

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Estimation of the Contribution of Assisted and Non-Assisted Reproductive Technology Fertility Treatments to Multiple Births During the Past 30 Years in Japan: 1979–2008

Twin Research and Human Genetics ◽

10.1375/twin.14.5.476 ◽

2011 ◽

Vol 14 (5) ◽

pp. 476-483 ◽

Cited By ~ 9

Author(s):

Syuichi Ooki

Keyword(s):

Assisted Reproductive Technology ◽

Social Impact ◽

Vital Statistics ◽

Reproductive Technology ◽

Multiple Births ◽

Fertility Treatment ◽

Approximation Formula ◽

Multiple Birth ◽

Fertility Treatments ◽

Ovulation Stimulation

The effect of assisted reproductive technology (ART) and non-ART ovulation stimulation fertility treatment on the number and rate of multiple live births from 1979–2008 in Japan was estimated using two independent data sources, ART statistics and vital statistics. Japanese ART statistics presented by the Japan Society of Obstetrics and Gynecology between 1989 and 2008 were gathered and reanalyzed. The number and rates of ART between 1984 and 1988 were interpolated using an approximation formula, using the values from 1983, when the first ART baby was born in Japan, and the 1989–1992 values. The number of ART multiples between 1979–1982 was set as equal to zero. The minimum (or maximum) number of non-ART iatrogenic multiple births was estimated by subtracting the maximum (or minimum) ART multiples from the total iatrogenic multiples, which was estimated by vital statistics assuming that spontaneous multiple-birth rates according to maternal age class would be constant. There was an overall increase in the non-ART multiple births during the 30-year period, whereas ART multiples tended to increase from 1983 to 2005, and then rapidly decreased thereafter. The number or percentage of ART multiples was almost consistently lower than that of non-ART multiples. The percentage of non-ART multiples (33%) among the total multiples was estimated to be about three times more than the ART multiples (11–12%) in 2008. Given the medical and social impact of multiple births, it is imperative to construct a hospital-based monitoring system for fertility treatments, specially non-ART fertility treatments and multiple births.

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Uterus transplantation—questions and answers about the procedure that is expanding the field of solid organ transplantation

Baylor University Medical Center Proceedings ◽

10.1080/08998280.2021.1925064 ◽

2021 ◽

pp. 1-5

Author(s):

Anji E. Wall ◽

Giuliano Testa ◽

David Axelrod ◽

Liza Johannesson

Keyword(s):

Organ Transplantation ◽

Solid Organ Transplantation ◽

Solid Organ ◽

Uterus Transplantation ◽

Questions And Answers

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Age-discriminated IVF Access and Evidence-based Ageism: Is There a Better Way?

Science Technology & Human Values ◽

10.1177/01622439211021914 ◽

2021 ◽

pp. 016224392110219

Author(s):

Giulia Cavaliere ◽

James Rupert Fletcher

Keyword(s):

Evidence Base ◽

Fertility Treatment ◽

Potential Candidate ◽

Vitro Fertilization ◽

Scarce Resources ◽

Fertility Treatments ◽

Age Related ◽

The Uk

Access to state-funded fertility treatments is age-restricted in many countries based on epidemiological evidence showing age-associated fertility decline and aimed at administering scarce resources. In this article, we consider whether age-related restrictions can be considered ageist and what this entails for a normative appraisal of access criteria. We use the UK as a case study due to the state-funded and centrally regulated nature of in vitro fertilization (IVF) provision. We begin by reviewing concepts of ageism and age discrimination in gerontological scholarship and contend that it is analytically useful to differentiate between them when considering age-restricted health services. We then argue that criteria to access IVF could be considered indirectly ageist so far as they rely on an age-related evidence base that manifests ageist categorizations of persons. Lastly, we examine whether there could be more normatively desirable alternatives to devise criteria to access fertility treatment, considering “lifestyle” as a potential candidate. We conclude, however, that lifestyle-based discrimination is problematic because, unlike age-based discrimination, it risks exacerbating existing socioeconomic and ethnic inequalities.

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Future Prospects of Organ Transplantation

10.5772/intechopen.94367 ◽

2020 ◽

Author(s):

Mehmet Nur Altinörs

Keyword(s):

Quality Of Life ◽

Organ Transplantation ◽

Solid Organ Transplantation ◽

Tissue Transplantation ◽

Solid Organ ◽

Uterus Transplantation ◽

Composite Tissue ◽

End Stage ◽

Therapeutic Alternatives

The gap between organ demand and supply is an universal problem in organ and tissue transplantation therapy. The gap is growing in spite of efforts spent in medical, educational, social areas and mass media support. This reality has created the need for completely new therapeutic alternatives for the management of end-stage organ disease. The present research should continue in future aiming to discover systems and devices capable of totally replacing the traditional transplantation. On the other hand, a different progress in underway in transplantation. The indication for solid organ transplantation is to save life and promote quality of life. The new developing transplantations of composite tissue, uterus and face are performed with completely different indications. Facial defects caused by various insults cause serious functional and esthetic disorders, psychological and social problems. Facial transplant surgery is accomplished to overcome such problems. Uterus transplantation is emerging as an alternative to female infertility. Transplantation of composite tissue includes different organs. The main purpose of composite tissue transplantation is to restore reduced or completely lost functions and to increase the quality of life. Nerve regeneration must occur as a consequence of transplant to regain sensory and motor functions. It appears that the future of transplantation involves developments in two main streams; invention of completely new tools for solid organ transplantation and advances in the transplantation of different organs including uterus, face and composite tissue.

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