使用子宫移植治疗绝对子宫因素不孕的当前伦理问题。
Current ethical aspects of absolute uterine factor infertility treatment using uterus transplantation.
出版信息
Ceska Gynekol. 2021;86(1):40-45. doi: 10.48095/cccg202140.
OBJECTIVE
An analysis of ethical studies related to uterus transplantation in the treatment of absolute uterine factor infertility.
METHODS
Literary research using the Web of Science, Google Scholar and Pubmed databases with the following keywords: absolute uterine factor infertility, ethics, deceased donor, living donor, and uterus transplantation. An analysis of articles published in impact and reviewed journals between 2000-2021.
RESULTS
Uterus transplantation is a promising treatment method for women with absolute uterine factor infertility. In the experimental studies, an ultimate goal of this complex treatment was repeatedly achieved: childbirth through a caesarean section. An important milestone towards the application of uterus transplantation in human was the Montreal criteria of its ethical feasibility, published in 2012-2013. In 2012, the first uterus transplant study from a living donor started in Sweden and, in 2016, further studies were initiated worldwide. The first childbirth from the transplanted uterus in 2014 increased the interest of ethicists in various aspects of this experimental treatment, and this trend continues. Current ethical analyzes are focused particularly on the comparison of advantages and disadvantages related to the utilization of living and deceased donors of uterus; comparing ethical aspects of gestational surrogacy and uterus transplantation; uterus transplantation as an extremely radical form of assisted reproduction; its impact on adoptions; uterus transplantation in trans-gender women; the importance of establishing an international registry for uterus transplants; and other important ethical issues associated with this complex form of assisted reproduction.
CONCLUSION
Uterus transplantation is still in an experimental stage. The ethical analysis of the individual steps of this comprehensive method in the treatment of female infertility should be carried out continuously, in connection with the gradually presented outcomes of ongoing scientific research studies.
目的
分析与治疗绝对子宫因素不孕相关的子宫移植的伦理研究。
方法
使用 Web of Science、Google Scholar 和 Pubmed 数据库进行文献研究,使用的关键词有:绝对子宫因素不孕、伦理、已故供体、活体供体和子宫移植。分析了 2000 年至 2021 年期间发表在有影响力和经过同行评审的期刊上的文章。
结果
子宫移植是治疗绝对子宫因素不孕妇女的一种很有前途的治疗方法。在实验研究中,这种复杂治疗的最终目标一再实现:通过剖腹产分娩。2012-2013 年公布的蒙特利尔标准是子宫移植在人类中应用的一个重要里程碑,该标准确定了其在伦理上的可行性。2012 年,瑞典开始了首例来自活体供体的子宫移植研究,2016 年,全世界进一步开展了这项研究。2014 年首例来自移植子宫的婴儿出生增加了伦理学家对这种实验性治疗各个方面的兴趣,这种趋势仍在继续。目前的伦理分析特别侧重于比较利用活体和已故供体子宫的优缺点;比较代孕和子宫移植的伦理方面;子宫移植作为一种极其激进的辅助生殖形式;对收养的影响;跨性别女性的子宫移植;建立国际子宫移植登记册的重要性;以及与这种复杂辅助生殖形式相关的其他重要伦理问题。
结论
子宫移植仍处于实验阶段。应结合正在进行的科学研究的逐渐呈现的结果,对这种综合治疗女性不孕的方法的各个步骤进行持续的伦理分析。