Recent advances in uterus transplantation (UTx) suggest it is on a trajectory toward becoming an accepted clinical practice to treat absolute uterine factor infertility (AUFI). Additional uses have been envisioned but not studied. UTx programs thus far have relied largely on ethical frameworks associated with clinical research, surgical innovation, organ transplantation, and assisted reproductive technologies, as reflected in the Revised Montreal Criteria and the Indianapolis Consensus. This article argues that it is time to develop integrated guidelines that incorporate existing evidence, acknowledge and address tensions among the ethical frameworks that have informed judgments of UTx for AUFI thus far, identify and address ethical questions on which existing frameworks are silent, and anticipate future ethical issues in UTx research.
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