Centering Black Birthing Persons in Reproductive Research: How Uterine Transplant Research Has Fallen Short of Inclusion

Folasade Lapite – University of Texas at Southwestern Medical Center; Sophie Schott – McGovern Medical School

Abstract: Uterine transplants (UTx) are a novel and complex family planning opportunity for patients with absolute uterine factor infertility (AUFI). To date, approximately 100 UTx have been performed, and more than 50 of these UTxs have been performed in the last 3 years. There are only three known Black uterine transplant recipients worldwide, according to the Penn Medicine UTx Clinical Trial (UNTIL). The unique historical and ethical implications pertaining to uterine transplants, impart a need to evaluate why Black representation in new technology development is critical.

By increasing representation of Black birthing persons in UTx research studies we can, (1) address disparities in infertility and infertility treatment, (2) promote reproductive autonomy for a group historically and presently subjugated and criminalized for their reproductive choices, and (3) advance human leukocyte antigen (HLA) matching which ensures a diverse, inclusive genome is assessed and incorporated for transplants. More inclusivity at the initial stages of research mitigates the risk of inequities and injustices in the post-research, clinical, and population health stages of UTx. Without significant efforts to engage underrepresented groups in UTx research, we may reinforce excluding these groups from cutting-edge advancements. As UTx technologies risk exacerbating existing racial disparities in fertility care and pregnancy outcomes, clinicians and bioethicists should be engaged in this critical conversation.

Keywords: Equity, Reproductive Research, Representation