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Alon I, Bussod I, Golan OC, Ravitsky V. Mapping ethical, legal, and social implications (ELSI) of fertility preservation. J Assist Reprod Genet 2024; 41:2495-2514. [PMID: 39141169 PMCID: PMC11405582 DOI: 10.1007/s10815-024-03210-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 07/17/2024] [Indexed: 08/15/2024] Open
Abstract
RESEARCH QUESTION The study examines the ethical, legal, and social implications of fertility preservation, highlighting its importance across oncofertility, elective egg freezing, and posthumous assisted reproduction, as well as its impact on transgender individuals undergoing gender-affirming surgeries. DESIGN A comprehensive analysis of 600 articles, focusing on a diverse range of disciplines, including bioethics, psychology, and sociology, to explore public and healthcare professionals' knowledge, patient experiences, and regulatory constraints. RESULTS The body of literature is growing, indicating increasing recognition of FP's significance. Key themes included the centrality of counseling and informed decision-making, especially in oncofertility and EEF, and ethical debates surrounding informed consent and the autonomy of involved individuals. The analysis underscored a western-centric bias in current research, emphasizing the need for more inclusive and culturally sensitive studies. CONCLUSIONS The study calls for a nuanced understanding of FP, advocating for policies that consider ethical, cultural, and social dimensions. It suggests the necessity for interdisciplinary research to address identified gaps, particularly in understanding non-Western perspectives and ensuring equitable access to FP services globally. Moreover, the review emphasizes the importance of integrating patient-centric approaches and ethical frameworks to guide FP practices and policies, ensuring they respect diverse values and meet individuals' needs.
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Affiliation(s)
- Ido Alon
- Department of Development Economics, Autonomous University of Madrid, Madrid, Spain.
- University of Montreal, Montreal, Canada.
| | | | - Orit Cherny Golan
- University of Montreal, Montreal, Canada
- Yezreel Valley College, Yezreel Valley, Israel
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2
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Linkeviciute A, Canario R, Peccatori FA, Dierickx K. Caring for Pregnant Patients with Cancer: A Framework for Ethical and Patient-Centred Care. Cancers (Basel) 2024; 16:455. [PMID: 38275896 PMCID: PMC10813952 DOI: 10.3390/cancers16020455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/13/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
(1) Background: Caring for pregnant cancer patients is clinically and ethically complex. There is no structured ethical guidance for healthcare professionals caring for these patients. (2) Objective: This concept paper proposes a theoretically grounded framework to support ethical and patient-centred care of pregnant cancer patients. (3) Methodological approach: The framework development was based on ethical models applicable to cancer care during pregnancy-namely principle-based approaches (biomedical ethics principles developed by Beauchamp and Childress and the European principles in bioethics and biolaw) and relational, patient-focused approaches (relational ethics, ethics of care and medical maternalism)-and informed by a systematic review of clinical practice guidelines. (4) Results: Five foundational discussion themes, summarising the key ethical considerations that should be taken into account by healthcare professionals while discussing treatment and care options with these patients, were identified. This was further developed into a comprehensive ethics checklist that can be used during clinical appointments and highlights the need for a holistic view to patient treatment, care and counselling while providing ethical, patient-centric care. (5) Conclusion: The proposed framework was further operationalised into an ethics checklist for healthcare professionals that aims to help them anticipate and address ethical concerns that may arise when attending to pregnant cancer patients. Further studies exploring clinicians' attitudes towards cancer treatment in the course of pregnancy and patient experiences when diagnosed with cancer while pregnant and wider stakeholder engagement are needed to inform the development of further ethical, patient-centred guidance.
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Affiliation(s)
- Alma Linkeviciute
- Fertility and Procreation Unit, Division of Gynecologic Oncology, European Institute of Oncology, IRCCS, 20141 Milan, Italy
| | - Rita Canario
- Cancer Metastasis i3S-Institute for Research & Innovation in Health, R. Alfredo Allen 208, 4200-135 Porto, Portugal;
- Research Centre, Portuguese Oncology Institute of Porto, 4200-072 Porto, Portugal
- ICBAS—School of Medicine and Biomedical Sciences, University of Porto, R. Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - Fedro Alessandro Peccatori
- Fertility and Procreation Unit, Division of Gynecologic Oncology, European Institute of Oncology, IRCCS, 20141 Milan, Italy
| | - Kris Dierickx
- Centre for Biomedical Ethics and Law, KU Leuven, 3000 Leuven, Belgium;
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de Miranda L, Loughlin M. Philosophical health: Unveiling the patient's personal philosophy with a person-centred method of dialogue. J Eval Clin Pract 2023; 29:1161-1170. [PMID: 37232228 DOI: 10.1111/jep.13871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/07/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023]
Abstract
Grounded in ideas about sense-making and whole-person care with a long intellectual heritage, the movement for Philosophical Health-with its specific conceptions of philosophical care and counselling-is a relatively recent addition to the ongoing debate about understanding better the perspectives of patients to improve health practice. This article locates the development of this movement within the context of broader discussions of person-centred care (PCC), arguing that the approach advocated by defenders of philosophical health can provide a straightforward method for implementing PCC in actual cases. This claim is explained and defended with reference to the SMILE_PH method created by Luis de Miranda (Sense-Making Interviews Looking at Elements of Philosophical Health), an approach recently trialled convincingly with people living with traumatic spinal cord injury.
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Affiliation(s)
- Luis de Miranda
- Center for Medical Humanities, Uppsala University, Uppsala, Sweden
| | - Michael Loughlin
- School of Biomedical Sciences, University of West London, London, UK
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Pérez-Hernández Y. Exploring Medical Egg Freezing as a Disease Management Strategy. Med Anthropol 2023; 42:136-148. [PMID: 36745574 DOI: 10.1080/01459740.2023.2174022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Medical egg freezing (MEF) allows women with fertility-threatening diseases to have their oocytes cryopreserved and stored for later use. Endometriosis is a common gynecological disease that might cause infertility. Qualitative research on endometriosis patients' experiences with MEF is minimal. I report on in-depth interviews among French endometriosis patients undertaking MEF. Their experiences are profoundly shaped by endometriosis-related pain. Egg freezing was described as a disease management strategy to cope with potential future infertility integral to their commitment to motherhood. Singlehood was a determining element for agreeing to undertake a physically and psychologically costly "additional" medical intervention.
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Harjee R, Chen J, Caudle J, Ouhibi N, Edsall S, Smrz J, Lardizabal J, Abdelghadir S, Nakhuda G. Oocyte Cryopreservation: A 9-Year Single-Centre Experience. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2022; 44:1271-1278. [PMID: 36272695 DOI: 10.1016/j.jogc.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Oocyte cryopreservation (OC) has increased in recent years; however, there is a paucity of published data on the use of cryopreserved oocytes and associated outcomes. METHODS A retrospective review of 748 OC cycles between 2013 and 2022 at a private fertility centre was performed. Outcome parameters for oocyte retrieval cycles were reviewed. For patients who returned for oocyte disposition, outcomes subsequent to oocyte re-warming, fertilization, and transfer were analyzed. RESULTS There were 748 OC cycles (653 elective and 95 non-elective) in 646 patients (556 elective and 90 non-elective). Patients were older at the time of freezing in the elective oocyte group compared with the non-elective group (36.5 vs. 28.8 y; P < 0.001). Sixty-five patients returned to warm and fertilize their oocytes (50 in the elective group and 15 in the non-elective group). The survival rate for warmed oocytes was 76.1% (541/711), and 66.2% of surviving oocytes were successfully fertilized, and 39.1% reached blastulation. Twenty-three patients underwent embryo transfers (10 after preimplantation genetic testing for aneuploidy), with 15 patients having at least 1 delivery or ongoing pregnancy. CONCLUSIONS To date, this is the largest published experience with OC in Canada. OC can lead to successful live births but does not guarantee a viable outcome for all patients. In this study, most patients with vitrified oocytes had not returned for disposition, so long-term follow-up is still required to verify the efficacy of OC.
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Affiliation(s)
- Rahana Harjee
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC.
| | - Jing Chen
- Olive Fertility Centre, Vancouver, BC
| | | | | | | | | | | | | | - Gary Nakhuda
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC; Olive Fertility Centre, Vancouver, BC
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Ahn SH, Kim JH. Healthcare Professionals' Attitudes and Practice of Sexual Health Care: Preliminary Study for Developing Training Program. Front Public Health 2020; 8:559851. [PMID: 33178658 PMCID: PMC7596252 DOI: 10.3389/fpubh.2020.559851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/11/2020] [Indexed: 11/23/2022] Open
Abstract
Health professionals contribute toward addressing the sexual health care (SHC) of cancer patients, given the frequency of contact with their patients. This study investigated nurses' and physicians' SHC attitudes, practices, and educational needs relating to cancer patients' SHC. Using a cross-sectional study design, we assessed South Korean health professionals' attitudes, practice, and training needs related to cancer patients' SHC. Differences in attitudes and practices among the groups were analyzed via an independent-samples t-test, ANOVA, and ANCOVA using SPSS. The demographic characteristics, including sex, marital status, and age, were associated with SHC attitudes and practices. There was a significant difference in the level of nurses' and physicians' attitudes regarding SHC. Compared to nurses, physicians were found to hold a more positive attitude toward SHC. Nurses performed practices pertaining to reproductive care significantly more than physicians after controlling for demographic variables. A small correlation was found between scores on the SHCS-A and the SHCS-P among the groups. Participants' educational needs regarding SHC included changes in sexual function, safe sex during treatment, reproductive health, and sexual counseling approaches. Equipping oncology nurses and physicians with the knowledge to extend their roles by managing cancer patients' sexual function, psychological and social problems, and reproductive care would be effective. Additionally, oncology nurses who are mainly women and relatively younger than physicians ought to enhance their skills in communicating with and counseling male cancer patients.
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Affiliation(s)
| | - Jung-Hee Kim
- College of Nursing, The Catholic University of Korea, Seoul, South Korea
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Castiglione Morelli MA, Iuliano A, Schettini SCA, Petruzzi D, Ferri A, Colucci P, Viggiani L, Cuviello F, Ostuni A. NMR metabolomics study of follicular fluid in women with cancer resorting to fertility preservation. J Assist Reprod Genet 2018; 35:2063-2070. [PMID: 30069850 PMCID: PMC6240554 DOI: 10.1007/s10815-018-1281-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/24/2018] [Indexed: 01/01/2023] Open
Abstract
PURPOSE The purpose of this study was to evaluate the possible application of metabolomics to identify follicular fluid changes in cancer patients undergoing fertility preservation. Although metabolomics have been applied already in cancer studies, this is the first application on follicular fluid of cancer patients. METHODS We selected for the study ten patients with breast cancer and lymphoma who resorted to oocyte cryopreservation to preserve fertility and ten healthy women undergoing in vitro fertilization treatments. Follicular fluid was collected at the time of oocytes retrieval. Metabolomic analysis of follicular fluids was performed by 1H-nuclear magnetic resonance (NMR) spectroscopy in combination with multivariate analysis to interpret the spectral data. Univariate statistical analysis was applied to find correlations between patients' features and metabolites identified by NMR. RESULTS Partial least squares discriminant analysis allowed to discriminate samples from cancer patients and healthy controls. Univariate statistical analysis found significant correlations between patients' features and metabolites identified by NMR. This finding allowed to identify biomarkers to differentiate both healthy controls from cancer patients and the two different classes of oncological patients. CONCLUSION The follicular fluids of cancer patients display significant metabolic alterations in comparison to healthy subjects. NMR-based metabolomics could be a valid prognostic tool for identifying and selecting the best cryopreserved oocytes and improving the outcome prediction in cancer women undergoing in vitro fertilization.
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Affiliation(s)
| | - Assunta Iuliano
- Center for Reproductive Medicine of "San Carlo" Hospital, Potenza, Italy
| | | | - Donatina Petruzzi
- Center for Reproductive Medicine of "San Carlo" Hospital, Potenza, Italy
| | - Angela Ferri
- Center for Reproductive Medicine of "San Carlo" Hospital, Potenza, Italy
| | - Paola Colucci
- Center for Reproductive Medicine of "San Carlo" Hospital, Potenza, Italy
| | - Licia Viggiani
- Department of Sciences, University of Basilicata, viale Ateneo Lucano 10, 85100, Potenza, Italy
| | - Flavia Cuviello
- Department of Sciences, University of Basilicata, viale Ateneo Lucano 10, 85100, Potenza, Italy
| | - Angela Ostuni
- Department of Sciences, University of Basilicata, viale Ateneo Lucano 10, 85100, Potenza, Italy.
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Kılıç A, Göçmen İ. Fate, morals and rational calculations: Freezing eggs for non-medical reasons in Turkey. Soc Sci Med 2018. [DOI: 10.1016/j.socscimed.2018.03.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Göçmen İ, Kılıç A. Egg freezing experiences of women in Turkey: From the social context to the narratives of reproductive ageing and empowerment. EUROPEAN JOURNAL OF WOMENS STUDIES 2017. [DOI: 10.1177/1350506817742929] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This article explores egg freezing experiences of women in Turkey. Since 2014, it has been legal in Turkey to use egg freezing technology for ageing women, while it was previously allowed only for disease-related purposes. In cooperation with a private fertility clinic in Istanbul, the authors conducted 21 interviews with older, single women who held either professional or managerial positions and who were undergoing or had undergone the procedure. Drawing on a qualitative analysis of these interviews, the authors explore the social context in which women postpone motherhood and decide to freeze their eggs. The study also looks at the women’s emotional responses to ageing that were triggered by the experience of egg freezing and their narratives of empowerment as a result of the procedure.
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Affiliation(s)
- İpek Göçmen
- Social Policy Forum, Boğaziçi University, Turkey
| | - Azer Kılıç
- Marie Skłodowska-Curie Fellow, Koç University, Turkey
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Bachmann G, MacArthur TA, Khanuja K. Need for Comprehensive Counseling in Women Requesting Oocyte Cryopreservation. J Womens Health (Larchmt) 2017; 27:227-230. [PMID: 29072973 DOI: 10.1089/jwh.2017.6423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES The aim of this study is to assess current counseling recommendations for women undergoing elective oocyte cryopreservation. DATA SOURCES PubMed and Clinical Key. MATERIALS AND METHODS A search of PubMed and Clinical Key was conducted to assess current counseling practices for elective oocyte cryopreservation. RESULTS It is substantiated that uniform counseling guidelines are lacking for this group of assisted reproductive technology (ART) patients presenting only for cryopreserving their oocytes. However, although a woman may be a suitable candidate for pregnancy at the point that she undergoes oocyte cryopreservation, possibly many years later, at the time of oocyte thawing, this same woman may have multiple risk factors, which will increase her risk for pregnancy-related maternal and fetal morbidity and mortality. CONCLUSIONS Given the increasing use of oocyte cryopreservation, data support that women be extensively counseled at the time they are requesting elective oocyte cryopreservation for future use in the same manner that they are counseled when requesting ART for pursuing an immediate pregnancy.
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Affiliation(s)
- Gloria Bachmann
- Department of Obstetrics Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School , New Brunswick, New Jersey
| | - Taleen A MacArthur
- Department of Obstetrics Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School , New Brunswick, New Jersey
| | - Kavisha Khanuja
- Department of Obstetrics Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School , New Brunswick, New Jersey
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Stevenson EL, Hurt MJ, Trotter KJ. Oocyte Cryopreservation for Fertility Preservation in Healthy Women. Nurs Womens Health 2017; 21:384-393. [PMID: 28987211 DOI: 10.1016/j.nwh.2017.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 03/29/2017] [Indexed: 06/07/2023]
Abstract
Advancements in methods of fertility preservation have resulted in more options available to women seeking to postpone reproduction. Preservation of unfertilized oocytes provides women with the possibility for reproduction even after age-related declines in fertility might make conceiving a child difficult to impossible. As oocyte cryopreservation rises in popularity among women, it is crucial for nurses and other clinicians to understand the background, process, ethical issues, and risks involved to help women make informed medical decisions.
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Medical and elective fertility preservation: impact of removal of the experimental label from oocyte cryopreservation. J Assist Reprod Genet 2017; 34:1207-1215. [PMID: 28656539 DOI: 10.1007/s10815-017-0968-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 06/01/2017] [Indexed: 12/22/2022] Open
Abstract
PURPOSE The purpose of this study was to compare baseline characteristics and ovarian stimulation outcomes between patients presenting for medically indicated vs. elective fertility preservation consultation and to determine the impact of the 2013 ASRM guidelines on oocyte cryopreservation on the patient population presenting for fertility preservation consultation. METHODS Retrospective cohort study conducted at an academic center. Study population included 332 patients presenting for medically indicated fertility preservation consultation and 210 patients presenting for elective consultation. RESULTS Patients presenting for elective fertility preservation consultation were more likely to be of advanced age, non-Caucasian, highly educated, single, nulligravid, and meet criteria for diminished ovarian reserve (DOR). Additionally, patients presenting electively were more likely to have fertility insurance benefits. A higher percentage of patients with insurance benefits for oocyte cryopreservation proceeded to stimulation. There were no differences in stimulation parameters or number of retrieved oocytes between the groups when adjusted for age. Following release of the ASRM guidelines on oocyte cryopreservation, there was no difference in the percentage of patients in the medical group who proceeded with stimulation; however, a higher percentage of patients presenting electively underwent ovarian stimulation. CONCLUSION Although the populations presenting for medical compared with elective fertility preservation differ at baseline, ovarian stimulation parameters and outcomes are similar when adjusted for age. Insurance benefits for fertility preservation are not comprehensive and impact the decision to proceed with stimulation in all patients. The publication of the ASRM guidelines on oocyte cryopreservation increased utilization of this technology among patients presenting electively; however, they remained at an advanced age and with decreased ovarian reserve parameters.
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Linkeviciute A, Dierickx K. Expanding Social Media Use Recommendations to Global, Multicentred, Industry Run Clinical Trials. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2017; 17:23-24. [PMID: 28207369 DOI: 10.1080/15265161.2016.1274799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Abstract
PURPOSE OF REVIEW To assess the effectiveness and ethical dimensions of oocyte cryopreservation for both medical and social indications. RECENT FINDINGS As more women are postponing motherhood for a variety of reasons, including lack of partner, for completing career plans and reaching financial stability, they are resorting to oocyte cryopreservation. To make informed choices, women rely on their primary care physicians (PCPs) for initial advice, but PCPs are not always fully prepared to discuss oocyte cryopreservation. Interestingly, there are mixed feelings among obstetricians/gynecologists on whether oocyte cryopreservation should be used for elective reasons, whereas it is fully supported for medical indications. SUMMARY Oocyte vitrification has become an established procedure for safeguarding future reproductive chances for medical reasons, and its use is progressively expanding. There is an urgent need in preparing future PCPs and obstetricians/gynecologists as to how to initiate discussions with their patients about elective oocyte banking consistent with fully respecting patient autonomy so as to facilitate informed decisions.
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Affiliation(s)
- Pasquale Patrizio
- aYale University Fertility Center, Department of Obstetrics, Gynaecology & Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut bNYU Langone Medical Center, Division of Medical Ethics, New York, New York, USA
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Abstract
PURPOSE OF REVIEW Elective oocyte cryopreservation for deferred childbearing has gained popularity worldwide, commensurate with increased knowledge regarding age-related fertility decline. The purpose of this review is to summarize recent data regarding trends in delayed childbearing, review recent findings surrounding age-related fertility decline, acknowledge significant gaps in knowledge among patients and providers regarding fertility decline and review outcomes following elective oocyte cryopreservation. RECENT FINDINGS Despite an inevitable decline in fertility and increase in miscarriage with increasing female age, there is a growing worldwide trend to delay childbearing. Patients and providers alike demonstrate large gaps in knowledge surrounding age-related fertility decline. Oocyte cryopreservation is clinically approved for medically indicated fertility preservation, but a growing number of women are using oocyte cryopreservation to defer childbearing and maintain reproductive autonomy. Mounting data support the efficacy and safety of oocyte cryopreservation when used to electively defer childbearing, with recent studies demonstrating rates of euploidy, implantation and live birth rates equivalent to in-vitro fertilization (IVF) with fresh oocytes. SUMMARY Oocyte cryopreservation provides women with an option to defer childbearing and maintain reproductive autonomy, with IVF success rates on par with fresh IVF. However, it is critical that patients understand the limitations of oocyte cryopreservation. Greater education regarding age-related fertility decline should be geared toward patients and providers to prevent unintended childlessness.
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Affiliation(s)
- Kara N Goldman
- New York University Fertility Center (NYUFC), NYU Langone Medical Center, New York, New York, USA
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Voultsos P, Raikos N, Vasileiadis N, Spiliopoulou C, Tarlatzis B. Ethico-legal issues related to ovarian tissue transplantation. MEDICINE, SCIENCE, AND THE LAW 2016; 56:293-304. [PMID: 27381404 DOI: 10.1177/0025802416657685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Ovarian tissue transplantation (OTT) is a promising experimental method which may soon become well-established. In cases of minor oncology, where patients' fertility is seriously threatened by treatment, it may be applied as a unique fertility preservation option. OTT has a dual nature ('organ' and 'gamete'). Many stakeholders are involved, including donor, recipient, child, health-care providers and society at large. There is considerable uncertainty about the long-term consequences of the application of OTT and OT cryopreservation (OTC). Thus, application of OTT gives rise to a number of very different ethico-legal issues and dilemmas which are hard to solve coherently through a principlism-based bioethical approach. This study focuses on such dilemmas and attempts to review them. The role of virtue ethics, which may be combined with principlism, is essential to solve such dilemmas coherently and reasonably. Dealing with conflicts of ethical principles equivalent between them, or moral dilemmas without available answers and mind-sharing in a difficult interpersonal process of decision making, requires a virtue-based ethical approach. Besides, ethico-legal issues related to OTC/OTT are complex issues requiring a multidisciplinary approach (ethical considerations, medical, psychological and social evaluations etc.). We stress the crucial role of multidisciplinary Ethics Committee which is considered indispensable for each reproductive health-care unit practicing OTC/OTT.
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Affiliation(s)
- P Voultsos
- 1 Department of Forensic Medicine and Toxicology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - N Raikos
- 1 Department of Forensic Medicine and Toxicology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - N Vasileiadis
- 1 Department of Forensic Medicine and Toxicology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Ch Spiliopoulou
- 2 Department of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - B Tarlatzis
- 3 Infertility and IVF Center, Department of Obstetrics and Gynaecology, Medical School, Aristotle University of Thessaloniki, Greece
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Liang T, Motan T. Mature Oocyte Cryopreservation for Fertility Preservation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 951:155-161. [DOI: 10.1007/978-3-319-45457-3_13] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Linkeviciute A, Dierickx K, Sanchini V, Boniolo G. Potential Pitfalls in the Evaluation of Ethics Consultation: The Case of Ethical Counseling. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2016; 16:56-57. [PMID: 26913668 DOI: 10.1080/15265161.2015.1134708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | | | | | - Giovanni Boniolo
- c Università degli Studi di Ferrara and Technische Universität München
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