1
|
Maor M, Billig M. Women Who Perform Social Egg Freezing as Moral Pioneers: The Case of Ultra-Orthodox Communities in Israel. JOURNAL OF RELIGION AND HEALTH 2024; 63:2581-2598. [PMID: 38782858 PMCID: PMC11319610 DOI: 10.1007/s10943-024-02062-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 05/25/2024]
Abstract
Social egg freezing (SEF) is a new reproductive technology that is increasingly used within ultra-Orthodox Jewish communities, stirring tensions between tradition and modernity. Based on in-depth semi-structured interviews, this study examined how ultra-Orthodox singles who employ SEF engage in social negotiations over gender- and body-related norms. Findings show that participants successfully assimilated SEF by establishing facts on the ground and discreetly spreading information while actively avoiding tensions that may threaten religious tradition. SEF did not push participants into modern individualism or dissolve their strong connection to the community. However they did modify social boundaries and articulated social criticism.
Collapse
Affiliation(s)
- Maya Maor
- Department of Sociology and Anthropology, Ariel University, Ariel, Israel.
| | - Miriam Billig
- Department of Sociology and Anthropology, Ariel University, Ariel, Israel
| |
Collapse
|
2
|
Wang H. Single women's access to egg freezing in mainland China: an ethicolegal analysis. JOURNAL OF MEDICAL ETHICS 2023; 50:50-56. [PMID: 37147115 DOI: 10.1136/jme-2023-108915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 04/12/2023] [Indexed: 05/07/2023]
Abstract
In the name of safeguarding public interests and ethical principles, China's National Health Commission bans unmarried women from using assisted reproductive technology (ART), including egg freezing. Supported by local governments, the ban has restricted single women's reproductive rights nationwide. Although some courts bypassed the ban to allow widowed single women to use ART, they have not adopted a position in favour of single women's reproductive autonomy, but quite the contrary. Faced with calls to relax the ban and allow single women to freeze eggs electively, the National Health Commission refused to amend their policy, partly to protect women's well-being paternalistically and partly to implement the central government's policies to boost the birthrate and maintain traditional family structures. While the government's concerns about elective egg freezing are not entirely unfounded, they have failed to demonstrate that banning single women's egg freezing is a suitable, necessary and proportionate means to safeguard societal interests and ethical principles. The authority's assumptions that women cannot make rational decisions for their health even with adequate informed consent procedures, that banning egg freezing by single women promotes a culture of having children 'at a proper age', and that egg freezing by single women offends China's public moralities have not been substantiated.
Collapse
Affiliation(s)
- Hao Wang
- Shen Junru Law School, Hangzhou Normal University, Hangzhou, Zhejiang, China
| |
Collapse
|
3
|
Lahoti U, Pajai S, Shegekar T, Juganavar A. Exploring the Landscape of Social Egg Freezing: Navigating Medical Advancements, Ethical Dilemmas, and Societal Impacts. Cureus 2023; 15:e47956. [PMID: 38034211 PMCID: PMC10685323 DOI: 10.7759/cureus.47956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
This narrative review article comprehensively explores the multifaceted landscape of social egg freezing, delving into its medical, ethical, societal, psychological, legal, and cultural dimensions. Oocyte cryopreservation, a developing procedure, gives women the chance to match their life goals with fertility goals. Informed decision-making, morally sound guidance, and open communication are all stressed by ethical considerations. Family planning practices, workplace cultures, and gender equality all have an impact on societal dynamics. The process's emotional toll and associated coping mechanisms are highlighted by psychological elements. Legal and policy frameworks need constant ethical reflection and understanding of the regulatory environment. Religious and cultural views highlight the variety of perspectives that influence attitudes toward this practice. For responsible practice to ensure individual liberty while navigating the evolving landscape of reproductive options, it is essential to comprehend how these aspects interact.
Collapse
Affiliation(s)
- Udit Lahoti
- Obstretics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sandhya Pajai
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Tejas Shegekar
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anup Juganavar
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
4
|
Muaygil R. Motherhood, Fairness, and Flourishing: Widening Reproductive Choices in Saudi Arabia. Camb Q Healthc Ethics 2023; 32:1-13. [PMID: 36594171 DOI: 10.1017/s0963180122000585] [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: 01/04/2023]
Abstract
In a landmark Fatwa, Saudi Arabia's highest religious authority-The Council of Senior Scholars-declared the Islamic permissibility of oocyte cryopreservation. The fatwa sanctioned the retrieval, preservation, and future use of oocytes, ovarian tissue, and whole ovaries from cancer patients receiving gonadotoxic interventions. Although momentous, the fatwa's specification of cancer patients effectively rendered this technology unavailable to others to whom it may be similarly beneficial, including patients with other medical conditions or patients seeking elective cryopreservation. This article argues in favor of widening reproductive choices through expanded access to oocyte cryopreservation in Saudi Arabia-regardless of the underlying cause of infertility-on three grounds: the technology's compliance with Islamic law, as a matter of fairness in medical practice, and as a means to support the well-being and flourishing of Saudi women within the context of a national societal and economic transformation strategy closely linked to their success.
Collapse
Affiliation(s)
- Ruaim Muaygil
- Department of Medical Education, The College of Medicine, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
5
|
Rosenkjær D, Skytte AB, Kroløkke C. Investigation of motivations for depositing sperm during the COVID-19 pandemic. HUM FERTIL 2022:1-7. [DOI: 10.1080/14647273.2022.2142857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Daniel Rosenkjær
- Cryos International Sperm and Egg bank, Vesterbro Torv 3, Aarhus C, Denmark
| | - Anne-Bine Skytte
- Cryos International Sperm and Egg bank, Vesterbro Torv 3, Aarhus C, Denmark
| | - Charlotte Kroløkke
- Department for the Study of Culture, University of Southern Denmark, Odense M, Denmark
| |
Collapse
|
6
|
Rolfes V, Bittner U, Kruessel JS, Fehm T, Fangerau H. In vitro gametogenesis: A benefit for women at advanced and very advanced age? An ethical perspective. Eur J Obstet Gynecol Reprod Biol 2022; 272:247-250. [PMID: 35405453 DOI: 10.1016/j.ejogrb.2022.03.038] [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: 07/29/2020] [Revised: 07/08/2021] [Accepted: 03/25/2022] [Indexed: 11/18/2022]
Abstract
Assisted reproductive technologies (ART) may be supplemented with in vitro gametogenesis (IVG). Although IVG is still experimental the question arises whether IVG offers any moral advantages compared to implemented methods. The aim of the paper is to present the landscape of ethical arguments in favour or against IVG. ART-related ethical issues in relation to reproductive autonomy, health risks for the woman and foetus, the welfare of the future child, the adverse effects of advanced motherhood, gender equality, and justice are similar for IVG, oocyte cryopreservation, and oocyte donation. IVG may have the following advantages: (I) the psychological and physical burden of stimulation and puncture of the oocyte could be avoided; (II) women do not necessarily have to cope with motherhood at young age; (III) ethical doubts associated with oocyte donation would be eliminated; (IV) by using IVG in combination with preimplantation diagnostics, it is more likely to find suitable oocytes or embryos to increase the probability of pregnancy; (V) women would have the opportunity to decide how many oocytes should be generated and how often an attempt should be made to achieve pregnancy. Simultaneously, however, the advent of IVG may lead to new moral disadvantages: pressure on women to give birth at an advanced age or pressure on women to follow 'male' career structures. Additionally, the reimbursement of costs related to IVG is an open question, especially if equal opportunities regarding motherhood are linked to demands for equal access to ART. An early discussion about the ethical, legal, and social consequences for IVG is necessary.
Collapse
Affiliation(s)
- Vasilija Rolfes
- Department of the History, Philosophy and Ethics of Medicine, Medical Faculty, University Hospital Dusseldorf, Moorenstrasse 5, 40225 Dusseldorf, Germany.
| | - Uta Bittner
- Department of the History, Philosophy and Ethics of Medicine, Medical Faculty, University Hospital Dusseldorf, Moorenstrasse 5, 40225 Dusseldorf, Germany.
| | - Jan-Steffen Kruessel
- Department of Obstetrics and Gynaecology, Medical Faculty, University Hospital Dusseldorf, Dusseldorf, Germany.
| | - Tanja Fehm
- Department of Obstetrics and Gynaecology, Medical Faculty, University Hospital Dusseldorf, Dusseldorf, Germany.
| | - Heiner Fangerau
- Department of the History, Philosophy and Ethics of Medicine, Medical Faculty, University Hospital Dusseldorf, Moorenstrasse 5, 40225 Dusseldorf, Germany.
| |
Collapse
|
7
|
De Proost M, Coene G, Nekkebroeck J, Provoost V. 'I feel that injustice is being done to me': a qualitative study of women's viewpoints on the (lack of) reimbursement for social egg freezing. BMC Med Ethics 2022; 23:35. [PMID: 35351108 PMCID: PMC8966350 DOI: 10.1186/s12910-022-00774-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 03/22/2022] [Indexed: 11/25/2022] Open
Abstract
Background During the last decade, the possibility for women to cryopreserve oocytes in anticipation of age-related fertility loss, also referred to as social egg freezing, has become an established practice at fertility clinics around the globe. In Europe, there is extensive variation in the costs for this procedure, with the common denominator that there are almost no funding arrangements or reimbursement policies. This is the first qualitative study that specifically explores viewpoints on the (lack of) reimbursement for women who had considered to uptake at least one social egg freezing cycle in Belgium. Methods To understand the moral considerations of these women, drawing from twenty-one interviews, this paper integrates elements of a symbiotic empirical ethics approach and thematic analysis. Results We identify four themes: (1) being confronted with unclear information; (2) financial costs as ongoing concern; (3) necessity of coverage; (4) extent of reimbursement. In the first theme, we found that some women were concerned about the lack of clear information about the cost of social egg freezing. In the second theme, we report moral sentiments of injustice and discrimination which some women attributed to their struggles and needs not being recognised. The third theme illustrates diverse views on reimbursement, ranging from viewing social egg freezing as an elective treatment not appropriate for reimbursement to preferences for greater public responsibility and wider access. Finally, we describe the participants’ varying proposals for partial reimbursement and the idea that it should not be made available for free. Conclusions This research adds important empirical insights to the bioethics debate on social egg freezing, in particular by presenting (potential) users’ views on the lack of reimbursement. While there is much more to say about the ethical and political complexities of the reimbursement of this procedure, our study highlighted the voices of (potential) users and showed that at least some of them would welcome the coverage of SEF through the public healthcare insurance. Supplementary Information The online version contains supplementary material available at 10.1186/s12910-022-00774-z.
Collapse
Affiliation(s)
- Michiel De Proost
- RHEA (Research Centre Gender, Diversity and Intersectionality), Vrije Universiteit Brussel, Brussels, Belgium.
| | - Gily Coene
- RHEA (Research Centre Gender, Diversity and Intersectionality), Vrije Universiteit Brussel, Brussels, Belgium
| | - Julie Nekkebroeck
- Centre for Reproductive Medicine and Centre for Medical Genetics, UZ Brussel, Brussels, Belgium
| | | |
Collapse
|
8
|
Awareness, Intentions, and Attitudes Toward Planned Oocyte Cryopreservation Among Female Medical Staff. Reprod Biomed Online 2022; 44:1169-1176. [DOI: 10.1016/j.rbmo.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 12/12/2021] [Accepted: 01/05/2022] [Indexed: 11/22/2022]
|
9
|
Rimon-Zarfaty N, Kostenzer J, Sismuth LK, de Bont A. Between "Medical" and "Social" Egg Freezing : A Comparative Analysis of Regulatory Frameworks in Austria, Germany, Israel, and the Netherlands. JOURNAL OF BIOETHICAL INQUIRY 2021; 18:683-699. [PMID: 34783957 PMCID: PMC8724162 DOI: 10.1007/s11673-021-10133-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 07/05/2021] [Indexed: 05/30/2023]
Abstract
Egg freezing has led to heated debates in healthcare policy and bioethics. A crucial issue in this context concerns the distinction between "medical" and "social" egg freezing (MEF and SEF)-contrasting objections to bio-medicalization with claims for oversimplification. Yet such categorization remains a criterion for regulation. This paper aims to explore the "regulatory boundary-work" around the "medical"-"social" distinction in different egg freezing regulations. Based on systematic documents' analysis we present a cross-national comparison of the way the "medical"-"social" differentiation finds expression in regulatory frameworks in Austria, Germany, Israel, and the Netherlands. Findings are organized along two emerging themes: (1) the definition of MEF and its distinctiveness-highlighting regulatory differences in the clarity of the definition and in the medical indications used for creating it (less clear in Austria and Germany, detailed in Israel and the Netherlands); and (2) hierarchy of medical over social motivations reflected in usage and funding regulations. Blurred demarcation lines between "medical" and "social" are further discussed as representing a paradoxical inclusion of SEF while offering new insights into the complexity and normativity of this distinction. Finally, we draw conclusions for policymaking and the bioethical debate, also concerning the related cryopolitical aspects.
Collapse
Affiliation(s)
- Nitzan Rimon-Zarfaty
- Department of Medical Ethics and History of Medicine, University Medical Centre Göttingen, Humboldtallee 36, 37073, Göttingen, Lower Saxony, Germany.
- Department of Human Resource Management Studies, Sapir Academic College, D.N. Hof Ashkelon, 7915600, Hof Ashkelon, Israel.
| | - Johanna Kostenzer
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, P.O. Box 1738, 3000 DR, The Netherlands
| | - Lisa-Katharina Sismuth
- Department of Medical Ethics and History of Medicine, University Medical Centre Göttingen, Humboldtallee 36, 37073, Göttingen, Lower Saxony, Germany
| | - Antoinette de Bont
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, P.O. Box 1738, 3000 DR, The Netherlands
| |
Collapse
|
10
|
Social Freezing: Pressing Pause on Fertility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158088. [PMID: 34360381 PMCID: PMC8345795 DOI: 10.3390/ijerph18158088] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/22/2021] [Accepted: 07/26/2021] [Indexed: 11/17/2022]
Abstract
Increasing numbers of women are undergoing oocyte or tissue cryopreservation for medical or social reasons to increase their chances of having genetic children. Social egg freezing (SEF) allows women to preserve their fertility in anticipation of age-related fertility decline and ineffective fertility treatments at older ages. The purpose of this study was to summarize recent findings focusing on the challenges of elective egg freezing. We performed a systematic literature review on social egg freezing published during the last ten years. From the systematically screened literature, we identified and analyzed five main topics of interest during the last decade: (a) different fertility preservation techniques, (b) safety of freezing, (c) usage rate of frozen oocytes, (d) ethical considerations, and (e) cost-effectiveness of SEF. Fertility can be preserved for non-medical reasons through oocyte, embryos, or ovarian tissue cryopreservation, with oocyte vitrification being a new and optimal approach. Elective oocyte cryopreservation is better accepted, supports social gender equality, and enhances women's reproductive autonomy. Despite controversies, planned oocyte cryopreservation appears as a chosen strategy against age-related infertility and may allow women to feel that they are more socially, psychologically, and financially stable before motherhood.
Collapse
|
11
|
Gonen LD. And When I Die: Theory of Planned Behavior as Applied to Sperm Cryopreservation. Healthcare (Basel) 2021; 9:554. [PMID: 34065091 PMCID: PMC8151572 DOI: 10.3390/healthcare9050554] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/25/2021] [Accepted: 04/30/2021] [Indexed: 11/16/2022] Open
Abstract
The present study investigates fertility intentions of men, aged 18-59, as expressed in willingness to cryopreserve sperm for future use in procreation. An economic stated-preference framework is combined with the Theory of Planned Behavior (TPB) to investigate which attributes are important in the decision to cryopreserve sperm, what is the Willingness to Pay (WTP) for cryopreservation, and which attributes influence it. A structured, two-part questionnaire was used, based on WTP and Conjoint analysis (CA) applied in tandem to elicit respondents' preferences in evaluating utility. Findings show which attributes are important in the decision to cryopreserve sperm among them Risk of Infertility, Personal monthly income, Chance of pregnancy from frozen semen, Age and what are significant predictor variables for the WTP which are Personal monthly income, Importance of the risk of infertility, Initial registration fee to sperm bank and cryopreservation, and Degree of religious observance. The findings further demonstrate that respondents value sperm cryopreservation and have a positive WTP for it as it seems to contribute to improving well-being. As a result of these findings, governments should consider state funding for cryopreservation as part of national health policy.
Collapse
Affiliation(s)
- Limor Dina Gonen
- Department of Economics and Business Administration, Ariel University, Ariel 40700, Israel
| |
Collapse
|
12
|
Kostenzer J, Bos AM, Bont AD, Exel JV. Unveiling the controversy on egg freezing in The Netherlands: A Q-methodology study on women's viewpoints. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2021; 12:32-43. [PMID: 33319082 PMCID: PMC7726258 DOI: 10.1016/j.rbms.2020.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 08/17/2020] [Accepted: 09/29/2020] [Indexed: 06/01/2023]
Abstract
Preserving the option to conceive through egg freezing (oocyte cryopreservation) is surrounded by value conflicts and diverse viewpoints, particularly when non-medical or so-called 'social' reasons are involved. The debate is controversial and shaped by normative perceptions of the life course, including concepts regarding reproductive ageing, gender, motherhood and biomedicalization. To unravel the controversy and systematically identify the variety of viewpoints on egg freezing, a Q-methodology study was conducted in The Netherlands between December 2018 and October 2019. Thirty-four women of reproductive age participated in the study. They ranked 40 statements according to their level of agreement, and explained their ranking during follow-up interviews. Data were analysed using by-person factor analysis and interpreted using both quantitative and qualitative data. Four viewpoints, of which the fourth was bipolar, were identified: (1) cautious about egg freezing technology; (2) my body, my choice; (3) egg freezing is unnatural; and (4) have children and have them early. The distinct viewpoints illustrate different prioritizations of values and normative dimensions of biomedical innovations. By knowing more about the prevalent opinions on egg freezing and the surrounding controversy, policy makers and practitioners can make better informed decisions in terms of promoting and providing patient-centred infertility care. The findings furthermore stimulate continuing scholarly work on egg freezing and other innovations in reproductive medicine which may continue to disrupt normative standards.
Collapse
Affiliation(s)
- Johanna Kostenzer
- Erasmus University Rotterdam, Erasmus School of Health Policy and Management, Rotterdam, the Netherlands
| | - Annelies M.E. Bos
- University Medical Centre Utrecht, Department of Reproductive Medicine and Gynaecology, Utrecht, the Netherlands
| | - Antoinette de Bont
- Erasmus University Rotterdam, Erasmus School of Health Policy and Management, Rotterdam, the Netherlands
| | - Job van Exel
- Erasmus University Rotterdam, Erasmus School of Health Policy and Management, Rotterdam, the Netherlands
- Erasmus University Rotterdam, Erasmus School of Economics, Rotterdam, the Netherlands
| |
Collapse
|
13
|
Kostenzer J, de Bont A, van Exel J. Women's viewpoints on egg freezing in Austria: an online Q-methodology study. BMC Med Ethics 2021; 22:4. [PMID: 33407392 PMCID: PMC7789674 DOI: 10.1186/s12910-020-00571-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 12/21/2020] [Indexed: 01/02/2023] Open
Abstract
Background Egg freezing has emerged as a technology of assisted reproductive medicine that allows women to plan for the anticipated loss of fertility and hence to preserve the option to conceive with their own eggs. The technology is surrounded by value-conflicts and is subject to ongoing discussions. This study aims at contributing to the empirical-ethical debate by exploring women’s viewpoints on egg freezing in Austria,
where egg freezing for social reasons is currently not allowed. Methods Q-methodology was used to identify prevailing viewpoints on egg freezing. 46 female participants ranked a set of 40 statements onto a 9-column forced choice ranking grid according to the level of agreement. Participants were asked to explain their ranking in a follow-up survey. By-person factor analysis was used to identify distinct viewpoints which were interpreted using both the quantitative and the qualitative data. Results Three distinct viewpoints were identified: (1) “women should decide for themselves”, (2) “we should accept nature but change policy”, and (3) “we need an informed societal debate”. These viewpoints provide insights into how biomedical innovations such as egg freezing are perceived by women in Austria and illustrate the normative tensions regarding such innovations. Conclusions Acknowledging the different prioritizations of values regarding assisted reproductive technologies is important to better understand the underlying normative tensions in a country where egg freezing for social reasons is currently not allowed. The study adds new empirical insights to the ongoing debate by outlining and discussing viewpoints of those directly affected: women. Following up on the lay persons perspective is particularly important in the context of future biomedical innovations that may challenge established norms and create new tensions. It therefore also adds to the societal debate and supports evidence-informed policy making in that regard.
Collapse
Affiliation(s)
- Johanna Kostenzer
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.
| | - Antoinette de Bont
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
| | - Job van Exel
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.,Erasmus School of Economics, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
| |
Collapse
|
14
|
Polyakov A, Rozen G. Social egg freezing and donation: waste not, want not. JOURNAL OF MEDICAL ETHICS 2021; 47:medethics-2020-106607. [PMID: 33402431 DOI: 10.1136/medethics-2020-106607] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/23/2020] [Accepted: 11/29/2020] [Indexed: 05/03/2023]
Abstract
The trend towards postponement of childbearing has seen increasing numbers of women turning towards oocyte banking for anticipated gamete exhaustion (AGE banking), which offers a realistic chance of achieving genetically connected offspring. However, there are concerns around the use of this technology, including social/ethical implications, low rate of utilisation and its cost-effectiveness. The same societal trends have also resulted in an increased demand and unmet need for donor oocytes, with many women choosing to travel overseas for treatment. This has its own inherent social, medical, financial and psychological sequelae. We propose a possible pathway to address these dual realities. The donation of oocytes originally stored in the context of AGE banking, with appropriate compensatory mechanisms, would ameliorate AGE banking concerns, while simultaneously improving the supply of donor oocytes. This proposed arrangement will result in tangible benefits for prospective donors, recipients and society at large.
Collapse
Affiliation(s)
- Alex Polyakov
- Obstetrics and Gynaecology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Melbourne IVF, East Melbourne, Victoria, Australia
| | - Genia Rozen
- Obstetrics and Gynaecology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Melbourne IVF, East Melbourne, Victoria, Australia
| |
Collapse
|
15
|
Barlevy D, Elger BS, Wangmo T, Ash S, Ravitsky V. The Meaning and Importance of Genetic Relatedness: Fertility Preservation Decision Making Among Israeli Adolescent Cancer Survivors and Their Parents. CANADIAN JOURNAL OF BIOETHICS 2020. [DOI: 10.7202/1073782ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: With multiple options available today to become a parent, how does the matter of genetic relatedness factor into adolescent cancer patients’ fertility preservation (FP) decision making? This study reports on and normatively analyzes this aspect of FP decision making. Methods: A convenience sample of Israeli adolescent cancer survivors and their parents were invited to participate in individual, semi-structured interviews. Results: In discussing the importance of genetic relatedness to future children or grandchildren, participants repeatedly brought up the interrelated issues of nature, normalcy, and personal identity. Regardless of preference or ambivalence for genetic relatedness, the majority of participants were aware of alternative parenting options and noted both their advantages and disadvantages. However, knowledge of alternative parenting options was not uniform. Conclusions: To ensure that adolescent patients and their parents make informed FP decisions that meet their personal goals and values, it is important for physicians to discuss alternative parenting options with them in a culturally sensitive manner. Greater credence also should be given to those who question the importance of genetic relatedness.
Collapse
Affiliation(s)
- Dorit Barlevy
- Institute for Biomedical Ethics, University of Basel, Switzerland
| | - Bernice S. Elger
- Institute for Biomedical Ethics, University of Basel, Switzerland
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Switzerland
| | - Shifra Ash
- Schneider Children’s Medical Center of Israel, Petach Tiqva, Israel
| | - Vardit Ravitsky
- Bioethics Program, School of Public Health, University of Montreal, Montreal, Canada
| |
Collapse
|
16
|
Alteri A, Pisaturo V, Nogueira D, D'Angelo A. Elective egg freezing without medical indications. Acta Obstet Gynecol Scand 2019; 98:647-652. [PMID: 30758059 DOI: 10.1111/aogs.13573] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 02/06/2019] [Indexed: 11/30/2022]
Abstract
The aim of this review is to provide current knowledge on fertility preservation for non-medical reasons in women willing to postpone childbearing. The topic is highly debatable, starting from disagreement about its terminology, the number of eggs necessary to predict chances of success, and the safety and socio/ethical point of view. Cost analysis and discrepancies among countries' recommendations and regulations are described to confirm the controversies and unsolved issues around this very interesting topic. Finally, an overview on the returning rate of women among "egg bankers" and reasons behind their decisions are illustrated.
Collapse
Affiliation(s)
- Alessandra Alteri
- Obstetrics and Gynecology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Valerio Pisaturo
- Reproductive Medicine Department, International Evangelical Hospital, Genoa, Italy
| | - Daniela Nogueira
- Laboratory of Reproductive Biology, INOVIE Fertilité, Toulouse, France
| | | |
Collapse
|
17
|
Baldwin K, Culley L. Women’s experience of social egg freezing: perceptions of success, risks, and ‘going it alone’. HUM FERTIL 2018; 23:186-192. [DOI: 10.1080/14647273.2018.1522456] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Kylie Baldwin
- Centre for Reproduction Research, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Lorraine Culley
- Centre for Reproduction Research, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| |
Collapse
|
18
|
Simopoulou M, Sfakianoudis K, Bakas P, Giannelou P, Papapetrou C, Kalampokas T, Rapani A, Chatzaki E, Lambropoulou M, Lourida C, Deligeoroglou E, Pantos K, Koutsilieris M. Postponing Pregnancy Through Oocyte Cryopreservation for Social Reasons: Considerations Regarding Clinical Practice and the Socio-Psychological and Bioethical Issues Involved. MEDICINA (KAUNAS, LITHUANIA) 2018; 54:E76. [PMID: 30366459 PMCID: PMC6262467 DOI: 10.3390/medicina54050076] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/01/2018] [Accepted: 10/19/2018] [Indexed: 11/21/2022]
Abstract
Oocyte freezing for 'social reasons' refers to women of reproductive age who are aiming to prolong, protect and secure their fertility. The term emerged to describe application of the highly promising technique, namely vitrification on oocytes retrieved through controlled ovarian stimulation (COS) from women intending to preserve their fertility for social reasons. These women opt to cryopreserve their oocytes at a point in their life when they need to postpone childbearing on the grounds of so called 'social' reasons. These reasons may include a highly driven career, absence of an adequate partner, financial instability, or personal reasons that make them feel unprepared for motherhood. This is a sensitive and multifaceted issue that entails medical, bioethical and socio-psychological components. The latest trend and the apparent increase noted on oocyte freezing for 'social reasons' has prompted our team of fertility specialists, embryologists, obstetricians, gynecologists and psychologists to proceed with a thorough, critical and all-inclusive comprehensive analysis. The wide range of findings of this analysis involve concerns of embryology and epigenetics that shape decisions made in the IVF laboratory, issues regarding obstetric and perinatal concerns on the pregnancy concluding from these oocytes and the respective delivery management and neonatal data, to the social and bioethical impact of this trend's application. This literature review refers to matters rising from the moment the 'idea' of this option is 'birthed' in a woman's thoughts, to proceeding and executing it clinically, up until the point of the pediatric follow up of the children born. We aim to shed light to the controversial issue of oocyte freezing, while objectively exhibit all aspects regarding this complex matter, as well as to respectfully approach how could the prospect of our future expectations be shaped from the impact of its application.
Collapse
Affiliation(s)
- Mara Simopoulou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece.
- Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, Greece.
| | | | - Panagiotis Bakas
- Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, Greece.
| | - Polina Giannelou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece.
- Centre for Human Reproduction, Genesis Athens Clinic, 14⁻16, Papanikoli, 15232 Athens, Greece.
| | - Christina Papapetrou
- Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, Greece.
| | - Theodoros Kalampokas
- Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, Greece.
| | - Anna Rapani
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece.
| | - Ekaterini Chatzaki
- Laboratory of Histology-Embryology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece.
| | - Maria Lambropoulou
- Laboratory of Pharmacology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece.
| | - Chrysoula Lourida
- Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, Greece.
| | - Efthymios Deligeoroglou
- Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, Greece.
| | - Konstantinos Pantos
- Centre for Human Reproduction, Genesis Athens Clinic, 14⁻16, Papanikoli, 15232 Athens, Greece.
| | - Michael Koutsilieris
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece.
| |
Collapse
|
19
|
Hurley EG, Ressler IB, Young S, Batcheller A, Thomas MA, DiPaola KB, Rios J. Postponing Childbearing and Fertility Preservation in Young Professional Women. South Med J 2018; 111:187-191. [DOI: 10.14423/smj.0000000000000789] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
20
|
Bozzaro C. Is egg freezing a good response to socioeconomic and cultural factors that lead women to postpone motherhood? Reprod Biomed Online 2018. [PMID: 29530402 DOI: 10.1016/j.rbmo.2018.01.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
In western societies, a growing number of women are currently turning to social egg freezing, a technique that makes it possible to freeze oocytes and thus preserve female reproductive possibilities. The current ethical debate has focused on normative aspects concerning the question of whether social egg freezing empowers women's reproductive autonomy. Due to this narrow focus on autonomy, deeper questions concerning the socio-economic conditions and cultural factors that lead women to delay reproduction, to feel pressured by their biological clock, and thus to consider social egg freezing have not yet received sufficient attention and analysis. The aim of this study was to broaden the ethical debate by focusing on whether social egg freezing is a good response to the socioeconomic and cultural constraints that lead women to postpone motherhood, and therefore whether it can be seen as a means of achieving what in virtue ethics is known as a 'good life'. I will argue that while social egg freezing can be seen as a means to empower women to adapt to current socioeconomic constraints, it is not an adequate response to cultural factors, as these cannot be solved by simply extending a woman's fertility.
Collapse
Affiliation(s)
- Claudia Bozzaro
- Department of Medical Ethics and History of Medicine, Albert-Ludwigs-University, Stefan-Meierstr. 26, 79104, Freiburg, Germany.
| |
Collapse
|
21
|
Abstract
PURPOSE OF REVIEW The use of oocyte cryopreservation via vitrification has increased lately, becoming a common strategy in many IVF centers. This review summarizes the current state of oocyte vitrification, by analyzing the most recent reports on its use in IVF as part of infertile treatment and its contribution to elective fertility preservation (EFP). RECENT FINDINGS Oocyte vitrification has become helpful for managing different clinical situations currently providing similar results to fresh oocytes. Owing to satisfactory results, oocyte vitrification is being offered to healthy women to extend their reproductive options (EFP). Although little is known about outcomes in this specific population, new evidence is starting to emerge. Currently, most women are motivated by age and lack of partner. Age is strongly related to the probability of having a child with better chances when they do EFP younger than 35. In contrast to the biological efficiency, the majority of studies show that EFP is more cost-effective at 37-38 years. SUMMARY Oocyte vitrification is an efficient tool which can be helpful in managing the IVF cycle. Fertility preservation providers should inform women about their specific probabilities according to their age at vitrification, making emphasis in the fact that egg freezing does not guarantee success, but increases the possibilities of having a biological child in the future.
Collapse
|
22
|
Shenfield F, de Mouzon J, Scaravelli G, Kupka M, Ferraretti A, Prados F, Goossens V. Oocyte and ovarian tissue cryopreservation in European countries: statutory background, practice, storage and use. Hum Reprod Open 2017; 2017:hox003. [PMID: 30895222 PMCID: PMC6276651 DOI: 10.1093/hropen/hox003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 02/08/2017] [Accepted: 03/10/2017] [Indexed: 01/18/2023] Open
Abstract
STUDY QUESTION What is known in Europe about the practice of oocyte cryopreservation (OoC), in terms of current statutory background, funding conditions, indications (medical and 'non-medical') and specific number of cycles? SUMMARY ANSWER Laws and conditions for OoC vary in Europe, with just over half the responding countries providing this for medical reasons with state funding, and none providing funding for 'non-medical' OoC. WHAT IS ALREADY KNOWN The practice of OoC is a well-established and increasing practice in some European countries, but data gathering on storage is not homogeneous, and still sparse for use. Ovarian tissue cryopreservation (OtC) is only practiced and registered in a few countries. STUDY DESIGN SIZE AND DURATION A transversal collaborative survey on OoC and OtC, was designed, based on a country questionnaire containing information on statutory or professional background and practice, as well as available data on ovarian cell and tissue collection, storage and use. It was performed between January and September 2015. PARTICIPANTS/MATERIALS SETTING AND METHODS All ESHRE European IVF Monitoring (EIM) consortium national coordinators were contacted, as well as members of the ESHRE committee of national representatives, and sent a questionnaire. The form included national policy and practice details, whether through current existing law or code of practice, criteria for freezing (age, health status), availability of funding and the presence of a specific register. The questionnaire also included data on both the number of OoC cycles and cryopreserved oocytes per year between 2010 and 2014, specifically for egg donation, fertility preservation for medical disease, 'other medical' reasons as part of an ART cycle, as well as for 'non-medical reasons' or age-related fertility decline. Another question concerning data on freezing and use of ovarian tissue over 5 years was added and sent after receiving the initial questionnaire. MAIN RESULTS AND THE ROLE OF CHANCE Out of 34 EIM members, we received answers regarding OoC regulations and funding conditions from 27, whilst 17 countries had recorded data for OoC, and 12 for OtC. The specific statutory framework for OoC and OtC varies from absent to a strict frame. A total of 34 705 OoC cycles were reported during the 5-year-period, with a continuous increase. However, the accurate description of numbers was concentrated on the year 2013 because it was the most complete. In 2013, a total of 9126 aspirations involving OoC were reported from 16 countries. Among the 8885 oocyte aspirations with fully available data, the majority or 5323 cycles (59.9%) was performed for egg donation, resulting in the highest yield per cycle, with an average of 10.4 oocytes frozen per cycle. OoC indication was 'serious disease' such as cancer in 10.9% of cycles, other medical indications as 'part of an ART cycle' in 16.1%, and a non-medical reason in 13.1%. With regard to the use of OoC, the number of specifically recorded frozen oocyte replacement (FOR) cycles performed in 2013 for all medical reasons was 14 times higher than the FOR for non-medical reasons, using, respectively, 8.0 and 8.4 oocytes per cycle. Finally, 12 countries recorded storage following OtC and only 7 recorded the number of grafted frozen/thawed tissues. LIMITATIONS REASONS FOR CAUTION Not all countries have data regarding OoC collection, and some data came from voluntary collaborating centres, rather than a national authority or register. Furthermore, the data related to use of OoC were not included for two major players in the field, Italy and Spain, where numbers were conflated for medical and non-medical reasons. Finally, the number of cycles started with no retrieval is not available. Data are even sparser for OtC. WIDER IMPLICATIONS OF THE FINDINGS There is a need for ART authorities and professional bodies to record precise data for practice and use of OoC (and OtC), according to indications and usage, in order to reliably inform all stakeholders including women about the efficiency of both methods. Furthermore, professional societies should establish professional standards for access to and use of OoC and OtC, and give appropriate guidance to all involved. STUDY FUNDING/COMPETING INTERESTS The study was supported by ESHRE. There are no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
| | - F. Shenfield
- Reproductive Medicine Unit, New EGA, UCLH, Euston Road, London NW1 2BU, UK
| | | | - G. Scaravelli
- National ART Register, National Centre for Epidemiology, Surveillance and Health Promotion Istituto Superiore di Sanità Viale Regina Elena, 299, 00161 Roma, Italy
| | - M. Kupka
- Reproductive Medicine Center, Altonaer Str. 59, D-20357 Hamburg, Germany
| | | | - F.J. Prados
- HM Fertility Center Montepríncipe Boadilla del Monte 28660, Madrid, Spain
| | - V. Goossens
- European Society of Human Reproduction and Embryology, Meerstraat 60, B-1852 Grimbergen, Belgium
| |
Collapse
|
23
|
Segers S, Mertes H, de Wert G, Dondorp W, Pennings G. Balancing Ethical Pros and Cons of Stem Cell Derived Gametes. Ann Biomed Eng 2017; 45:1620-1632. [PMID: 28091967 DOI: 10.1007/s10439-017-1793-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 01/09/2017] [Indexed: 12/18/2022]
Abstract
In this review we aim to provide an overview of the most important ethical pros and cons of stem cell derived gametes (SCD-gametes), as a contribution to the debate about reproductive tissue engineering. Derivation of gametes from stem cells holds promising applications both for research and for clinical use in assisted reproduction. We explore the ethical issues connected to gametes derived from embryonic stem cells (both patient specific and non-patient specific) as well as those related to gametes derived from induced pluripotent stem cells. The technology of SCD-gametes raises moral concerns of how reproductive autonomy relates to issues of embryo destruction, safety, access, and applications beyond clinical infertility.
Collapse
Affiliation(s)
- Seppe Segers
- Department of Philosophy and Moral Sciences, Bioethics Institute Ghent, Ghent University, Blandijnberg 2, 9000, Ghent, Belgium.
| | - Heidi Mertes
- Department of Philosophy and Moral Sciences, Bioethics Institute Ghent, Ghent University, Blandijnberg 2, 9000, Ghent, Belgium
| | - Guido de Wert
- Department of Health, Ethics and Society, Research Schools CAPHRI and GROW, Maastricht University, Peter Debyeplein 1, Maastricht, The Netherlands
| | - Wybo Dondorp
- Department of Health, Ethics and Society, Research Schools CAPHRI and GROW, Maastricht University, Peter Debyeplein 1, Maastricht, The Netherlands
| | - Guido Pennings
- Department of Philosophy and Moral Sciences, Bioethics Institute Ghent, Ghent University, Blandijnberg 2, 9000, Ghent, Belgium
| |
Collapse
|
24
|
de Groot M, Dancet E, Repping S, Goddijn M, Stoop D, van der Veen F, Gerrits T. Perceptions of oocyte banking from women intending to circumvent age-related fertility decline. Acta Obstet Gynecol Scand 2016; 95:1396-1401. [PMID: 27623090 DOI: 10.1111/aogs.13019] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 09/06/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Women can now opt to bank their oocytes with the intention of increasing their chances of achieving a pregnancy after their fertility has declined. This exploratory study aimed to gain insight into how women, considering oocyte banking to circumvent age-related fertility decline, perceive this intervention. MATERIAL AND METHODS We conducted a qualitative study in a Dutch university medical center and held in-depth interviews with women on the waiting list for oocyte banking. We recorded the interviews, transcribed them verbatim and used thematic analysis. RESULTS All women were financially independent and lived in single-person urban households. They opted for oocyte banking because they wished to share parenthood with a future partner rather than becoming a single parent. This strong desire was key in their interpretation of all aspects of the intervention. Women set aside information about the limited success rates and potential risks, as they were optimistic about their own prognosis, thought that the chances for success were equally likely as the chances it would fail, and because of "anticipatory regret". They perceived oocyte banking as a "helping hand" to achieve shared parenthood. Although women found the costs of the intervention high, they were willing to invest their money to increase their chances for shared parenthood. CONCLUSIONS Oocyte banking allows women to circumvent age-related fertility decline. The prospect of potential shared parenthood overrules the perceived health risks and burden. Health professionals should take this into account when informing potential users of oocyte banking.
Collapse
Affiliation(s)
- Marije de Groot
- Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, the Netherlands
| | - Eline Dancet
- Center for Reproductive Medicine, Women and Children's Clinic, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.,Leuven University Fertility Center, Leuven University Hospital, Leuven, Belgium
| | - Sjoerd Repping
- Center for Reproductive Medicine, Women and Children's Clinic, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Mariette Goddijn
- Center for Reproductive Medicine, Women and Children's Clinic, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Dominic Stoop
- Center for Reproductive Medicine, UZ Brussel, Free University of Brussels, Brussels, Belgium
| | - Fulco van der Veen
- Center for Reproductive Medicine, Women and Children's Clinic, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Trudie Gerrits
- Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, the Netherlands
| |
Collapse
|
25
|
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: 2] [Impact Index Per Article: 0.3] [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.
Collapse
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
| |
Collapse
|
26
|
Vialle M, Perrin J, Amar-Hoffet A, Boyer P, Courbiere B. [Female age - related fertility decline: Far from the myth of the "selfish working-girl" and the "right to have a child"]. ACTA ACUST UNITED AC 2016; 44:225-31. [PMID: 27053038 DOI: 10.1016/j.gyobfe.2016.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 02/25/2016] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To study the social dimension of age-related female infertility through an analysis of three key themes: the personal life histories of infertile women over 40 years of age; representations of age and the desire to become pregnant after age 40; opinions of French legislations framing Assisted Reproductive Technologies, age limits, egg donation, and egg freezing for non-medical reasons. METHODS This qualitative sociological study was based on semi-structured interviews with infertile women over age 40 going through fertility treatments. The interviews contained three parts: personal and relationship histories; experiences related to age; opinions related to French legislation. RESULTS Twenty-three interviews were conducted; each lasting between 90 to 120minutes. Far from having similar life histories, the women interviewed had very different backgrounds leading to their desire for a pregnancy after 40 years of age. From the beginning of their fertility treatments, they perceived a "race against the clock". This feeling of urgency accompanied their experiences and was related to the desire to not be too old for their future child. The women interviewed were mainly in favor of loosening French bioethical laws in order to avoid the need to travel abroad to pursue fertility treatments. CONCLUSION The profiles studied attest to a growing gap between biological and biographical temporalities, as well as an inability of women to reduce their desire for a child. Faced with this disparity, egg donation and egg freezing were seen as practical solutions.
Collapse
Affiliation(s)
- M Vialle
- Centre Norbert Elias-UMR 8562, École des Hautes Études en Sciences Sociales, CNRS, Aix Marseille Université, 2, rue de la Charité, 13002 Marseille, France.
| | - J Perrin
- Pôle Femmes-Parents-Enfants, Centre Clinico-biologique d'AMP-CECOS, AP-HM, l'hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix Marseille Université, CNRS, IRD, Avignon Université, IMBE UMR 7263, 13397, Marseille, France
| | - A Amar-Hoffet
- Service de médecine et biologie de la reproduction (SMBR), hôpital Saint-Joseph, 26, boulevard de Louvain, 13008 Marseille, France
| | - P Boyer
- Service de médecine et biologie de la reproduction (SMBR), hôpital Saint-Joseph, 26, boulevard de Louvain, 13008 Marseille, France
| | - B Courbiere
- Pôle Femmes-Parents-Enfants, Centre Clinico-biologique d'AMP-CECOS, AP-HM, l'hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix Marseille Université, CNRS, IRD, Avignon Université, IMBE UMR 7263, 13397, Marseille, France
| |
Collapse
|
27
|
Argyle CE, Harper JC, Davies MC. Oocyte cryopreservation: where are we now? Hum Reprod Update 2016; 22:440-9. [DOI: 10.1093/humupd/dmw007] [Citation(s) in RCA: 161] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 02/15/2016] [Indexed: 11/15/2022] Open
|
28
|
Withnall RDJ, Morris L. Career or family planning? Oocyte cryopreservation for UK Servicewomen. J ROY ARMY MED CORPS 2015; 162:3-4. [PMID: 26472119 DOI: 10.1136/jramc-2015-000468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2015] [Indexed: 11/04/2022]
Affiliation(s)
- Richard D J Withnall
- Academic Department of Military General Practice and Primary Care, Royal Centre for Defence Medicine, Birmingham, UK
| | - Louisa Morris
- Royal Centre for Defence Medicine (Research & Academia), Birmingham, UK
| |
Collapse
|
29
|
Baldwin K, Culley L, Hudson N, Mitchell H, Lavery S. Oocyte cryopreservation for social reasons: demographic profile and disposal intentions of UK users. Reprod Biomed Online 2015; 31:239-45. [PMID: 26099440 DOI: 10.1016/j.rbmo.2015.04.010] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 04/27/2015] [Accepted: 04/30/2015] [Indexed: 11/25/2022]
Abstract
A small number of studies from the USA and Europe have provided some data on the profile and characteristics of women who have undergone oocyte cryopreservation for what has been termed elective, social or non-medical reasons; however, little is known in a UK context about which women are undergoing oocyte cryopreservation or their reproductive intentions and actions after the procedure. Drawing on data from an exploratory study of 23 UK resident women who had undergone social oocyte cryopreservation, the demographic profile of these women, their reproductive intentions and actions are discussed, as well as their attitudes and intentions towards their cryopreserved oocytes should they never require them in treatment. The study found that, at the time of oocyte cryopreservation, women were on average 36.7 years of age, were university educated, with 65% of the sample holding further postgraduate or professional qualifications. Fifty-seven per cent of the participants were in professional employment. All participants identified as heterosexual and 87% were not in a relationship at the time of cryopreserving their oocytes. Most (88%) participants stated that they would donate unwanted oocytes to research or to other women for use in fertility treatment should they never require them.
Collapse
Affiliation(s)
- Kylie Baldwin
- De Montfort University, Applied Social Sciences, Hawthorn Building, The Gateway, Leicester, Leicestershire LE1 9HB, UK.
| | - Lorraine Culley
- De Montfort University, Applied Social Sciences, Hawthorn Building, The Gateway, Leicester, Leicestershire LE1 9HB, UK
| | - Nicky Hudson
- De Montfort University, Applied Social Sciences, Hawthorn Building, The Gateway, Leicester, Leicestershire LE1 9HB, UK
| | - Helene Mitchell
- De Montfort University, Applied Social Sciences, Hawthorn Building, The Gateway, Leicester, Leicestershire LE1 9HB, UK
| | - Stuart Lavery
- Hammersmith Hospital, Department of Reproductive Medicine, 3rd Floor Hammersmith House, Du Cane Road, London W12 0HS, UK
| |
Collapse
|
30
|
Dittrich R, Lotz L, Fehm T, Krüssel J, von Wolff M, Toth B, van der Ven H, Schüring AN, Würfel W, Hoffmann I, Beckmann MW. Xenotransplantation of cryopreserved human ovarian tissue--a systematic review of MII oocyte maturation and discussion of it as a realistic option for restoring fertility after cancer treatment. Fertil Steril 2015; 103:1557-65. [PMID: 25881879 DOI: 10.1016/j.fertnstert.2015.03.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 02/28/2015] [Accepted: 03/02/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To systematically review the reporting of MII (MII) oocyte development after xenotransplantation of human ovarian tissue. DESIGN Systematic review in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). SETTING Not applicable. PATIENT(S) Not applicable. INTERVENTION(S) Formation of MII oocytes after xenotransplantation of human ovarian tissue. MAIN OUTCOME MEASURE(S) Any outcome reported in Pubmed. RESULT(S) Six publications were identified that report on formation of MII oocytes after xenotransplantation of human ovarian tissue. CONCLUSION(S) Xenografting of human ovarian tissue has proved to be a useful model for examining ovarian function and follicle development in vivo. With human follicles that have matured through xenografting, the possibility of cancer transmission and relapse can also be eliminated, because cancer cells are not able to penetrate the zona pellucida. The reported studies have demonstrated that xenografted ovarian tissue from a range of species, including humans, can produce antral follicles that contain mature (MII) oocytes, and it has been shown that mice oocytes have the potential to give rise to live young. Although some ethical questions remain unresolved, xenotransplantation may be a promising method for restoring fertility. This review furthermore describes the value of xenotransplantation as a tool in reproductive biology and discusses the ethical and potential safety issues regarding ovarian tissue xenotransplantation as a means of recovering fertility.
Collapse
Affiliation(s)
- Ralf Dittrich
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
| | - Laura Lotz
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Tanja Fehm
- Department of Obstetrics and Gynecology, Düsseldorf University Hospital, Düsseldorf, Germany
| | - Jan Krüssel
- Department of Obstetrics and Gynecology, Düsseldorf University Hospital, Düsseldorf, Germany
| | - Michael von Wolff
- Division of Gynecologic Endocrinology and Reproductive Medicine, University Women's Hospital, Berne, Switzerland
| | - Bettina Toth
- Department of Gynecologic Endocrinology and Fertility Disorders, Ruprecht-Karls University Hospital, Heidelberg, Germany
| | - Hans van der Ven
- Department of Obstetrics and Gynecology, Bonn University Hospital, Bonn, Germany
| | - Andreas N Schüring
- Department of Obstetrics and Gynecology, UKM Kinderwunschzentrum, Münster University Hospital, Münster, Germany
| | | | - Inge Hoffmann
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Matthias W Beckmann
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| |
Collapse
|
31
|
Stoop D, Maes E, Polyzos NP, Verheyen G, Tournaye H, Nekkebroeck J. Does oocyte banking for anticipated gamete exhaustion influence future relational and reproductive choices? A follow-up of bankers and non-bankers. Hum Reprod 2014; 30:338-44. [DOI: 10.1093/humrep/deu317] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
32
|
Baldwin K, Culley L, Hudson N, Mitchell H. Reproductive technology and the life course: Current debates and research in social egg freezing. HUM FERTIL 2014; 17:170-9. [DOI: 10.3109/14647273.2014.939723] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
33
|
Hans JD, Dooley B. Attitudes toward making babies … with a deceased partner's cryopreserved gametes. DEATH STUDIES 2014; 38:571-581. [PMID: 25010854 DOI: 10.1080/07481187.2013.809033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A multiple segment factorial vignette was used with a probability sample of 857 U.S. households to assess the effects of contextual variables on attitudes toward posthumous reproduction using the cryopreserved gametes of a deceased partner. Attitudes were affected in predictable directions by marital status, gender of the deceased individual, disposition of the deceased's parents, and the deceased's wishes. In addition, respondents who identified more closely with their chosen religion tended to perceive posthumous conception as less appropriate and those who had never had children attributed a greater degree of obligation to assist on the part of medical professionals.
Collapse
Affiliation(s)
- Jason D Hans
- a Department of Family Sciences , University of Kentucky , Lexington , Kentucky , USA
| | | |
Collapse
|
34
|
Should Postponing Motherhood via “Social Freezing” Be Legally Banned? An Ethical Analysis. LAWS 2014. [DOI: 10.3390/laws3020282] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
35
|
Stoop D, van der Veen F, Deneyer M, Nekkebroeck J, Tournaye H. Oocyte banking for anticipated gamete exhaustion (AGE) is a preventive intervention, neither social nor nonmedical. Reprod Biomed Online 2014; 28:548-51. [PMID: 24631381 DOI: 10.1016/j.rbmo.2014.01.007] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 11/12/2013] [Accepted: 01/09/2014] [Indexed: 10/25/2022]
Abstract
The scope of female fertility preservation through cryopreservation of oocytes or ovarian cortex has widened from mainly oncological indications to a variety of fertility-threatening conditions. So far, no specific universally accepted denomination name has been given to cryopreservation of oocytes or ovarian cortex for the prevention of age-related fertility decline. We argue that the commonly used phrases 'social' and 'nonmedical freezing' to denote the indication for cryopreservation are not entirely correct. We suggest 'AGE banking', as this has not only the advantage of being catchy but also depicts the exact indication for the strategy, anticipated gamete exhaustion.
Collapse
Affiliation(s)
- Dominic Stoop
- Centre for Reproductive Medicine, UZ Brussel of the Dutch Speaking Free University of Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium.
| | - Fulco van der Veen
- Center for Reproductive Medicine, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Michel Deneyer
- Department of Paediatrics, UZ Brussel of the Dutch Speaking Free University of Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Julie Nekkebroeck
- Centre for Reproductive Medicine, UZ Brussel of the Dutch Speaking Free University of Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Herman Tournaye
- Centre for Reproductive Medicine, UZ Brussel of the Dutch Speaking Free University of Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium
| |
Collapse
|
36
|
Blyth E, Yee S, Lee GL. Freezing the Biological Clock: A Viable Fertility Preservation Option for Young Singaporean Women? ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2013. [DOI: 10.47102/annals-acadmedsg.v42n9p472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In March 2012, an article in The Straits Times entitled ‘Freezing eggs could reverse falling birth rate’ suggested that employing the latest oocyte cryopreservation techniques could both foster individual women’s reproductive autonomy and impact Singapore’s fertility rate, which in recent years has consistently been among the world’s lowest. The article cited both local and international fertility specialists’ approval of elective oocyte cryopreservation for young women wishing to protect their reproductive potential against ageing and as a potential antidote to the contemporary ‘delay and defer’ model of family-building. Later in 2012, the Ministry of Health announced a review of oocyte cryopreservation policy taking into account related medical, scientific and ethical issues, while the Singapore College of Obstetricians and Gynaecologists endorsed oocyte cryopreservation as an “important, safe and efficient technology”. This paper outlines and analyses the arguments and empirical evidence used both to support and oppose offering elective oocyte cryopreservation as a routine fertility service, before concluding that this remains unjustifiable on the basis of insufficient evidence of its clinical efficacy and safety as regards either pregnancy rates or birth outcomes. If it is to be made available at all for these reasons in Singapore, it should be subjected to rigorous clinic-specific evaluation in accordance with accepted clinical and ethical norms.
Key words: Elective oocyte cryopreservation, Outcomes
Collapse
Affiliation(s)
- Eric Blyth
- School of Human and Health Sciences, University of Huddersfield England, United Kingdom
| | - Samantha Yee
- Centre for Fertility and Reproductive Health, Mount Sinai Hospital Toronto, Canada
| | | |
Collapse
|
37
|
Cobo A, Garcia-Velasco JA, Domingo J, Remohí J, Pellicer A. Is vitrification of oocytes useful for fertility preservation for age-related fertility decline and in cancer patients? Fertil Steril 2013; 99:1485-95. [PMID: 23541405 DOI: 10.1016/j.fertnstert.2013.02.050] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 02/20/2013] [Accepted: 02/25/2013] [Indexed: 02/05/2023]
Abstract
The aim of this review is to provide current knowledge on oocyte cryopreservation, with special emphasis on vitrification as a means to preserve fertility in different indications. Major advancements achieved in the past few years in the cryolaboratory have facilitated major changes in our practice. Areas such as fertility preservation for social or oncologic reasons, the possibility to create oocyte banks for egg donation programs, the opportunity to avoid ovarian hyperstimulation syndrome, or to accumulate oocytes in low-yield patients, or even to offer treatment segmentation by stimulating the ovaries, vitrifying, and then transferring in a natural cycle are some of the options that are now available with the development of cryopreservation. We present general experience from our group and others on fertility preservation for age-related fertility decline as well as in oncologic patients, confirming that oocyte vitrification is a standardized, simple, reproducible, and efficient option.
Collapse
|
38
|
Vallejo V, Lee JA, Schuman L, Witkin G, Cervantes E, Sandler B, Copperman AB. Social and psychological assessment of women undergoing elective oocyte cryopreservation: A 7-year analysis. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/ojog.2013.31001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
39
|
Hans JD, Gillen M. Social security survivors benefits: the effects of reproductive pathways and intestacy law on attitudes. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2013; 41:514-524. [PMID: 23802901 DOI: 10.1111/jlme.12059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Most minor children are eligible for Social Security survivors benefits if a wage-earning parent dies, but eligibility of children not in utero at the time of death is more nuanced. The purpose of this study was to examine attitudes concerning access to Social Security survivors benefits in the context of posthumous reproduction. A probability sample of 540 Florida households responded to a multiple-segment factorial vignette designed to examine the effects of state intestacy laws and five reproductive pathways - normative, posthumous birth, cryopreserved embryo, cryopreserved gametes, and posthumous gamete retrieval - on attitudes toward eligibility for the Social Security survivors benefits. Broad support was found for the survivors benefits following normative and posthumous birth pathways, but attitudes were decidedly less favorable when the child was not in utero at the time of parental death. In addition, in stark contrast to the recent U.S. Supreme Court decision in Astrue v. Capato, the vast majority of respondents did not believe state intestacy laws should determine eligibility for Social Security survivors benefits.
Collapse
Affiliation(s)
- Jason D Hans
- Department of Family Sciences, University of Kentucky, USA
| | | |
Collapse
|
40
|
Mertes H, Pennings G, Dondorp W, de Wert G. Implications of oocyte cryostorage for the practice of oocyte donation. Hum Reprod 2012; 27:2886-93. [PMID: 22802093 DOI: 10.1093/humrep/des250] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
As the efficiency of oocyte cryopreservation has increased rapidly in recent years, oocytes are currently being stored either in the course of IVF treatments or as a fertility preservation measure. These practices may have an impact on the number of available donor oocytes due to two different dynamics: first, a certain percentage of women for whom oocytes were cryopreserved will eventually not use their oocytes and may decide to donate them to others; secondly, especially in the practice of social freezing, women may opt to donate a portion of the retrieved oocytes in 'freeze-and-share' schemes in order to reduce the costs. In this article, we aim to sketch the ethical implications of such developments in general and the issue of payment to oocyte donors in particular.
Collapse
Affiliation(s)
- Heidi Mertes
- Bioethics Institute Ghent, Ghent University, Ghent, Belgium.
| | | | | | | |
Collapse
|
41
|
Wyndham N, Marin Figueira PG, Patrizio P. A persistent misperception: assisted reproductive technology can reverse the “aged biological clock”. Fertil Steril 2012; 97:1044-7. [DOI: 10.1016/j.fertnstert.2012.02.015] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 02/09/2012] [Accepted: 02/10/2012] [Indexed: 11/29/2022]
|
42
|
Oocyte Cryopreservation in Canada: A Survey of Canadian ART Clinics. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2012; 34:250-256. [DOI: 10.1016/s1701-2163(16)35185-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
43
|
Oocyte cryopreservation, will it be a real social choice and family solution? MIDDLE EAST FERTILITY SOCIETY JOURNAL 2012. [DOI: 10.1016/j.mefs.2012.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
44
|
Dondorp W, de Wert G, Pennings G, Shenfield F, Devroey P, Tarlatzis B, Barri P, Diedrich K. Oocyte cryopreservation for age-related fertility loss. Hum Reprod 2012; 27:1231-7. [DOI: 10.1093/humrep/des029] [Citation(s) in RCA: 159] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
45
|
Campos JR, Rosa-e-Silva ACJDS. Cryopreservation and fertility: current and prospective possibilities for female cancer patients. ISRN OBSTETRICS AND GYNECOLOGY 2011; 2011:350813. [PMID: 22191044 PMCID: PMC3236388 DOI: 10.5402/2011/350813] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Accepted: 10/26/2011] [Indexed: 11/23/2022]
Abstract
With the evolution of the treatment of malignant neoplasms, the survival rates of patients undergoing chemo- or radiotherapy are increasing. The continuous development of techniques of assisted human reproduction has led to important strategies in an attempt to maintain reproductive function in patients subjected to treatment of neoplastic diseases, among them cryopreservation of embryos, gametes, and ovarian cortical tissue. The freezing of ovarian tissue is currently being proposed with the primary purpose of preserving ovarian function in these patients. Currently, the major challenge of groups working with preservation of fertility is the use of cryopreserved ovarian tissue after disease remission. The main alternatives presented today are the implantation of hetero- or orthotopic tissue and isolation of immature follicles from ovarian tissue followed by in vitro maturation and assisted reproduction procedures.
Collapse
Affiliation(s)
- Jacira Ribeiro Campos
- Department of Obstetrics and Gynecology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, 14049-900 Ribeirão Preto, SP, Brazil
| | | |
Collapse
|
46
|
Mertes H, Pennings G. Social egg freezing: for better, not for worse. Reprod Biomed Online 2011; 23:824-9. [DOI: 10.1016/j.rbmo.2011.09.010] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Revised: 08/08/2011] [Accepted: 09/19/2011] [Indexed: 10/17/2022]
|
47
|
|
48
|
van Loendersloot LL, Moolenaar LM, Mol BWJ, Repping S, van der Veen F, Goddijn M. Expanding reproductive lifespan: a cost-effectiveness study on oocyte freezing. Hum Reprod 2011; 26:3054-60. [DOI: 10.1093/humrep/der284] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
49
|
Shkedi-Rafid S, Hashiloni-Dolev Y. Egg freezing for age-related fertility decline: preventive medicine or a further medicalization of reproduction? Analyzing the new Israeli policy. Fertil Steril 2011; 96:291-4. [PMID: 21722891 DOI: 10.1016/j.fertnstert.2011.06.024] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 06/09/2011] [Indexed: 11/18/2022]
Abstract
In December 2009, the Israel National Bioethics Council (INBC) issued recommendations permitting egg freezing to prevent both disease- and age-related fertility decline. The INBC report forms the basis of Israel's new policy regarding egg freezing. This article analyzes the medical section of the INBC's recommendations, comparing it with guidelines formulated by medical regulatory bodies in Europe and the United States. Our findings suggest that the INBC's recommendations consider age-related fertility decline to be a medical problem, and hence treat the new technology favorably, as preventive medicine, which we perceive as another instance of medicalization. The technology's risks are downplayed by the INBC, unlike the positions of medical organizations in both Europe and the United States, which consider the new technology experimental. This may culminate in raising false hopes about women's possible late genetic motherhood leading to involuntary future childlessness.
Collapse
Affiliation(s)
- Shiri Shkedi-Rafid
- The Institute for Medical Research, Faculty of Medicine, The Hebrew University of Jerusalem, Israel.
| | | |
Collapse
|
50
|
Egg cell preservation and the right to die in the Netherlands: citizens' choices and the limits of medicine. Camb Q Healthc Ethics 2011; 20:449-57. [PMID: 21676332 DOI: 10.1017/s0963180111000132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
It is a funny thing with the Dutch. On one hand, they seem preoccupied with death and adamant that patients be allowed to decide for themselves in what way they want to die. On the other, contrary to popular belief, the Dutch physician is allotted a very influential role in treatment decisions, far more prominent than in many other Western countries. From an American perspective Dutch professional ethics may seem quite paternalistic: a patient's freedom to decide to have a particular medical treatment is limited by the physician's professional assessment of the medical need of this treatment. The question arises: What is the relationship between the professional responsibility of Dutch physicians and the right of Dutch patients to decide for themselves? This question is illustrated by the ongoing national debate in The Netherlands on euthanasia and the growing demand for a further reaching right to self-determination concerning ending one's life. However, contrary to popular belief, not all Dutch ethical debate concerns end-of-life questions.
Collapse
|