Ethical Quandaries in Gamete-Embryo Cryopreservation Related to Oncofertility

Ayensu-Coker, Leslie; Essig, Ellen; Breech, Lesley; Lindheim, Steven R.

doi:10.1111/jlme.12081

Cited by 24 publications

(15 citation statements)

References 25 publications

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“…Some women opt to freeze both oocytes and embryos to increase their chances for a future child and to take into account that their relationship status may have changed when they are ready to start a family. Oocyte cryopreservation may be preferred by women who do not have a partner, do not wish to use donor sperm, or have ethical and/or religious objections to embryo cryopreservation …”

Section: Psychosocial and Ethical Considerationsmentioning

confidence: 99%

“…Although health insurance policies are not required to cover these costs for the cancer patient, the landscape is changing. The argument has been put forward that coverage for fertility preservation should be considered in the context of coverage for other side effects of treatment . Several major insurers have made individual decisions to provide coverage, and the American Medical Association has issued a statement urging insurers to cover fertility preservation services in the setting of a cancer diagnosis…”

Section: Psychosocial and Ethical Considerationsmentioning

confidence: 99%

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Infertility in reproductive‐age female cancer survivors

Levine

Kelvin

Quinn

et al. 2015

Cancer

137

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Improved survival rates among reproductive‐age females diagnosed with cancer have increased the focus on long‐term quality of life, including maintenance of the ability to conceive biological children. Cancer‐directed therapies such as high‐dose alkylating agents and radiation to the pelvis, which deplete ovarian reserve, radiation to the brain, which affects the hypothalamic‐pituitary‐gonadal axis, and surgical resection of reproductive structures can decrease the likelihood of having biological children. Standard fertility preservation strategies such as embryo and oocyte cryopreservation before the onset of therapy offer the opportunity to conserve fertility, but they may not be feasible because of the urgency to start cancer therapy, financial limitations, and a lack of access to reproductive endocrinologists. Ovarian tissue freezing is considered experimental, with limited data related to pregnancies, but it minimizes treatment delay. Studies evaluating gonadotropin‐releasing hormone analogues have had mixed results, although a recent randomized, prospective study in women with breast cancer demonstrated a protective effect. Fertility preservation programs are increasingly being developed within cancer programs. In this article, we describe risks to infertility and options for preservation, raise psychosocial and ethical issues, and propose elements for establishing an effective fertility preservation program. Cancer 2015;121:1532–1539. © 2015 American Cancer Society.

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Section: Psychosocial and Ethical Considerationsmentioning

confidence: 99%

Section: Psychosocial and Ethical Considerationsmentioning

confidence: 99%

Infertility in reproductive‐age female cancer survivors

Levine

Kelvin

Quinn

et al. 2015

Cancer

137

View full text Add to dashboard Cite

show abstract

“…Lastly, it is important to emphasize that costs and insurance coverage for FP57,58 and legislation regulating the storage of embryos and gametes vary considerably around the world 59…”

Section: Methods For Fp In Premenopausal Bc Patientsmentioning

confidence: 99%

Preserving fertility in patients undergoing treatment for breast cancer: current perspectives

Moffat¹,

Güth²

2014

BCTT

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Invasive breast cancer (BC) is the most frequent cancer of young women. Considering the trend toward postponing childbearing until the later reproductive years, the number of childless women at diagnosis of BC will continue to increase. The American Society of Clinical Oncology and the American Society for Reproductive Medicine have recommended that the impact of cancer treatments on fertility should be addressed with all cancer patients of reproductive age and that options for fertility preservation, such as cryopreservation of embryos and oocytes, ovarian tissue, in vitro maturation of immature oocytes, and ovarian suppression with gonadotropin-releasing hormone analogs, should be discussed routinely. To optimally counsel patients on how to best weigh the risks and benefits of fertility preservation, both the health care provider and the patient must know about the options, their risks, and their likelihood of success. The aim of this review is to summarize current knowledge on fertility preservation options for young BC patients, surrogates of ovarian function, psychosocial aspects of infertility after cancer treatment, women’s attitudes towards childbearing after cancer treatment, and health care providers’ attitudes towards fertility preservation.

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“…4 However, the existing ethical analyses have been conducted in cancer survivors. There is an absence of research describing the psychological effects of childbearing for metastatic patients and/or their gestational carriers, or the physical/psychological outcomes in their offspring.…”

Section: Dear Editormentioning

confidence: 99%