On the ethics of social egg freezing and fertility preservation for nonmedical reasons

Abstract

Abstract:The practice of egg freezing reached a new milestone in 2012, when the American Society for Reproductive Medicine removed its designation as "experimental". Studies of the safety and efficacy of egg freezing led the ASRM to recommend egg freezing for patients facing infertility due to gonadotoxic therapies, but prompted continued caution against egg freezing when undertaken for nonmedical reasons. The European Society of Human Reproduction and Embryology has more explicitly supported nonmedical egg freezing. Ethical debate about nonmedical egg freezing raises many familiar issues, including the limits of individual autonomy when a medical technology is used for an elective reason. Concerns include commercial exploitation, pressure on women to use egg freezing, and the overall impact of egg freezing on sex inequality and professional norms. The ethical debate also calls for a more careful consideration of whether age-related fertility decline should count as a medical justification for fertility preservation. In lieu of broad consensus on these matters, this paper recommends honoring the principle of autonomy while insisting on better information about utilization and outcomes. Given the significant drop-off in success rates for women who attempt egg freezing when they are older than 38 years, full disclosure in the informed consent process must involve information about success rates by age-group. Much greater consistency and thoroughness in reporting would yield better and more generalizable data.

Financing future fertility: Women’s views on funding egg freezing

“…There is some debate amongst feminist scholars and bioethicists on the ethical issues raised by EF (Harwood, 2015), including whether EF enhances reproductive freedom or constitutes undue pressure and promotes pronatalist views (Petropanagos et al, 2015;Ravitsky and Lemoine, 2014). These issues, and the impact that funding EF may have on them, will be discussed in a forthcoming publication that explores the rising trend of employers offering financial support for their employees to access EF (Johnston et al, in press).…”

Initiating patient discussions about oocyte cryopreservation: Attitudes of obstetrics and gynaecology resident physicians

“…OC may be viewed by many as an elective procedure that falls outside the general scope of routine gynaecological care, and would only be discussed given unique patient circumstances. Physicians may also have other concerns related to OC given that more information is needed about long-term success rates, ethical implications, optimal timing for the procedure, and patient motivations for future use ( Hammarberg et al, 2017 , Harwood, 2015 ). Future studies that examine barriers to physician/patient discussion of OC are needed to understand the complexity of this issue more fully.…”

CRISPR-Cas and Its Wide-Ranging Applications: From Human Genome Editing to Environmental Implications, Technical Limitations, Hazards and Bioethical Issues

“…Fears that scientists may one day start “playing God” are not new after all: decades ago, in vitro fertilization (IVF) has been harshly criticized by many as “unnatural” or taking on prerogatives that do not belong to men [ 139 , 140 , 141 ]. IVF techniques are still morally and ethically controversial and often restricted, as are fertility preservation procedures capable of prolonging the time frame in which parenthood is achievable [ 142 , 143 , 144 , 145 ].…”