There are several ethical issues surrounding oocycte cryopreservation. These issues vary based on whether there are medical indications for fertility preservation or for elective use in otherwise healthy women.
Oocyte Cryopreservation for Medical Indications
Medical indications for oocyte cryopreservation include but are not limited to women undergoing treatment for cancer and women at risk of premature menopause, including women with galactosemia or Turner’s syndrome. While embryo cryopreservation is typically preferred given demonstrates higher rates of successful pregnancy outcomes, some women may have ethical objections to embryo cryopreservation and others may lack a partner when faced with the need to make this decision (Bltyh et al. year?). Some of the ethical issues that arise when contemplating fertility preservation for these patients includes the right to procreate, the risks and benefits of delaying treatment for fertility-sparing procedures, and the well-being of future progeny and the disposition of unused gametes [REF]. Many groups consider reproductive rights to be a manifestation of patient autonomy or a human right [31, 32]. Furthermore, the potentially shortened lifespan in a patient with cancer is not sufficient reason to deny a patient the opportunity to reproduce, although there are potential risks to offspring including possible early loss of a parent, or potential risks of physical defects or cancer in the offspring themselves due to lingering treatment effects, mutations, or risk of the process of fertility preservation itself .
Informed consent for fertility preservation is another ethical issue that may arise in the treatment of children and adolescents with cancer. In the case of childhood disease, this generally involves parental consent or child assent when possible (HHS, 2004). Some have recommended a two stage consent process, one for the risks and benefits associated with gamete harvesting and a second to consent for potential fertilization at a later date should the need arise . Regarding oocyte disposition, it has been recommended that a person pursuing fertility preservation make explicit her desire for the disposition of her gametes in the event she does not live long enough to reproduce . Given the many considerations for fertility preservation in patients with cancer, the American Society of Clinical Oncology recommends discussions begin at the earliest appropriate time possible .
Elective Oocyte Cryopreservation in Healthy Women
The elective use of oocyte cryopreservation in healthy women that desire to delay childbearing for social reasons is more controversial. The major argument for offering elective oocyte cryopreservation include that this method allows a woman who has either not found a suitable partner, or is engaged in other career or life pursuits to delay childbearing until she is ready [REF]. A major argument against elective oocyte...