Abstract
Cancer survivors may wish to become parents, if they have lost their reproductive function, by using previously stored gametes or gonadal tissue. Fertility preservation serves such a wide range of medico-social circumstances, some quite unique, that patient care requires an individualized and multidisciplinary approach. In particular, fertility specialists offering fertility preservation options to cancer patients should be properly trained and knowledgeable to discuss patient’s treatment plan, prognosis, as well as unusual health risks for future offspring and the potential harmful effects of pregnancy. Overall, there should be no ethical objections to offer these services since they are offered with the scope of preserving future fertility. However, in practice, there are objections: many options are still experimental; posthumous use of stored tissue or gametes carries some legal issues; concerns exist about the welfare of offspring resulting from an expected shortened life span of the parent; concerns exist about the welfare of children born using gametes frozen after chemotherapy already started; and reseeding of cancer is possible after transplanting cryopreserved tissue.
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References
Gosden RG. Fertility preservation-definition, history and prospect. Semin Reprod Med. 2009;27(6):433–7.
SEER Cancer Statistics Review, 1975–2000, National Cancer Institute, Bethesda, MD, (http://seer.cancer.gov)
Bromer JG, Patrizio P. Gynecologic management of fertility. In: Wingard JR, Gastineau D, Leather H, Snyder EL, Szczepiorkowski ZM, editors. Hematopoietic stem cell transplantation: a clinician’s handbook. Bethesda, MD: AABB Press; 2009.
Patrizio P, Butt S, Caplan A. Ovarian tissue preservation and future fertility: emerging technologies and ethical considerations. J Natl Cancer Inst Monogr. 2005;34:107–10.
Hirtz DG, Fitzsimmons LG. Regulatory and ethical issues in the conduct of clinical research involving children. Curr Opin Pediatr. 2002;14:669–75.
Grundy R, Larcher V, Gosden RG, Hewitt M, Leiper A, Spoudeas HA, et al. Fertility preservation for Âchildren treated for cancer (2): ethics of consent for gamete storage and experimentation. Arch Dis Child. 2001;84:360–2.
Grundy R, Larcher V, Gosden RG, Hewitt M, Leiper A, Spoudeas HA, et al. Fertility preservation for children treated for cancer (1): scientific advances and research dilemmas. Arch Dis Child. 2001;84:355–9.
Bahadur G. Ethics of testicular stem cells medicine. Hum Reprod. 2004;19:2702–10.
Chian RC, Huang JY, Tan SL, et al. Obstetric and perinatal outcome in 200 infants conceived from vitrified oocytes. Reprod Biomed Online. 2008;16:608–10.
Noyes N, Porcu E, Borini A. Over 900 oocyte cryopreservation babies born with no apparent increase in congenital anomalies. Reprod Biomed Online. 2009;18(6):769–76.
Sutcliffe AG, Dsouza SW, Cadman J, et al. Minor congenital anomalies, major congenital malformations and development in children conceived from cryopreserved embryos. Hum Reprod. 1995;10:3332–7.
Wennerholm UB, Soderstrom-Anttila V, Bergh C, Aittomaki K, Hazekamp J, Nygren KG, et al. Children born after cryopreservation of embryos or oocytes: a systematic review of outcome data. Hum Reprod. 2009;24(9):2158–72.
Donnez J, Dolmans MM, Demylle D, et al. Livebirth after orthotopic transplantation of cryopreserved Âovarian tissue. Lancet. 2004;364(9443):1405–10.
Meirow D, Levron J, Eldar-Geva T, et al. Pregnancy after transplantation of cryopreserved ovarian tissue in a patient with ovarian failure after chemotherapy. N Engl J Med. 2005;353(3):318–21.
Demeestere I, Simon P, Emiliani S, Delbaere A, Englert Y. Fertility preservation: successful transplantation of cryopreserved ovarian tissue in a young patient previously treated for Hodgkin’s disease. Oncologist. 2007;12(12):1437–42.
Andersen CY, Rosendahl M, Byskov AG, et al. Two successful pregnancies following autotransplantation of frozen/thawed ovarian tissue. Hum Reprod. 2008;23:2266–72.
Sanchez-Serrano M, Crespo J, Mirabet V, et al. Twins born after transplantation of ovarian cortical tissue and oocyte vitrification. Fertil Steril. 2010;93:268.e11–3.
Silber SJ, DeRosa M, Pineda J, Lenahan K, Grenia D, Gorman K, et al. A series of monozygotic twins discordant for ovarian failure: ovary transplantation (cortical versus microvascular) and cryopreservation. Hum Reprod. 2008;23:1531–7.
Ernst E, Bergholdt S, Jørgensen JS, Andersen CY. The first woman to give birth to two children following transplantation of frozen/thawed ovarian tissue. Hum Reprod. 2010;25:1280–1.
Roux C, Amiot C, Agnani G, Aubard Y, Rohrlich PS, Piver P. Live birth after ovarian tissue autograft in a patient with sickle cell disease treated by allogeneic bone marrow transplantation. Fertil Steril. 2010;93:2413.e15–9.
Silber SJ, Grudzinskas G, Gosden RG. Successful pregnancy after microsurgical transplantation of an intact ovary. N Engl J Med. 2008;359:2617–8.
Robertson JA. Procreative liberty, harm to offspring, and assisted reproduction. Am J Law Med. 2004;30:7–40.
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Patrizio, P. (2012). Ethical Discussions in Approaching Fertility Preservation. In: Seli, E., Agarwal, A. (eds) Fertility Preservation. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1783-6_2
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DOI: https://doi.org/10.1007/978-1-4419-1783-6_2
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