27 Jul

Elective fertility cryo-preservation instigates debate in the Netherlands


New technology has that unique property of creating fascinating moral debates, which is especially so when it relates to new technology regarding life, death, or in this case: fertility. For a few years, technology has been available for the cryo-preservation of oocytes or ovarian tissue, which is used to help save the fertility of women who run the risk of losing it, for instance due to chemotherapy. Now, the question is raised whether such techniques should be made available to healthy women as well.

The main reason for allowing healthy women to have access to such (medical) procedures, is that an increasing number of women are confronted with the biological (/natural?) limits to their fertility associated with their increasing age, but did not yet find the partner to have children with. If such women preserve oocytes, these can be stored till the data she finds a partner, with which she can decide to have children, possibly with the aid of (already commonly used) IVF techniques. The most important reason to provide such techniques to women, I believe, is that the quality of the oocytes in a woman’s ovarians often deteriorates years before her physical ability to bear children.

The Amsterdam Academic Medical Centre recently issues a statement stating that soon they will indeed start offering these techniques to women in their thirties, who strongly want to have children, but did not yet find the partner to have children with. Of course, this raised a debate, which seems to be discussed from three perspectives: the medical perspective (technique is not yet sufficiently tested), the religious view (do not tamper with nature), and what could be referred to as an emancipatory view, arguing that it should be the women who decide.

All very interesting, but I found the discussion to be a bit shallow: know ones’ background, and their position (in favor, or against) is immediately clear. For those interested in a more thorough discussion of the ethical aspects, I point out that a very interesting article by Dondorp and De Wert was published in ‘Human Reproduction’ (2009). In contrast with the limited discussion in the popular media (often with said binary opinions), they are able to evaluate the issue on a multitude of aspects, including (but not limited to):

  • Gender-equality in reproduction
  • Biological boundaries and the limits of medicine
  • The value of a child of one’s own
  • Risk for mother and child of a late pregnancy
  • The spectre of medicalization
  • The principle of ‘primum non nocere’

Alse, these authors evaluate the alternative of proactive IVF, and contemplate on the ‘conditions for offering cryopreservation of ovarian tissue or oocytes’ to healthy women. A few of the interesting statements I found in the article include that men already can cryopreserve their sperm for years, the fact that it already is accepted for many reasons to have medical procedures carried out other than to save a person’s health, arguing the predominance of the actual situation in which women find themselves over the fear for medicalization, and considering the conditions for using these new techniques.

All in all, the authors come to a balanced conclusion:

We argue that there are no convincing a priori moral reasons why cryopreservation of ovarian tissue or oocytes should not also be available for healthy women. However, this is on the assumption of established techniques, also in terms of the efficient and safe use of any frozen reserve.”

On a final note: I’m very interested in this debate, and relating issues. I expect to be writing a lot more about these issues in the not-so-distant future. I would very much welcome some input from my readers. So, what do you think about issues regarding technology, morality, and fertility?

Dondorp, W., & De Wert, G. (2009). Fertility preservation for healthy women: ethical aspects Human Reproduction, 24 (8), 1779-1785 DOI: 10.1093/humrep/dep102

3 comment on “Elective fertility cryo-preservation instigates debate in the Netherlands

  • First of all, do you know your way around the infertility blogosphere? If not, email me and I’ll send you a few pointers. It teems with women who had to wait to find the person they wanted to have children with, and now find it difficult to get pregnant.

    Also, I find it strange that the authors discussed the risk of a late pregnancy,but not the risk of not getting pregnant at all. For me, that would be the key issue. Even with beautifully preserved eggs, IVF is less likely to work the older you get.

  • Hi perceval,

    I agree with you on your second point, but I think the position of the authors is that the women for which this new technique is intended, already run the risk of not getting pregnant at all. Indeed, they constantly stress that women undergoing such procedures should be informed carefully. But, indeed, when such procedures are present, it may send the message to (other) women that it is OK to wait, some of whom will run into fertility problems later. So, not only the women who want to have this procedure should be informed, but actually the whole population (women and men) should be more informed about fertility.

  • Good Topic..and yes as Rense said , woman and man both should have knowledge about fertility and technologies..

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