Ethical issues in fertility preservation for adolescent cancer survivors: oocyte and ovarian tissue cryopreservation.

摘要

Oocyte and ovarian tissue harvesting and implantation may one day restore fertility in adolescent cancer survivors. Discussion ensues regarding ways to respect patients and address ethical issues in future clinical trials. STUDY OBJECTIVE: To offer a normative analysis of ethical issues in oocyte and ovarian tissue cryopreservation and implantation for adolescent cancer survivors. DESIGN: Normative ethical analysis. RESULTS AND CONCLUSION: Oocyte and ovarian tissue harvesting and implantation hold promise in restoring fertility in adolescent cancer survivors; however, more research is required before adolescents can ethically be enrolled in clinical trials. As these methods advance, clinician investigators serve these patients best by (1). ensuring that the intervention does not harm the patient by delaying cancer treatment; (2). ensuring that no remnant cancer cells will be reintroduced in transplantation or fertilization; (3). preventing damaged cryopreserved oocytes from being fertilized and implanted; (4). seeking informed assent from adolescent patients and informed consent from their parents or guardians; (5). developing policies to protect the patient's future rights to her gametes; (6). developing policies addressing the disposition of gametes if the patient dies; and (7). respecting the patient by protecting her from harm while also honoring her right to self-determination.