The Ethics of Ovarian Tissue Transplantation: A Teleological Perspective

摘要

Many female patients present with malignant and non-malignant conditions whose treatment causes infertility. Women who are diagnosed with neoplastic diseases before or during their reproductive years and undergo ootoxic therapies, those who undergo an oophorectomy due to non-malignant disorders, those of reproductive age at risk for premature menopause associated with genetic disorders, and those who have undergone conditioning regimens for bone marrow transplantation may experience partial or total loss of their fertility. Fortunately, in recent decades, medical science has witnessed dramatic improvements in chemo- and radiotherapy for neoplastic diseases together with noteworthy advances in fertility preservation techniques. Such advances have allowed more and more women who survive malignant and non-malignant illnesses to focus on improving their post-treatment quality of life, including the restoration of their fertility and the possibility of childbearing. Ovarian tissue cryopreservation and transplantation, though still experimental, hold out real promise for these women. Here, I will conduct a teleological analysis of selected ethical issues from three clinical cases of women who experienced the reactivation of ovarian function and a live birth as a result of ovarian tissue transplantation (OTT). In case #1, a woman who experienced ovarian failure after cancer therapy for non-Hodgkins lymphoma subsequently conceived by means of IVF following a frozen-thawed ovarian autograft. In case #2, an infertile monozygotic twin conceived spontaneously as a result of a fresh ovarian graft from her fertile identical twin, and, in case #3, a woman who experienced ovarian failure after cancer therapy for stage IV Hodgkins lymphoma conceived spontaneously through autotransplantation of frozen-thawed ovarian tissue. Lastly, I will assess the ethics of case #4 in which a healthy woman has stored her ovarian tissue to prolong her reproductive life.