Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (9): 47-52.doi: 10.6040/j.issn.1671-7554.0.2022.0909

Previous Articles     Next Articles

Ethical issues and considerations in fertility preservation

HAO Guimin, LUO Zhuoye, WANG Yizhuo   

  1. Department of Reproductive Medicine, The Second Hospital of Hebei Medical University;
    Hebei Provincial Quality Management and Control Center for Human Assisted Reproductive Technology;
    Hebei Clinical Research Center for Birth Defects;
    Hebei Key Laboratory of Infertility and Genetics, Shijiazhuang 050000, Hebei, China
  • Published:2022-09-02

RichHTML

12

PDF (PC)

543

Abstract: As an emerging technology, fertility preservation technology has gradually developed from experimental to clinical application in recent years. On the one hand, it meets peoples growing demand for maintaining fertility. On the other hand, ethical issues inevitably arise when implementing this technology. On the basis of adherence to the ethical principles of respect, beneficence and justice in clinical practice, developing technology, optimizing the allocation of medical resources, improving policies, and strengthening ethical scrutiny may provide methods for solving ethical problems.

Key words: Fertility preservation, Ethics, Assisted reproductive technology

CLC Number: 

  • R711
[1] 中华人民共和国国家卫生健康委员会. 不孕不育防治健康教育核心信息[EB/OL].(2021-11-08)[2022-07-31]. http://www.nhc.gov.cn/fys/s3581/202111/64f7b7f7ecb84abe91d8cb07f1cadbf1.shtml.
[2] Cronin KA, LakeA J, Scott S, et al. Annual report to the nation on the status of cancer, part I: National Cancer Statistics[J]. Cancer, 2018, 124(13): 2785-2800.
[3] Johanna M, Laura M, Hirvonen E, et al. Use of fertility drugs in early-onset female cancer survivors—a finnish register-based study on 8, 929 survivors[J]. Int J Cancer, 2020, 146(3): 829-838.
[4] 176号文件. 人类辅助生殖技术与人类精子库相关技术规范基本标准和伦理原则[S]. 北京:中华人民共和国原卫生部,2003.
[5] Practice Committees of the American Society for Reproductive Medicine and Society of Reproductive Biologists and Technologists. A review of best practices of rapid-cooling vitrification for oocytes and embryos: a committee opinion[J]. Fertil Steril, 2021, 115(2): 305-310.
[6] Donnez J, Dolmans MM. Fertility preservation in women[J]. N Engl J Med, 2017, 377(17): 1657-1665.
[7] 陈振文. 辅助生殖技术规范化培训教材—辅助生殖男性技术[M]. 北京:人民卫生出版社, 2016.
[8] Macklon KT. Cryopreservation of ovarian tissue works, but challenges remain[J]. Fertil Steril, 2020, 114(2): 281-282.
[9] Fayomi AP, Peters K, Sukhwani M, et al. Autologous grafting of cryopreserved prepubertal rhesus testis produces sperm and offspring[J]. Science, 2019, 363(6433): 1314-1319.
[10] Martinez F, International Society for Fertility Preservation-ESHRE-ASRM Expert Working Group. Update on fertility preservation from the Barcelona International Society for Fertility Preservation-ESHRE-ASRM 2015 expert meeting: indications, results and future perspectives[J]. Fertil Steril, 2017, 108(3): 407-415.e11.
[11] ESHRE Guideline Group on Female Fertility Preservation, Anderson RA, Amant F, et al. ESHRE guideline: female fertility preservation[J]. Hum Reprod Open, 2020(4): hoaa052. doi: 10.1093/hropen/hoaa052.
[12] Oktay K, Harvey BE, Partridge AH, et al. Fertility preservation in patients with cancer: asco clinical practice guideline update[J]. J Clin Oncol, 2018, 36(19): 1994-2001.
[13] Santaballa A, Márquez-Vega C, Rodríguez-Lescure Á, et al. Multidisciplinary consensus on the criteria for fertility preservation in cancer patients[J]. Clin Transl Oncol, 2022, 24(2): 227-243.
[14] 14号文件. 人类辅助生殖技术管理办法[S]. 北京:中华人民共和国原卫生部,2001.
[15] 梁晓燕,方丛,李晶洁,等. 中国女性肿瘤患者生育力保护及保存专家共识[J].中国肿瘤临床, 2020, 47(5): 217-221.
[16] 中国妇幼保健协会生育力保存专业委员会. 女性生育力保存临床实践中国专家共识[J]. 中华生殖与避孕杂志, 2021, 41(5): 383-391.
[17] 中华医学会生殖医学分会. 生育力保存中国专家共识[J]. 生殖医学杂志, 2021, 30(9): 1129-1134. Chinese Society of Reproductive Medicine. Chinese expert consensus on fertility preservation[J]. Journal of Reproductive Medicine, 2021, 30(9): 1129-1134.
[18] 中国男性生育力保存专家共识编写组. 中国男性生育力保存专家共识[J]. 中华生殖与避孕杂志, 2021, 41(3): 191-198.
[19] 庞聪, 王国豫. 精准医疗背景下的知情同意:困境与反思[J]. 中国医学伦理学, 2021, 34(2): 137-142. PANG Cong, WANG Guoyu. Informed consent in the context of precision medicine: dilemma and reflection[J]. Chinese Medical Ethics, 2021, 34(2): 137-142.
[20] Childress J, 范瑞平, 王明旭, 等. 关于生命伦理学四原则的对话[J]. 中国医学伦理学, 2020, 33(11): 1295-1299. James Childress, FAN Ruiping, WANG Mingxu, et al. A dialogue on the four principles of bioethics[J]. Chinese Medical Ethics, 2020, 33(11): 1295-1299.
[21] 黎欣盈, 张念樵, 钟筱华, 等. 人类辅助生殖技术应用的伦理问题及工作实践[J]. 中国医学伦理学, 2021, 34(7): 856-860. LI Xinying, ZHANG Nianqiao, ZHONG Xiaohua, et al. Ethical issues and practices of the application of human assisted reproductive technology[J]. Chinese Medical Ethics, 2021, 34(7): 856-860.
[22] Ahuja KK, Simons EG, Rimington MR. et al. One hundred and three concurrent IVF successes for donors and recipients who shared eggs: ethical and practical benefits of egg sharing to society[J]. Reprod biomed online, 2000, 1(3): 101-105.
[23] 于修成. 辅助生殖的伦理与管理[M]. 北京: 人民卫生出版社, 2014.
[24] 杨芳,曹云霞. 选择性卵子冷冻若干伦理问题研究[J]. 中华生殖与避孕杂志, 2018, 38(8): 662-666.
[25] Waks AG, Partridge AH. Fertility preservation in patients with breast cancer: necessity, methods, and safety[J]. J Natl Compr Canc Netw, 2016, 14(3): 355-363.
[26] Jackson E. ‘Social’ egg freezing and the UKs statutory storage time limits[J]. J Med Ethics, 2016, 42(11): 738-741.
[27] 中华医学会生殖医学分会第四届委员会. 冷冻胚胎保存时限的中国专家共识[J]. 生殖医学杂志, 2018, 27(10): 925-931. The Fourth Session of the Committee of Chinese Society of Reproductive Medicine. CSRM committee opinions regarding the time limit of embryo cryopreservation[J]. Journal of Reproductive Medicine, 2018, 27(10): 925-931.
[28] “单身女性冻卵案”一审败诉:单身女性生育权该如何合理保护?[EB/OL].(2022-07-31)[2022-07-31]. https://www.cqcb.com/paian/2022-07-31/4974974_pc.html.
[29] Goold I, Savulescu J. In favour of freezing eggs for non-medical reasons[J]. Bioethics, 2009, 23(1): 47-58.
[30] Lauritzen P, Vicini A. Oncofertility and the boundaries of moral reflection[J]. Theological Studies, 2011, 72(45): 116-130.
[31] 刘鑫,解志勇,雎素利,等. 冻卵政策一旦放开将刺激代孕兴起[N]. 法治日报, 2021-01-29(004).
[32] Del-Pozo-Lérida S, Salvador C, Martínez-Soler F, et al. Preservation of fertility in patients with cancer[J]. Oncol Rep, 2019, 41(5): 2607-2614.
[33] 睢素利,张迪. 冷冻胚胎属性的界定和失主胚胎权利归属的探讨[J]. 中国计划生育学杂志, 2020, 28(10): 1514-1517. SUI Suli, ZHANG Di. Discussion on the definition of frozen embryo and the ownership of lost embryo[J]. Chinese Journal of Family Planning, 2020, 28(10): 1514-1517.
[34] 中华人民共和国全国人民代表大会. 中华人民共和国民法典[M]. 北京:人民出版社, 2020.
[35] 王金华. MDT诊疗及在妇科恶性肿瘤中的应用[J]. 中国肿瘤外科杂志, 2022, 14(3): 257-261. WANG Jinhua. Application of MDT in gynecological malignant tumors[J]. Chinese Journal of Surgical Oncology, 2022, 14(3): 257-261.
[36] 周宏伟. 推进分级诊疗制度优化医疗资源配置[J]. 中国机构改革与管理, 2021(7): 51-52.
[37] 马艺, 白符, 刘畅, 等. 推进卵子冷冻技术临床应用的若干思考[J]. 中华生殖与避孕杂志, 2017, 37(8): 667-670.
[38] 杨青青, 黎斐文, 曾彬, 等. 恶性肿瘤女性患者生育力保存的伦理思考[J].中国医学伦理学, 2022, 35(3): 277-281.
[1] LIN Yun, XIE Yanqiu. Fertility protection and preservation in breast cancer patients [J]. Journal of Shandong University (Health Sciences), 2022, 60(9): 42-46.
[2] WU Ruifang, LI Changzhong. Status and progress of female fertility protection [J]. Journal of Shandong University (Health Sciences), 2022, 60(9): 1-7.
[3] RUAN Xiangyan, CHENG Jiaojiao, DU Juan, GU Muqing. Ovarian tissue cryopreservation and preservation [J]. Journal of Shandong University (Health Sciences), 2022, 60(9): 24-30.
[4] SHI Yuhua, PAN Ye, XIE Yanqiu. Latest advances of embryo cryopreservation technology [J]. Journal of Shandong University (Health Sciences), 2022, 60(9): 12-18.
[5] LU Qun, ZHAO Lulu. Progress on assisted reproductive technology for women with atypical endometrial hyperplasia and endometrial carcinoma receiving fertilitysparing treatment [J]. Journal of Shandong University (Health Sciences), 2022, 60(9): 35-41.
[6] YAN Lei, YUE Caixin, LIU Yichun. Fertility preservation in patients with endometriosis [J]. Journal of Shandong University (Health Sciences), 2022, 60(9): 31-34.
[7] SHI Yuhua, WANG Qiumin, QI Dan. Frontier research hotspot and progress in assisted reproductive technology [J]. Journal of Shandong University (Health Sciences), 2021, 59(9): 97-102.
[8] ZHAO Bingqing, GAO Xuan, LI Jiangxia. A retrospective analysis of chromosome karyotypes in RSA couples from assisted reproductive population [J]. Journal of Shandong University (Health Sciences), 2021, 59(7): 26-31.
[9] ZHU Xuli, ZHOU Liang, WANG Yue, SUN Qingyun, CAO Mingya, DU Yuanjie, CAO Jinfeng, ZHAO Zhiming, HAO Guimin. Correlation analysis of freezing methods with different sperm sources and pregnancy outcomes [J]. Journal of Shandong University (Health Sciences), 2021, 59(6): 86-93.
[10] CAO Mingya, ZHAO Hanjie, FENG Tengfei, JIA Rui, ZHAO Zhiming, HAO Guimin. Effect of fetal reduction in early pregnancy on perinatal mothers and infants after embryo transfer [J]. Journal of Shandong University (Health Sciences), 2020, 58(11): 65-70.
[11] RUAN Xiangyan, CHENG Jiaojiao, DU Juan, LI Yanglu, JIN Fengyu, Alfred O. MUECK. Research progress of fertility preservation methods [J]. Journal of Shandong University (Health Sciences), 2019, 57(2): 29-34.
[12] TAN Jichun, DONG Meng, LI Pingping. Common ethical issues on assisted reproductive technology and their management [J]. Journal of Shandong University (Health Sciences), 2019, 57(10): 60-66.
[13] LI Xiaojuan, DUAN Haixia. Application and key points of hysteroscopic surgery in assisted reproductive technology [J]. Journal of Shandong University (Health Sciences), 2019, 57(10): 38-44.
[14] HUANG Wei, ZHU Huili. Prevention and treatment of ectopic pregnancy after assisted reproductive technology [J]. Journal of Shandong University (Health Sciences), 2019, 57(10): 27-32.
[15] ZHANG Yingchun. Safety of human assisted reproductive technology offspring [J]. Journal of Shandong University (Health Sciences), 2019, 57(10): 52-59.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] SUO Dongyang, SHEN Fei, GUO Hao, LIU Lichang, YANG Huimin, YANG Xiangdong. Expression and mechanism of Tim-3 in animal model of drug-induced acute kidney injury[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 1 -6 .
[2] MA Qingyuan, PU Peidong, HAN Fei, WANG Chao, ZHU Zhoujun, WANG Weishan, SHI Chenhui. Effect of miR-27b-3p regulating SMAD1 on osteosarcoma cell proliferation, migration and invasion[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 32 -37 .
[3] ZHANG Baowen, LEI Xiangli, LI Jinna, LUO Xiangjun, ZOU Rong. miR-21-5p targeted TIMP3 to inhibit proliferation and extracellular matrix accumulation of mesangial cells in Type II diabetic nephropathy mice[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 7 -14 .
[4] FU Jieqi, ZHANG Man, ZHANG Xiaolu, LI Hui, CHEN Hong. Molecular mechanism of Toll-like receptor 4 in the aggravation of blood lipid accumulation by inhibiting the peroxisome proliferator-activate receptor γ[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 24 -31 .
[5] XU Yuxiang, LIU Yudong, ZHANG Peng, DUAN Ruisheng. A retrospective analysis of risk factors of cerebral microbleeds in 101 patients with cerebral small vessel disease[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 67 -71 .
[6] DING Xiangyun, YU Qingmei, ZHANG Wenfang, ZHUANG Yuan, HAO Jing. Correlation of the expression of insulin-like growth factor II in granulosa cells and ovulation induction outcomes of 84 patients with polycystic ovary syndrome[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 60 -66 .
[7] LONG Tingting, XIE Ming, ZHOU Lu, ZHU Junde. Effect of Noggin protein on learning and memory abilities and the dentate gyrus structure after cerebral ischemia reperfusion injury in mice[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 15 -23 .
[8] LI Ning, LI Juan, XIE Yan, LI Peilong, WANG Yunshan, DU Lutao, WANG Chuanxin. Expression of LncRNA AL109955.1 in 80 cases of colorectal cancer and its effect on cell proliferation, migration and invasion[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 38 -46 .
[9] XIAO Juan, XIAO Qiang, CONG Wei, LI Ting, DING Shouluan, ZHANG Yuan, SHAO Chunchun, WU Mei, LIU Jianing, JIA Hongying. Comparison of diagnostic efficacy of two kinds of thyroid imagine reporting and data systems[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 53 -59 .
[10] GUO Zhihua, ZHAO Daqing, XING Yuan, WANG Wei, LIANG Leping, YANG Jing, ZHAO Qianqian. Single-stage end-to-end anastomosis in the management of severe cervical tracheal stenosis[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 72 -76 .
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd