C
URRENT
O
PINION
Ethics of medical and nonmedical oocyte
cryopreservation
Pasquale Patrizio
a
, Emanuela Molinari
a
, and Arthur Caplan
b
Purpose of review
To assess the effectiveness and ethical dimensions of oocyte cryopreservation for both medical and social
indications.
Recent findings
As more women are postponing motherhood for a variety of reasons, including lack of partner, for
completing career plans and reaching financial stability, they are resorting to oocyte cryopreservation. To
make informed choices, women rely on their primary care physicians (PCPs) for initial advice, but PCPs are
not always fully prepared to discuss oocyte cryopreservation. Interestingly, there are mixed feelings among
obstetricians/gynecologists on whether oocyte cryopreservation should be used for elective reasons,
whereas it is fully supported for medical indications.
Summary
Oocyte vitrification has become an established procedure for safeguarding future reproductive chances for
medical reasons, and its use is progressively expanding. There is an urgent need in preparing future PCPs
and obstetricians/gynecologists as to how to initiate discussions with their patients about elective oocyte
banking consistent with fully respecting patient autonomy so as to facilitate informed decisions.
Keywords
delayed motherhood, IVF, oocyte cryopreservation, reproductive ethics
INTRODUCTION
Over the past decade, fertility preservation
has become an important aspect of patient care
particularly in cases in which medical treatments
could irreversibly impair the ability of an individual
to reproduce. Prior to embarking on chemotherapy,
radiation and surgery, as chemotherapy in particu-
lar can result in sterility, fertility preservation
must be discussed. The ability to preserve eggs has
introduced a new dimension into medical practice,
raising awareness over the concept of ‘salvaging’
fertility as a component of care for women of
reproductive age and younger.
Women with other medical, noncancer
conditions, including benign ovarian tumors, auto-
immune disorders such as systemic lupus erythema-
tosus, carriers of BRCA mutations and patients
requesting body sex modification by removal of
their ovaries, are also using egg freezing as a method
to preserve their chance of a future biological child
(Table 1).
Of interest, a recent survey [1
&&
] assessing the
knowledge, attitudes and intentions toward fertility
awareness and oocyte cryopreservation among
obstetrics and gynecology (OB/GYN) resident
physicians revealed that they overestimated the
age at which female fertility markedly declines. This
finding is problematic as women prefer to get
their health information from their primary care
providers including gynecologists.
A major improvement in the method of cooling,
called vitrification, has allowed oocyte cryopreser-
vation procedure to become popular also among
women with nonmedical indications. For this
group, oocyte cryopreservation is seen as a potential
‘insurance policy’ against fertility decline due to
aging. The practice has been called ‘social freezing’
or ‘elective oocyte banking’ [1
&&
].
a
Yale University Fertility Center, Department of Obstetrics, Gynaecology
& Reproductive Sciences, Yale School of Medicine, New Haven,
Connecticut and
b
NYU Langone Medical Center, Division of Medical
Ethics, New York, New York, USA
Correspondence to Arthur Caplan, NYU Langone Medical Center,
Division of Medical Ethics, New York, New York, USA.
E-mail: Caplan@nyumc.org
Curr Opin Endocrinol Diabetes Obes 2016, 23:000–000
DOI:10.1097/MED.0000000000000292
1752-296X Copyright ß 2016 Wolters Kluwer Health, Inc. All rights reserved. www.co-endocrinology.com
REVIEW
Copyright © 2016 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.