Dondorp W J, De Wert G M W R
Department of Health, Ethics & Society, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
Hum Reprod. 2009 Aug;24(8):1779-85. doi: 10.1093/humrep/dep102. Epub 2009 Apr 21.
There is currently much debate about cryopreservation of ovarian tissue or oocytes as a possible means of fertility preservation for women urgently needing potentially sterilizing medical treatment. Although both techniques are still experimental, some centres have started offering them also to healthy women who want to postpone childbearing until after they may have lost their natural reproductive capacity, or fear that they may not before that time find a partner with whom to raise a family. This article explores and discusses the ethical issues raised by this practice. 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. The fact that there is still uncertainty about these aspects is rightly seen as a reason for only offering cryopreservation of ovarian tissue or oocytes in an experimental setting. But does that also mean that these techniques should presently only be available for a medical reason, i.e. for women facing iatrogenic fertility loss? We argue against this conclusion.
目前,对于卵巢组织或卵母细胞的冷冻保存作为一种可能的生育力保存手段,存在诸多争议,这适用于急需可能导致绝育的医学治疗的女性。尽管这两种技术仍处于实验阶段,但一些中心已开始向健康女性提供这些技术,这些女性希望推迟生育,直到她们可能失去自然生殖能力之后,或者担心在此之前可能找不到与之组建家庭的伴侣。本文探讨并讨论了这种做法引发的伦理问题。我们认为,没有令人信服的先验道德理由表明卵巢组织或卵母细胞的冷冻保存不应该也提供给健康女性。然而,这是基于成熟技术的假设,包括对任何冷冻储备的有效和安全使用。这些方面仍存在不确定性这一事实,被恰当地视为仅在实验环境中提供卵巢组织或卵母细胞冷冻保存的一个理由。但这是否也意味着这些技术目前仅应出于医学原因提供,即仅适用于面临医源性生育能力丧失的女性呢?我们反对这一结论。