Bioethics Institute Ghent, Blandijnberg 2, Gent, Belgium.
Reprod Biomed Online. 2011 Dec;23(7):824-9. doi: 10.1016/j.rbmo.2011.09.010. Epub 2011 Sep 29.
The possibility for healthy women to cryopreserve their oocytes in order to counter future infertility has gained momentum in recent years. However, women tend to cryopreserve oocytes at an age that is suboptimal from a clinical point of view--in their late thirties--when both oocyte quantity and quality have already considerably diminished and success rates for eventually establishing a pregnancy are thus limited. This also gives rise to ethical concerns, as the procedure is seen as giving false hope to (reproductively speaking) older women. This study evaluates which measures can be taken to turn social freezing into a procedure that is both clinically and ethically better than the current practice. The main objective of these measures is to convince those women who are most likely to (want to) reproduce at an above-average age to cryopreserve their oocytes at a time when this intervention is still likely to lead to a live birth and to discourage fertility clinics from specifically targeting women who have already surpassed the age at which good results can be expected. The possibility for healthy women to cryopreserve their oocytes in order to counter future infertility has gained momentum in recent years. However, women tend to cryopreserve oocytes at a time that is suboptimal from a clinical point of view - in their late thirties - when both oocyte quantity and quality have already considerably diminished and success rates for eventually establishing a pregnancy are thus limited. This also gives rise to ethical concerns, as the procedure is seen as giving false hope to (reproductively speaking) older women. We evaluate which measures can be taken to turn social freezing into a procedure that is both clinically and ethically better than the current practice and discern three different steps: creating public awareness; offering individualized, age-specific information and counselling; and offering predictive tests such as anti-Müllerian hormone measurements or antral follicle count. The main objective of these measures is to convince those women who are most likely to benefit from social freezing to present themselves before age 35 and to discourage fertility clinics from specifically targeting women who have already surpassed the age at which good results can be expected.
近年来，为了应对未来的不孕不育，健康女性冷冻保存卵子的可能性逐渐增加。然而，从临床角度来看，女性往往会选择在不太理想的年龄冷冻保存卵子，即 30 多岁时，此时卵子数量和质量已经大幅下降，最终怀孕的成功率也因此受到限制。这也引发了伦理问题，因为该程序被视为给（生殖意义上的）老年女性带来了虚假的希望。本研究旨在评估可以采取哪些措施将社会冷冻变成一种在临床和伦理上都优于现有实践的程序。这些措施的主要目的是说服那些最有可能在高于平均年龄生育的女性，在干预仍有可能导致活产的时期冷冻保存卵子，并劝阻生育诊所专门针对已经超过可能取得良好效果的年龄的女性。
