RHEA (Research Centre Gender, Diversity and Intersectionality), Vrije Universiteit Brussel, Brussels, Belgium.
Centre for Reproductive Medicine and Centre for Medical Genetics, UZ Brussel, Brussels, Belgium.
BMC Med Ethics. 2022 Mar 29;23(1):35. doi: 10.1186/s12910-022-00774-z.
During the last decade, the possibility for women to cryopreserve oocytes in anticipation of age-related fertility loss, also referred to as social egg freezing, has become an established practice at fertility clinics around the globe. In Europe, there is extensive variation in the costs for this procedure, with the common denominator that there are almost no funding arrangements or reimbursement policies. This is the first qualitative study that specifically explores viewpoints on the (lack of) reimbursement for women who had considered to uptake at least one social egg freezing cycle in Belgium.
To understand the moral considerations of these women, drawing from twenty-one interviews, this paper integrates elements of a symbiotic empirical ethics approach and thematic analysis.
We identify four themes: (1) being confronted with unclear information; (2) financial costs as ongoing concern; (3) necessity of coverage; (4) extent of reimbursement. In the first theme, we found that some women were concerned about the lack of clear information about the cost of social egg freezing. In the second theme, we report moral sentiments of injustice and discrimination which some women attributed to their struggles and needs not being recognised. The third theme illustrates diverse views on reimbursement, ranging from viewing social egg freezing as an elective treatment not appropriate for reimbursement to preferences for greater public responsibility and wider access. Finally, we describe the participants' varying proposals for partial reimbursement and the idea that it should not be made available for free.
This research adds important empirical insights to the bioethics debate on social egg freezing, in particular by presenting (potential) users' views on the lack of reimbursement. While there is much more to say about the ethical and political complexities of the reimbursement of this procedure, our study highlighted the voices of (potential) users and showed that at least some of them would welcome the coverage of SEF through the public healthcare insurance.
在过去的十年中，女性为了应对与年龄相关的生育能力下降而冷冻卵子的可能性，也称为社会卵子冷冻，已经成为全球生育诊所的一项既定实践。在欧洲，这项手术的费用差异很大，共同点是几乎没有任何资金安排或报销政策。这是第一项专门探讨比利时至少考虑过一次社会卵子冷冻周期的女性对该手术缺乏报销的观点的定性研究。
为了从 21 次访谈中理解这些女性的道德考虑因素，本文结合了共生实证伦理方法和主题分析的元素。
我们确定了四个主题：（1）面临不明确的信息；（2）持续关注财务成本；（3）报销的必要性；（4）报销的程度。在第一个主题中，我们发现一些女性对社会卵子冷冻费用缺乏明确信息感到担忧。在第二个主题中，我们报告了一些女性认为自己的困境和需求没有得到认可，从而产生了不公正和歧视的道德情绪。第三个主题说明了对报销的不同看法，从将社会卵子冷冻视为不适合报销的可选治疗方法，到偏好更大的公共责任和更广泛的获取途径。最后，我们描述了参与者对部分报销的不同建议，以及认为不应该免费提供该服务的想法。
这项研究为社会卵子冷冻的生物伦理学辩论增添了重要的实证见解，特别是通过展示（潜在）使用者对缺乏报销的看法。尽管关于该手术报销的伦理和政治复杂性还有很多需要讨论，但我们的研究突出了（潜在）使用者的声音，并表明至少其中一些人欢迎通过公共医疗保险覆盖 SEF。
