Department of Reproductive Medicine, Fertility Preservation, Hôpital Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France.
Department of Reproductive Medicine, Fertility Preservation, Hôpital Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; Department of Reproductive Medicine, Fertility Preservation, Hôpital Antoine-Béclère, 157, rue de la Porte de Trivaux, 92140 Clamart, France; Université Paris-Sud, Université Paris Saclay, 94276 Le Kremlin Bicêtre, France.
Ann Endocrinol (Paris). 2022 Jun;83(3):207-209. doi: 10.1016/j.ando.2022.04.011. Epub 2022 Apr 21.
As the concepts of society, parenthood and family evolve, the French law on bioethics has recently been updated by authorizing oocyte and sperm cryopreservation for all individuals who wish to do so, in the absence of medical indications. For women, aging irremediably impairs reproductive competence, both quantitatively and qualitatively. For men, aging has a negative impact on sperm parameters. Hence, this possibility of social oocyte/sperm freezing is a real breakthrough, offering to all the opportunity to better anticipate age-related fertility decline and be better actors of one's reproductive life. In its current form, the new French bioethics law allows unrestricted access to fertility preservation techniques to all women and men that fulfill the age criteria. In light of the lack of official recommendations, many questions remain. In clinical practice, it is therefore up to centers to determine on a case-by-case basis the limits of these procedures, notably to define when to stop fertility preservation. This also questions the place of the patient as a decision maker in the procedure and to which extent these procedures should be performed according to patient preference. Altogether, despite the wide range of possibilities enabled by these major legal and technical advances, it is essential to make clear to all that undergoing fertility preservation procedures is not a guarantee of future pregnancy and does not replace timely care of fertility issues.
随着社会、父母身份和家庭观念的演变,法国最近更新了生物伦理法,授权所有希望这样做的个人(无医学指征)进行卵母细胞和精子冷冻保存。对于女性而言,年龄的增长不可避免地会降低生殖能力,无论是在数量上还是质量上。对于男性而言,年龄的增长会对精子参数产生负面影响。因此,这种社会卵子/精子冷冻的可能性是一个真正的突破,为所有人提供了更好地预测与年龄相关的生育能力下降并更好地掌控生殖生活的机会。在目前的形式下,新的法国生物伦理法允许所有符合年龄标准的女性和男性无限制地使用生育力保存技术。鉴于缺乏官方建议,仍有许多问题悬而未决。因此,在临床实践中,各个中心需要根据具体情况确定这些程序的限制,特别是要确定何时停止生育力保存。这也质疑了患者作为决策制定者在程序中的地位,以及根据患者的意愿应在多大程度上进行这些程序。总而言之,尽管这些重大法律和技术进步带来了广泛的可能性,但必须向所有人明确指出,进行生育力保存程序并不能保证未来怀孕,也不能替代及时解决生育问题。