October 15, 2012 | Posted By Lisa Campo-Engelstein, PhD

I just returned from the annual Oncofertility Consortium Conference and one of the ethical topics that came up was the possibility of disputes over frozen reproductive materials. Before undergoing life-saving cancer treatment, people may opt to freeze gametes, gonadal tissue, or embryos in order to preserve their fertility. If these people die or separate from their partners, a battle over what to do with the frozen reproductive materials can ensue. The best and easiest way to deal with disputes over reproductive material is to try to prevent them before they happen. In this blog, I discuss two ways to prevent such disputes. 

One way is to have the individual with cancer write an advance directive that clearly outlines what should be done with the reproductive material should the patient die. If the reproductive materials are gametes or gonadal tissue, then ultimately the decision of what to do with the reproductive material should be made by individual with cancer, as it is her/his genetic material. If the reproductive materials are embryos, then the individuals who contributed the gametes to create the embryos should come to an agreement about how the embryos should be handled under unfortunate circumstances (e.g. death of the genetic parents or separation of the couple). Many infertility clinics require all patients—both individuals and couples—to complete a document outlining how to handle reproductive materials in unfortunate circumstances and I think this should be standard practice for oncofertility patients as well. 

Another way to prevent disputes over reproductive material is to suggest and perhaps even encourage individuals to freeze their gametes or gonadal tissue rather than creating and freezing embryos. Determining who should have control over reproductive material that contain just one person’s genes is much easier than reproductive material that is a mix of two people’s genes. For men, this proposal is easy. For women, however, it’s more complicated because freezing eggs, unlike freezing sperm, is considered experimental and has a lower success rate than freezing embryos. Some women, especially women in long-term committed relationships, opt for freezing embryos because they want the technology with the highest success rate and they are not concerned about potential disputes over frozen embryos. The dilemma of whether to freeze embryos or eggs (in some cases women freeze both) may soon be moot as new data shows that egg freezing technology is quickly improving and its success rates could rival those of embryo freezing in the not too distant future.

This blog was also published with the Oncofertility Consortium.

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.