Fertility preservation for non-medical reasons: controversial, but increasingly common.

von Wolff, Michael; Germeyer, Ariane; Nawroth, Frank (2015). Fertility preservation for non-medical reasons: controversial, but increasingly common. Deutsches Ärzteblatt international, 112(3), pp. 27-32. Deutscher Ärzte-Verlag 10.3238/arztebl.2015.0027

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BACKGROUND

Fertility-preserving measures for women are increasingly being performed for non-medical reasons in Germany. This is now a controversial matter.

METHODS

The authors searched the PubMed database for pertinent publications on the basis of their clinical and scientific experience and evaluated relevant data from the registry of the German FertiPROTEKT network (www.fertiprotekt. com). The various fertility-preserving measures that are available are described and critically discussed.

RESULTS

In most cases, the creation of a fertility reserve currently involves the cryopreservation of unfertilized oocytes, rather than of ovarian tissue. Most of the women who decide to undergo this procedure are over 35 years old. According to data from the FertiPROTEKT registry, most such procedures carried out in the years 2012 and 2013 involved a single stimulation cycle. The theoretical probability of childbirth per stimulation is 40% in women under age 35 and 30% in women aged 35 to 39. If the oocytes are kept for use at a later date, rather than at once, the maternal risk is higher, because the mother is older during pregnancy. The risk to the child may be higher as well because of the need for in vitro fertilization (IVF). Pregnancy over age 40 often leads to complications such as gestational diabetes and pre-eclampsia. IVF may be associated with a higher risk of epigenetic abnormalities. Ethicists have upheld women's reproductive freedom while pointing out that so-called social freezing merely postpones social problems, rather than solving them.

CONCLUSION

Fertility preservation for non-medical reasons should be critically discussed, and decisions should be made on a case-by-case basis.

Item Type:	Journal Article (Review Article)
Division/Institute:	04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology
UniBE Contributor:	von Wolff, Michael
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1866-0452
Publisher:	Deutscher Ärzte-Verlag
Language:	English
Submitter:	Monika Zehr
Date Deposited:	19 Feb 2016 11:03
Last Modified:	05 Dec 2022 14:52
Publisher DOI:	10.3238/arztebl.2015.0027
PubMed ID:	25657073
URI:	https://boris.unibe.ch/id/eprint/77668