Ovarian tissue cryopreservation: promises and uncertainties.

摘要

Cancer in children and young adults is increasingly being cured by operations, radiotherapy and/or chemotherapy. However, one of the serious side effects of these treatments is the risk of damage to fertility. Whereas the most important goal used to be survival, now increasing attention is being paid to the quality of life in the long term, thanks to the success of these treatments. Infertility affects the quality of life. In post-pubescent boys and men semen can be frozen for later use prior to treatment that harms the spermatogenesis. In girls and young women the solution for reduced fertility or infertility after ovary damaging treatment, may consist of the cryopreservation of ovarian tissue prior to this treatment. At a later stage a decision can be made to transplant this ovarian tissue into the patient or to follow an IVF procedure. There are important normative questions regarding this experimental treatment. The main question is, whether it may be introduced in health care as a regular treatment or should be subject to medical research first. In the Netherlands, a working party of both doctors and ethical, legal and psychological experts recommended to carry out proper research before introducing ovarian tissue cryopreservation in regular health care. This article is meant to elucidate this policy and, including some relevant updates, thus to contribute to the discussion on this question in other European countries.