Assisted reproductive technology is a complex medical intervention with many potential social sensitivities. Within this domain, oocyte cryopreservation has emerged as an important research area for preserving female fertility. Against the backdrop of the hotly debated first legal case in China of a single woman wishing to freeze her eggs, and the implementation of the ‘three‐child policy’ in China, there is an urgent need to evaluate policies and address ethical considerations surrounding oocyte cryopreservation for non‐medical reasons. This review (...) examines current policies, explores China's practices and research, and examines the latest ethical challenges surrounding non‐medical oocyte cryopreservation. It develops strategies and recommendations that will be relevant in China and other developing countries seeking to navigate this complex landscape. (shrink)

Cryopreservation and vitrification are techniques employed in fertility clinics to preserve embryos not used in in vitro fertilization cycles. These frozen embryos carry the dignity of persons, and it has been suggested that they could be unfrozen and adopted. Experts have offered divergent opinions on the legitimacy of this practice. This essay reviews the debate and offers a phenomenological description of embryo adoption considered in itself, as well as reflections on current circumstances which the author proposes make embryo adoption (...) not only imprudent but illicit. (shrink)

In this article, I will be focusing specifically on cryopreservation and two of the American biotechnomedical tenets introduced by Robbie Davis-Floyd and Gloria St. John in their technocratic model of medicine: the “body as machine” and “death as defeat.” These axioms are embraced by both the biotechnomedical establishment as well as the cryopreservation communities when they discuss the future of humankind. In particular, I will be focusing on the political economy of cryopreservation as an embodiment of American (...) neoliberalism—as well as a Durkheimian death ritual—in the twenty-first century. Finally, I will theorize on a future populated by human beings from “the past” and the implications and consequences that may be caused by contemporary humans experiencing a temporal shift from traveling in deep time vis-à-vis cryopreservation. (shrink)

This paper explores the ethical implications of a possible future technology; namely cryonics of embryos/fetuses extracted from the uterus. We argue that more research should be conducted in order to explore the feasibility of such technology. We highlight the advantages that this option would offer; including the foreseeable prevention of a considerable number of abortions.

Many of the thousands of human embryos currently in cryogenic storage will sooner or later be discarded, often after being experimented upon. Others will remain in storage indefinitely, left there by parents who have no plans either to bring them to term or to offer them for adoption. These facts, coupled with a commitment to the basic moral equality of all human beings at all stages of development, generate a pressing question: What should be done for these embryos whose vital (...) activities have been suspended and whose futures look so bleak? This paper offers a case that allows some of these cryogenically stored embryos to thaw and die, allows disposal of their remains in a manner that reflects their status, and is morally acceptable in that it is consistent with the principles that many accept as governing the removal of life-sustaining treatment in end-of-life cases. (shrink)

Testicular tissue cryopreservation aims to preserve the future option of genetic reproduction for prepubescent cancer patients who are at risk of infertility as a result of their cancer therapies. This technology is experimental and currently only offered in the research context. As TTCP moves towards becoming more widely available, it is imperative that healthcare providers recognize the complex ethical issues surrounding this technology. This scoping review study identifies and assesses the range and depth of ethical concerns related to this (...) testicular tissue cryopreservation technology. At present, no such scoping review of ethical concerns exists in the TTCP literature. The forty-three full-text articles included in this study yielded twenty-two different ethical considerations discussed in relation to TTCP. It was observed that these ethical considerations fit within a mainstream Principlism approach to bioethics. Accordingly, there are ethical gaps in the TTCP literature that can be identified with alternative moral lenses. In particular, it was found that ethical concerns related to context and relational aspects of identity were absent in nearly all ethical examinations of TTCP. Furthermore, only 9 per cent of articles reviewed in this study focused primarily on the ethics of TTCP, thus demonstrating a need for further in depth ethical analyses of this technology. The results of this study are important for supporting the ethical provision of TTCP and can contribute to policy and guideline development. The findings of this study demonstrate the need for greater depth and diversity in analyses of ethical considerations related to this technology. (shrink)

Freezing Fertility: Oocyte Cryopreservation and the Gender Politics of Aging is the fourth path-breaking monography in the flourishing literature on egg freezing in just a few years. In April 2019, The Oocyte Economy: The Changing Meaning of Human Eggs by the renowned Australian social scientist Catherine Waldby, was published, the first book to examine the emergence of a global market for eggs through biomedical innovation. In September 2019, sociologist Kylie Baldwin of De Montfort University published Egg Freezing, Fertility and (...) Reproductive Choice: Negotiating Responsibility, Hope and Modern Motherhood, in which she explores the experiences of some pioneering women who are having eggs frozen in the United... (shrink)

Under current UK law, an embryo cannot be transferred to a woman's uterus without the consent of both of its genetic parents, that is both of the people from whose gametes the embryo was created. This consent can be withdrawn at any time before the embryo transfer procedure. Withdrawal of consent by one genetic parent can result in the other genetic parent losing the opportunity to have their own genetic children. We argue that offering couples only one type of consent (...) agreement, as happens at present, is too restrictive. An alternative form of agreement, in which one genetic parent agrees to forego the right to future withdrawal of consent, should be available alongside the current form of agreement. Giving couples such a choice will better enable them to store embryos under a consent agreement that is appropriate for their circumstances. Allowing such a choice, with robust procedures in place to ensure the validity of consent, is the best way to respect patient autonomy. (shrink)

Researchers are developing a fertility preservation technique?testicular tissue cryopreservation (TTCP)?for prepubescent boys who may become infertile as a result of their cancer treatment. Although this technique is still in development, some researchers are calling for its widespread use. They argue that if boys do not bank their tissue now, they will be unable to benefit from any therapies that might be developed in the future. There are, however, risks involved with increasing access to an investigational procedure. This article examines (...) four methods of expanding access to TTCP: (1) expansion of institutional review board (IRB)-approved research trials; (2) offering TTCP as an innovative procedure in hospitals; (3) offering TTCP as a standard practice in hospitals; and (4) commercialization of TTCP. The ethical and practical implications of each are evaluated through a comparison with umbilical cord blood banking (UCBB), a technology that has achieved widespread use based on similar claims of future benefit. (shrink)

The American Journal of Bioethics, Volume 12, Issue 6, Page 46-47, June 2012.

This research examines the practice of cryonics and provides empirical evidence for an improved understanding of the motivations and attitudes of participants. Cryonics is the freezing of a person who has died of a disease in hopes of restoring life at some future time when a cure may be available. So far, about 300 people have been cryopreserved, and an additional 1200 have enrolled in such programs. The current work has three vectors. First, the results of a worldwide cryonics survey (...) carried out as part of this research are discussed. Second, a theoretical model is developed from the survey results to propose a Theory of Cryonic Life Extension which explains an individual’s decision to select cryopreservation. Third, the most distinctive survey result, a conceptualization of personal identity malleability, is extended with a philosophical formulation. Personal identity is found to be emergent, not fundamental, and thus may continue to evolve in concept and application, particularly in the longer time frames implicated by cryonics. The potential consequences of this work are that the conceptual norms materializing in the cryonics community could be forerunners of wider societal trends of how humans understand themselves as subjects in an era increasingly configured by science and technology. (shrink)

In the USA, one child in 285 children is diagnosed with cancer every year, but thanks to improvements in medicine, the survival rate has reached 80%. However, cancer treatments, such as chemotherapy and radiation, are likely to affect their fertility later in life, limiting their ability to conceive. To reduce this risk, ovarian tissue cryopreservation is a surgical procedure that allows the ovarian tissue to be retrieved and cryopreserved in order to be reimplanted back into the abdomen and restore (...) ovarian function in children who become infertile due to gonadotoxic treatments. A case study published in 2014 offered recommendations to help assess whether such a procedure should be offered to female patients who have not yet entered puberty. This paper will investigate whether, in light of more recent and updated literature, their recommendations may need to be revised. (shrink)

Those who oppose human embryonic stem cell research argue for a clear position on the metaphysical and moral status of human embryos. This position does not differ whether the embryo is present inside its mother’s reproductive tract or in a cryopreservation tank. It is worth examining, however, whether an embryo in “suspended animation” has the same status as one actively developing in utero. I will explore this question from the perspective of Thomas Aquinas’s metaphysical account of human nature. I (...) conclude that a cryopreserved human embryo counts, both metaphysically and morally, as a person; and thus the utilization of such embryos for inherently destructive research purposes is impermissible. (shrink)

As is the case around the globe, South African fertility clinics face an ever‐expanding problem: what to do with the growing number of surplus cryopreserved embryos. Fertility clinics remain hesitant to destroy these abandoned embryos, partly because of concerns about the legal ramifications. This article clarifies the legal position in South Africa and offers practical recommendations to assist fertility clinics in managing abandoned embryos. In sum, fertility clinics cannot deem embryos as abandoned and discard them if fertility patients fail to (...) respond to a notice that the embryo storage agreement is about to expire. However, if there is non‐payment for embryo storage by fertility patients and the fertility clinic has informed the fertility patients of other options available to them with respect to their embryos, and there is still no response, the fertility clinic is legally entitled – and legally obliged – to discard the embryos. (shrink)

The field of assisted reproduction is advancing rapidly and is ripe for regulation and guidance. In 2018, over four thousand frozen eggs and embryos were lost to approximately one thousand patients at Ahuja University Hospital in Cleveland, Ohio, due to an accidental thaw of a cryopreservation tank. The precedent that will be set by the Ahuja class‐action case is significant for both past events and future possibilities and is core to the discussion of policy involving the cryopreservation of (...) gametes and embryos. (shrink)

Elective egg freezing for fertility preservation - commonly referred to as social egg freezing or non-medical egg freezing, will be permitted in Singapore from 2023. There...

While cancer rates continue to increase, therapy has dramatically decreased the mortality rates. The increased efficacy of current therapies may unfortunately have profound toxic effects on gamete function in both adolescent and reproductive age groups, with infertility as an expected consequence of cancer therapy. Significant progress in the advancement of fertility preservation therapies provides realistic options for future fertility in cancer survivors. However, a number of challenging issues need to be considered when presenting fertility preservation options. This overview highlights some (...) of these considerations including religious-cultural-ethical values, access to care and cost of services, developmental capacity and consent, and posthumous reproduction. (shrink)

Cancer rates in men and women of reproductive age have continued to increase in recent years; however, therapy has dramatically decreased the mortality rates. Since 1990, the prevalence of cancer survivors in young adults increased from 1 in 1,000 to 1 in 250 patients due to more aggressive therapies. Current therapies may have profound toxic effects on gamete function with infertility as an expected consequence of cancer therapy. Depending on the site and stage of cancer, age of the patient, and (...) the type of treatment, approximately 90% of men and women diagnosed with cancer may be at risk of permanent infertility.Fertility preservation has emerged as a discipline dedicated to improving the future reproductive potential of cancer survivors. Significant progress in the advancement of fertility preservation therapies and a heightened awareness of the availability of therapies has occurred in the past 10 years. The American Society of Clinical Oncology and the American Society of Reproductive Medicine have advanced these efforts by formally recognizing the importance of fertility awareness. (shrink)

This essay has two purposes. The first is to argue that our moral duties towards human embryos should be assessed in light of the Golden Rule by asking the normative question, “how would I want to be treated if I were an embryo?” Some reject the proposition “I was an embryo” on the basis that embryos should not be recognized as persons. This essay replies to five common arguments denying the personhood of human embryos: (1) that early human embryos lack (...) ontological individuation; (2) that they are members of the species Homo sapiens but not yet human persons; (3) that the argument for personhood commits the “heap argument” fallacy; (4) that since human procreation in nature is inefficient, human embryos cannot be persons; and (5) the “burning building” scenario proves that all arguments for personhood are irrational or inconsistent. The second purpose is to set forth and criticize in light of the normative judgement defended in part one the present legal situation of cryo-preserved embryos in the U.S. The essay ends by proposing legislative reforms to protect ex utero human embryos. (shrink)

The American Journal of Bioethics, Volume 12, Issue 6, Page 50-52, June 2012.

Cryopreservation presents the possibility of circumventing irreversible death through the body’s extreme cooling. Once cooled, this ‘cryon’ is then stored at sub-zero temperatures until medical kno...

Advances in assisted reproductive technologies can give rise to several ethical challenges. One of these challenges occurs when the reproductive desires of two individuals become incompatible and conflict. To address such conflicts, it is important to unbundle different aspects of (non)parenthood and to recognize the corresponding reproductive rights. This article starts on the premise that the six reproductive rights—the right (not) to be a gestational, genetic, and social parent—are negative rights that do not entail a right to assistance. Since terminating (...) or continuing a pregnancy is a form of assistance, the right (not) to be a gestational parent should enjoy primacy in conflicts. However, while refusing assistance may hinder the reproductive project of another person, “prior assistance” does not entitle someone to violate a reproductive right. Therefore, our analysis provides reasons to argue that someone has a right to unilaterally use cryopreserved embryos or continue the development of an entity in an extracorporeal gestative environment (i.e., ectogestation). Although this could lead to a violation of the right not to be a genetic parent, it does not necessarily entail a violation of the right not to be a social parent. (shrink)

This article explores the impact of Dobbs on access to assisted reproductive technologies. Clinical aspects of IVF, including embryo discard and cryopreservation, preimplantation genetic testing, and selective reduction of multiple pregnancy are potentially jeopardized by a new legal landscape that protects embryos over the interest of infertility patients.

The article focuses on the ability of some animals and plants to respond to changing environmental conditions by temporarily suspending metabolic processes. In contemporary biology, this state between life and death is commonly labelled ‘cryptobiosis’, combining the Greek kryptos (hidden, concealed, secret) with biōsis (mode of life). I argue that the notion of ‘cryptobiosis’ does not account sufficiently for the processual and relational dimensions of ametabolic life. The article advances a related but different concept, which better addresses this liminal state (...) of biological organisation: s uspended life. While cryptobiosis still nurtures the imaginary of some latent life, suspended life stresses the liminality of the neither-nor life and death. The notion also grasps the dynamic and ongoing transfer between the biological and the technological. While the debate on cryptobiosis has so far remained confined to the description of natural processes, suspended life (or limbiosis) promises to account for contemporary technological practices of cryopreservation. (shrink)

The North American wood frog, Rana sylvatica, endures seasonal whole‐body freezing during the winter and thawing during the spring without sustaining any apparent damage from ice or oxidative stress. Strategies from these frogs may solve the shortage of human donor organs, which is a multidisciplinary problem that can be alleviated by eliminating geographical boundaries. Rana sylvatica deploys an array of molecular and physiological responses, such as glucose production and microRNA regulation, to help it survive the cold. These strategies have been (...) adapted in the lab to impart cryotolerance in liver cells, and the non‐freezing supercooled storage of transplantable rat livers − milestones that have advanced the field toward cryopreserving human donor organs in the clinic. In this review, a case is presented for the use of non‐coding RNAs to decrease oxidative damage of donor organs by activating endogenous antioxidant systems prior to procurement. (shrink)

In a landmark Fatwa, Saudi Arabia’s highest religious authority—The Council of Senior Scholars—declared the Islamic permissibility of oocyte cryopreservation. The fatwa sanctioned the retrieval, preservation, and future use of oocytes, ovarian tissue, and whole ovaries from cancer patients receiving gonadotoxic interventions. Although momentous, the fatwa’s specification of cancer patients effectively rendered this technology unavailable to others to whom it may be similarly beneficial, including patients with other medical conditions or patients seeking elective cryopreservation. This article argues in favor (...) of widening reproductive choices through expanded access to oocyte cryopreservation in Saudi Arabia—regardless of the underlying cause of infertility—on three grounds: the technology’s compliance with Islamic law, as a matter of fairness in medical practice, and as a means to support the well-being and flourishing of Saudi women within the context of a national societal and economic transformation strategy closely linked to their success. (shrink)

Oocyte cryopreservation, or ‘egg freezing,’ is the practice of preserving unfertilised oocytes for later fertilisation. This practice allows women to extend their reproductive years. In 2014, Facebook and Apple announced that they would subsidise their female employees’ elective — or ‘social’ — use of egg freezing so that these women can more easily reconcile the demands of career and family life. This announcement engendered controversy and moral debate. Given that social egg freezing is becoming more popular, ethical and empirical (...) analyses are warranted. Here, I utilise content analysis to examine media messages in advertising for SEF. I conclude that many fertility clinics engage in biased advertising — i.e. they advertise the service persuasively, not informatively, emphasising indirect benefits while minimising risks and the low chance of successfully bringing a child to term. As advertising for medical services has been shown to influence the use of those services, advertising for SEF should emphasise clear and easily interpretable statistics about success rate, usage rate, cost, and risk. (shrink)

Cryopreservation of human embryos remains, in many jurisdictions, a critical component of the use of the technology of in vitro fertilisation in assisted reproduction. However, although the reasons for the freezing of reproductive material—such as cost effectiveness and reducing risks of IVF—are a constant across jurisdictions, the desirable length of storage remains subject to ongoing regulatory debate. Internationally embryo storage limits are variable. This article features data from a recent Australian research project which explores individual attitudes, desires and understandings (...) of law of IVF patients who had or who have embryos in storage. This article uses interviews from the study to argue that storage limits, like any apparently neutral regulatory tool, apply unequally causing unintended physical, mental and emotional harm—particularly to women. This analysis of storage limits exposes the interaction of time, science and law to create, apply and enforce norms and practices of ‘natural’ embryo storage, suggesting that the imposition of inflexible legislative restrictions upon embryo storage are socially contingent and value laden rather than ‘natural’ or ‘scientific’. This outcome has relevance to wider debates over assisted reproduction policies, suggesting that legal frameworks should adopt more flexibility in application to the patients who use this technology. (shrink)

Background: In 2014, companies began covering the costs of egg freezing for their employees. The adoption of this benefit was highly contentious. Some argued that it offered women more reproductive...

Cryonics—also known as cryopreservation or cryosuspension—is the preservation of legally dead individuals at ultra-low temperatures. Those who undergo this procedure hope that future technology will not only succeed in reviving them, but also cure them of the condition that led to their demise. In this sense, some hope that cryopreservation will allow people to continue living indefinitely. This book discusses the moral concerns of cryonics, both as a medical procedure and as an intermediate step toward life extension. In (...) particular, Minerva analyses the moral issues surrounding cryonics-related techniques by focusing on how they might impact the individuals who undergo cryosuspension, as well as society at large. (shrink)

Radical feminists have argued for both the radical potential of assisted reproductive technology (ART) and its oppressive and damaging effects for women. This paper will address the question of what constitutes a radical feminist position on ART; I will argue that the very debate over whether ART liberates or oppresses women is misguided, and that instead the issue should be understood dialectically. Reproductive technologies are neither inherently liberating nor entirely oppressive: we can only understand the potential and effects by considering (...) how they are actually taken up within a culture. The internal contradictions, tensions, and inconsistencies within ART and the way it is addressed within the law points to a dialectic that resists a simple reductivist understanding. (shrink)

Objective: To determine cryopreservation-induced alterations in the cytoskeleton of metaphase II mouse oocytes and the implications of these alterations in functionality of the cytoskeleton and polyploidy after fertilization.Design: Comparative study.Setting: Clinical and academic research environment at a medical school teaching hospital.Intervention : Oocytes were frozen using a slow-cooling and slow-thawing protocol in 1.5 M dimethyl sulfoxide and 0.2 M sucrose and were analyzed before and after fertilization.Main Outcome Measure : Cytoskeletal alterations, fertilization, and polyploidy rates.Result : When analyzed immediately (...) after thawing, the oocytes displayed dramatic cytoskeletal alterations. Only slight recovery was observed upon removal of the cryoprotectants. However, incubation after thawing of 1 hour at 37oC completely reestablished a normal microfilament and microtubule pattern while partially restoring normal spindle morphology and chromosome alignment. Accordingly, insemination immediately after removal of cryoprotectants resulted in a significantly decreased fertilization rate and aberrant dynamics of cytoskeleton-dependent events, whereas oocytes inseminated after the post-thaw incubation displayed fertilization rates and cytoskeletal dynamics comparable to those in controls. Cryopreservation did not increase polyspermy but significantly increased digyny when the oocytes were inseminated after the post-thaw incubation. All digynic eggs displayed an abnormal spindle remnant in comparison with diploid or polyspermic eggs.Conclusion : A brief period of incubation after thawing allows recovery and positively affects fertilization and cytoskeletal dynamics. Cryopreservation does not impair the functionality of microfilaments and cytoplasmic microtubules during postfertilization events. Our findings suggest that the increased rate of digyny in cryopreserved oocytes may be related to the spindle disorganization, leading to failure in segregation of the chromosomes, rather than to direct malfunction of the microfilaments in polar body formation. (shrink)

I am happy to comment on T S Petersen’s1 examination of the ‘individualization argument against non-medical egg freezing ’. Petersen intervenes in the ethical discussion on egg freezing by critically reconsidering a specific type of argument against oocyte cryopreservation for reasons that are not directly related with medical issues. Petersen dissects the claim that such non-medical usage is ‘an individualistic and morally problematic solution to the social problems that women face, for instance, in the labour market’.1 Proponents of this (...) argument believe that egg freezing should not be used by women on an individual level to solve social problems but that one should instead address gendered inequalities on the labour market. Petersen asserts that this individualisation argument is unconvincing—although morally appealing—because of empirically and ethically flawed assumptions. I am enthusiastic—with some minor reservations—about his unravelment of the individualisation argument and his call for more empirical backing. As I understand his presentation, the argument that is the subject of Petersen’s analysis is a recurring argumentative trope in the broader realm of assisted reproduction ethics. For instance, the anticipated positive effect of artificial womb technology in terms of liberation from reproductive and related social inequalities is one of the most dominant ectogenesis …. (shrink)

This article is a response to McLeod and Baylis (2007) who speculate on the dangers of requesting fresh ‘spare’ embryos from IVF patients for human embryonic stem cell (hESC) research, particularly when those embryos are good enough to be transferred back to the woman. They argue that these embryos should be frozen instead. We explore what is meant by ‘spare’ embryos. We then provide empirical evidence, from a study of embryo donation and of embryo donors' views, to substantiate some of (...) their speculations about the problems associated with requesting fresh embryos. However, we also question whether such problems are resolved by embryo freezing, since further empirical evidence suggests that this raises other social and ethical problems for patients. There is little evidence that the request for embryos for research, in itself, causes patients distress. We suggest, however, that no requests for fresh embryos should be made in the first cycle of IVF treatment. Deferring the request to a later cycle ensures that potential donors are better informed (by experience and reflection) about the possible destinations of their embryos and about the definition of ‘spare embryos’. Both this article, and that by McLeod and Baylis, emphasize the need to consider the views and experiences of embryo donors when evaluating the ethics of embryo donation for hESC research. (shrink)

Opponents of abortion are often described as ‘inconsistent’ (hypocrites) in terms of their beliefs, actions and/or priorities. They are alleged to do too little to combat spontaneous abortion, they should be adopting cryopreserved embryos with greater frequency and so on. These types of arguments—which we call ‘inconsistency arguments’—conform to a common pattern. Each specifies what consistent opponents of abortion would do (or believe), asserts that they fail to act (or believe) accordingly and concludes that they are inconsistent. Here, we show (...) that inconsistency arguments fail en masse. In short, inconsistency arguments typically face four problems. First, they usually fail to account for diversity among opponents of abortion. Second, they rely on inferences about consistency based on isolated beliefs shared by some opponents of abortion (and these inferences often do not survive once we consider other beliefs opponents of abortion tend to hold). Third, inconsistency arguments usually ignore the diverse ways in which opponents of abortion might act on their beliefs. Fourth, inconsistency arguments criticise groups of people without threatening their beliefs (eg, that abortion is immoral). Setting these problems aside, even supposing inconsistency arguments are successful, they hardly matter. In fact, in the two best-case scenarios—where inconsistency arguments succeed—they either encourage millions of people to make the world a (much) worse place (from the critic’s perspective) or promote epistemically and morally irresponsible practices. We conclude that a more valuable discussion would be had by focusing on the arguments made by opponents of abortion rather than opponents themselves. (shrink)