Bioethics Blogs

Oncofertility for Adolescents: Some ethical and gendered considerations

Last month I attended the Oncofertility Consortium conference and gave a talk titled “Ethical Considerations of Fertility Preservation in Adolescents.” The goals of this talk were to describe the common ethical considerations of fertility preservation (FP) for adolescent cancer patients and to explore the different medical and social considerations for adolescent females and males due to sex and gender.
Like any medical intervention for the adolescent population, there is the question of whether adolescents are able to assent or consent to FP. Should the decision to pursue FP rest in the hands of the adolescent or the adolescent’s parents/guardians? On the one hand, adolescents may choose to forgo FP because they do not understand the value of their fertility may have them later especially since, at their age, they are bombarded with messages about avoiding pregnancy. On the other hand, adolescents may feel pushed to undergo FP due to parental pressure (e.g. their parents/guardians want to be grandparents in the future).
In addition to the broader ethical considerations for FP for adolescents, there are also sex and gender specific considerations. Looking at sex differences in the reproductive systems, gamete retrieval in males is faster, easier, and safer than in females. Gamete retrieval in males carries far fewer physical risks than in females particularly if it is achieved through masturbation. Even for males who are not able to masturbate and instead use electroejaculation for gamete retrieval, there are still fewer physical risks than egg retrieval, which requires in vitro fertilization (IVF). Because IVF requires hormonal stimulation, the process of egg retrieval can take two to six weeks, which can delay cancer treatment.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.