Fertility preservation for children treated for cancer (2): ethics of consent for gamete storage and experimentation

• Published in: Archives of disease in childhood Vol. 84; no. 4; pp. 360 - 362
• Main Authors: Grundy, R, Larcher, V, Gosden, R G, Hewitt, M, Leiper, A, Spoudeas, H A, Walker, D, Wallace, W H B
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.04.2001; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adolescent; Bioethics; Biological and medical sciences; Biomedical Research; Birth control; Cancer; Cancer in children; Cancer therapies; Care and treatment; Chemotherapy; Child; Childhood cancer; Children & youth; Consent; Donors; Embryology; Ethical aspects; Ethics; Ethics, Medical; Evidence; Experiments; Families & family life; Female; Fertility; Fertility, Human; General and Specialist Paediatrics; Genitalia; Germ Cells; Gonads; Gynecology. Andrology. Obstetrics; Health aspects; Human fertility; Humans; Infertility; Informed Consent; Injuries; Male; Medical sciences; Medical Services; Neoplasms - therapy; Oocytes; Parent Responsibility; Patients; Physiological aspects; Preservation; Program Proposals; Reproductive organs; Reproductive technology; Research Proposals; Risk Assessment; Self Determination; Specimen Handling - standards; Spermatozoa; Sterility. Assisted procreation; Storage; Tissue Preservation; United Kingdom; Human; Ethics; Gamete; Cryopreservation; Fertility; Scientific research; Assisted procreation; Informed consent; Review; Malignant tumor; Child; Genetics and Reproduction; Human Fertilisation and Embryology Authority; Biomedical and Behavioral Research
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.84.4.360

Phase 1 Develop a consensus of treatment related risks of germ cell damage Develop a consensus of risks to the child associated with germ cell harvest Phase 2 Develop methods of prospective data collection aimed at registering germ cell tissues, collection methods, and conditions of storage Develop a register of patients at risk of subfertility Phase 3 Monitor success rates of the use of stored germ cell material and the fertility rates of all those registered Phase 4 Careful follow up of the offspring of children born following assisted reproduction Conclusion Although the primary objective of modern multimodality treatment of childhood cancer is cure, it is axiomatic that the quality and cost of such treatment should be fully considered with patients and/or their guardians. In offering the chance of preserving fertility to parents of young children, we are inevitably raising expectations. [...]clinicians bear a responsibility to counsel families cautiously with respect to success rates in the future, the potential for harm, and concerns over circumventing the natural barriers to selection.