Area of Science:

• Reproductive Medicine
• Oncology
• Bioethics

Background:

• Cancer treatments like chemotherapy and radiotherapy can cause premature ovarian failure, impacting fertility.
• Fertility preservation is a significant concern for childhood cancer patients, affecting future reproductive autonomy.
• Prepubescent girls have limited fertility preservation options, with ovarian tissue cryopreservation and transplantation being the primary method.

Purpose of the Study:

• To address the ethical complexities of fertility preservation in prepubescent girls undergoing cancer treatment.
• To evaluate the balance between the benefits and risks of ovarian tissue cryopreservation and transplantation.
• To propose an ethical framework for decision-making regarding fertility preservation for this vulnerable population.

Main Methods:

• Ethical analysis of fertility preservation procedures for prepubescent girls.
• Review of current medical literature on ovarian tissue cryopreservation and transplantation.
• Application of bioethical principles, including beneficence, non-maleficence, and the child's right to an open future.

Main Results:

• Ovarian tissue cryopreservation is the only current fertility preservation option for prepubescent girls.
• The procedure involves ethical concerns regarding its experimental nature, surgical risks, anesthesia, and potential reintroduction of malignant cells.
• A conflict exists between the principles of beneficence and non-maleficence in fertility preservation decisions.

Conclusions:

• The ethical challenges of fertility preservation for prepubescent girls necessitate a framework prioritizing the child's right to an open future.
• Beneficence should be interpreted through the lens of reproductive autonomy and the potential for future genetic parenthood.
• Balancing risks and benefits requires careful consideration of the child's long-term well-being and reproductive autonomy.