1. Ethical Considerations in Pediatric Fertility Preservation
Michelle L. McGowan, PhD
Research Associate Professor
Ethics Center, Cincinnati Children’s
Departments of Pediatrics and Women’s, Gender & Sexuality Studies, University of Cincinnati

2. Ethical considerations regarding the practice of fertility preservation
Sociocultural and religious values regarding gametes, embryos, and assisted reproduction
Gendered moral dimensions of fertility preservation techniques
Degree to which decision about fertility preservation presumes a particular kind of future life after treatment
Values regarding impact of fertility preservation on future offspring
Whose values matter here?
These issues may be particularly salient for decision-makers considering fertility preservation for younger children who may not have articulated a particular vision of their future selves

3. Ethical issues in the practice of fertility preservation
Education and informed decision-making regarding
safety, efficacy, and short- and long-term health risks associated with fertility preservation procedures
costs of the procedure and later use (e.g. IUI, IVF), insurance coverage, storage fees, and “use by” dates
realistic success rates
ideal window and timing for fertility preservation
E.g.
Disposition of cryopreserved gametes if patient does not survive/posthumous reproduction

4. Ethical issues unique to pediatric fertility preservation
Degree to which pediatric patients are involved in decision-making
Consent
Assent
Best interests
Pubertal + gendered complexities of established treatments vs. experimental procedures
Pre-and post-pubertal considerations

5. Justice implications Fair distribution? Equality of opportunity?
Benefits and burdens
Scarce medical resources
Equality of opportunity?
Potential for exclusionary access along the lines of insurance coverage and socioeconomic status
From a reproductive justice perspective fertility preservation has the potential to promote stratified reproduction

6. Question for co-panelists
How can health care providers optimize pediatric patients’ and families’ understanding and informed decisions regarding fertility preservation?