非医学指征卵子冷冻伦理问题及对策探讨
昆明医科大学第一附属医院, 生殖遗传科, 云南昆明 650032
| 摘 要： | 中国的人口问题形势日渐严峻，现代女性因为职业、经济、情感等因素一再地推迟生育年龄，越来越多的女性想要寻求卵子冷冻保存以备将来不时之需，实现生育自由。卵子冷冻目前在中国的应用仅针对医学指征明确的女性：包括罹患肿瘤、自身免疫病以及遗传病等情况的患者，在接受损伤卵巢功能的治疗前可行卵子冷冻保存生育力；或者疾病本身进展会导致卵巢功能衰竭的女性也可以尽进行卵子冷冻等技术来生育力保存。除此之外还有大量不满足医学指征的卵子冷冻需求目前尚存在争议，在充分论证和解决非医学指征的卵子冷冻可能会带来的风险和问题。因此本文就针对非医学指征的卵子冷冻所涉及的伦理问题进行探讨，并提出切实可行的解决对策，为更好的应用卵子冷冻技术提供理论依据，将来更广大的女性有望在充分保障女性生育权的同时，避免可能面临的风险。 |
| 关 键 词： | 卵子冷冻; 非医学指征; 伦理; 对策 |
| DOI： | 10.57237/j.wjcm.2023.02.002 |
View:
Downloads:
收稿日期: 2022-09-28
接受日期: 2022-12-02
在线出版日期: 2023-04-25
Problems and Countermeasures on Ethics of Non-medical Indicated Oocyte Freezing
Department of Genetics and Reproduction, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| Abstract: | The threat of declining birth rate in China was becoming more and more serious. Modern women have delayed their childbearing age due to occupational, economic, emotional, and other factors. More and more women wanted to seek for freezing oocyte with the aims to preserve future emergencies situation and achieve reproductive freedom, which mainly included the populations, such as patients suffering from tumor, immune diseases, and genetic diseases and person who might get treatment with the damage to their fertility. At present, except the people who might suffer the damage to their fertility with medical indicator, oocyte freezing was not reliable for women with non-medical indications in China. Since there were still many problems especially ethical issues that have not been solved well, oocyte freezing for non-medical indications in China was only performed for patients with tumors and other diseases that needed to receive treatment, which could damage the function of ovarian, or the diseases would lead to the decrease of ovarian function. However, such strict standards for oocyte freezing have turned away the fertility preservation needs of a comparable group of women. But if there were no restrictions on the indication of oocyte freezing for non-medical indications, which could cause our society withstand the corresponding potential risks? Therefore, we fully discussed the ethical issues involving in oocyte freezing without medical indications in this article, and promoted its countermeasures. This would provide a theoretical reference for better protecting women's reproductive rights while avoiding corresponding risks in the future. |
| Keywords: | Oocyte Frozen; Non-medical Indication; Ethics; Countermeasures |
基金
| 1. | 上海市胚胎源性疾病重点实验室开放课题 (She2020006) |
| 2. | 云南省卫生健康委员会高层次医学学科带头人 (D-2017007) |
| 3. | 云南省高层次人才培养职称计划“名医专项” (RLMY20200017) |
| 4. | 国家自然科学基金项目 (82160281) |
参考文献
| [1] | 郝明睿, 孙一君, 马文豪, 等. 生育率不升反降原因探析——基于我国育龄青年生育意愿的实证研究 [J]. 经济学, 2020, 3 (3): 65-67. |
| [2] | Crawford N M, Steiner A Z. Age-related Infertility [J]. Obstetrics and Gynecology Clinics of North America, 2015, 42 (1): 15-25. |
| [3] | Marta D, Rosa T, Ignacio R, et al. Cumulative live birth rates and number of oocytes retrieved in women of advanced age. A single centre analysis including 4500 women ≥38 years old [J]. Human Reproduction, 2018, 33 (11): 2010-2017. |
| [4] | Beebeejaun Y, Athithan A, Copeland T P, et al. Risk of breast cancer in women treated with ovarian stimulation drugs for infertility: a systematic review and meta-analysis [J]. Fertility and Sterility, 2021, 116 (1): 198-207. |
| [5] | 郑敏, 龙雯晴. 辅助生殖技术中非多囊卵巢综合征患者发生卵巢过度刺激综合征的高危因素分析 [J]. 诊断学理论与实践, 2016, 0 (3): 287-290. |
| [6] | 高惠娟, 黄荷凤. 经阴道超声引导取卵术并发症的预防和处理 [J]. 中国实用妇科与产科杂志, 2006, 22 (12): 886-888. |
| [7] | 琚晓燕, 姜振华, 李燕平. 青年婚恋意愿调查:面对婚姻,年轻人在忧虑什么 [J]. 现代青年, 2021, (11): 60-62. |
| [8] | 新京报, 国外“冻卵”二三事 https://www.bjnews.com.cn/world /2020/01/02/ 669250.html |
| [9] | 辛颖. 冷冻卵子产业蠢蠢欲"冻" [J]. 法人, 2015, (9): 70-71. |
| [10] | 贺昕. 浅析冻卵背后的相关法律问题 [J]. 知识经济, 2015, (24): 29+31. |
| [11] | Inhorn M C. The Oocyte Freezing Revolution? Gender, Technology, and Fertility Preservation in the Twenty-First Century: An Interdisciplinary, Searchable, and Linkable Resource [M]. American Cancer Society, 2017. |
| [12] | Inhorn M C, Birenbaum-Carmeli D, Birger J, et al. Elective oocyte freezing and its underlying socio-demography: A binational analysis with global implications [J]. Reproductive Biology and Endocrinology, 2018, 16 (1): 70 (2018). |
| [13] | Inhorn M, Birenbaum-Carmeli D. Assisted Reproductive Technologies and Culture Change [J]. Social Science Electronic Publishing, 2008, (37): available at SSRN: https://ssrn.com/abstract=1141312. |
| [14] | 姚天冲, 范诗笛. 浅析高龄父母对孩子心理成长的影响[J]. 教育界: 高等教育, 2014 (1): 140-141. |
| [15] | 孙贇, 黄国宁, 孙海翔,等. 卵子捐赠与供/受卵相关问题的中国专家共识 [J]. 生殖医学杂志, 2018, 27, (10): 932-939. |
