Should Postponing Motherhood via “Social Freezing” Be Legally Banned? An Ethical Analysis
2. Arguments and Criticism
2.1. Arguments over Benefits and Risks
2.1.1. Risks of Egg Retrieval and Cryopreservation Techniques
2.1.2. Risks of a Late Pregnancy
2.1.3. Benefits of SF
Conflicts of Interest
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- 1This research was funded by VolkswagenStiftung, Germany, as part of the research group “Autonomy and Trust in Modern Medicine”.
- 2Several conditions such as cancer or autoimmune diseases require gonadotoxic therapy. Another reason for opting for SF can be the legal situation in the respective country, e.g., if embryo cryopreservation is prohibited by law as in Italy (e.g., by the Italian law on medically assisted reproduction (Law 40/2004)).
- 3In 2011, we conducted a questionnaire survey “On the ethical aspects of the cryopreservation of unfertilized oocytes” among fertility physicians. 51% of respondents were in favor of a legal regulation of “social freezing”. Of the 51% who spoke out in favor of legal regulation, a majority (55%) chose “maximum age at the time of implantation” as the matter to be regulated. This means that 28% of all of those we surveyed were in favor of an age limit for “social freezing”.
- 4Slow freezing is a freezing process in which cells are cooled at a rate of 1 °C/1.8 °F per minute. Vitrification requires a rapid reduction in temperature. During the process, fluid is withdrawn from the cell by cryoprotectants. The cell content and the remainder of the cell fluid go into a firm viscous aggregate state. This process requires larger amounts of cryoprotectants.
- 5Immature eggs can likewise be frozen and subsequently ripen in vitro. Research is currently being conducted on this method. To date, convincing results are yet to be achieved (e.g., ).
- 6Alterations of the cell relate to a vacuolization of the cytoplasm and a hardening of the zona pellucida (the surrounding membrane of the cytoplasm) .
- 7The effects should actually be dealt with under the topic of late parenthood. Since SF relates to women and the criticism is based on aspects of late motherhood, we concentrate on these points of criticism. Beyond this, however, there is need of a critical discussion from the perspective of gender.
- 8This point is important because it complicates the stipulation of a specific upper age limit. Another important aspect to be mentioned is that the differing age categories and age ranges within medical studies as well as the probably differing risks after natural conception, egg donation or SF make a clear analysis of the risks involved in late pregnancy difficult.
- 9PubMed search on 22 January 2014. Other search combinations ([advanced age], [postponed] AND [motherhood], [advanced age], [postponed] AND [fatherhood]) yielded similar proportions among the results, albeit at a very low number of articles (max. 7). MeSH terms on this topic could not be identified.
- 10Aneuploidy means that the number of chromosomes in a cell deviates from the usual distribution of chromosomes. Chromosomal aberration refers to a change in the structure of the chromosome due to mutated, missing, or extra DNA.
- 11Success rates of IVF depend mostly upon the age of the woman at the time of hormonal stimulation and/or egg retrieval. The quality of the egg decreases significantly with increasing age [68,69]. For 2012, the HFEA reports a live birth rate per IVF cycle (a transferred fresh embryo) between 41.5% for women aged 18–34 and 3.4% for women aged 45 and older (, p. 26).
- 12In the article cited, Angel Petropanagos analyzes whether there is a moral difference between disease-related egg freezing and age-related egg freezing (which we refer to here as SF). In her doctoral thesis, she gives a comprehensive moral analysis of SF. She concludes that an upper age limit for access to reproductive technologies is morally appropriate because women would otherwise be in danger of “ageist discrimination by inclusion”, meaning that women would feel under pressure to bear a child even later in life (, p. 143). The reasons for an upper age limit are possible harms to the woman, the resulting offspring, and others in society, especially other women (, p. 142). She also doubts that the decision of older women to opt for risky procedures of reproductive technologies is an autonomous choice of their own. She mentions internalized oppressive social norms, pronatalist and ageist values in particular, as the main reasons for this lack of autonomy (, pp. 146, 165).
© 2014 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/).
Bernstein, S.; Wiesemann, C. Should Postponing Motherhood via “Social Freezing” Be Legally Banned? An Ethical Analysis. Laws 2014, 3, 282-300. https://doi.org/10.3390/laws3020282
Bernstein S, Wiesemann C. Should Postponing Motherhood via “Social Freezing” Be Legally Banned? An Ethical Analysis. Laws. 2014; 3(2):282-300. https://doi.org/10.3390/laws3020282Chicago/Turabian Style
Bernstein, Stephanie, and Claudia Wiesemann. 2014. "Should Postponing Motherhood via “Social Freezing” Be Legally Banned? An Ethical Analysis" Laws 3, no. 2: 282-300. https://doi.org/10.3390/laws3020282