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因社会原因通过卵母细胞冷冻保存来推迟妊娠:关于临床实践以及所涉及的社会心理和生物伦理问题的考量

Postponing Pregnancy Through Oocyte Cryopreservation for Social Reasons: Considerations Regarding Clinical Practice and the Socio-Psychological and Bioethical Issues Involved.

作者信息

Simopoulou Mara, Sfakianoudis Konstantinos, Bakas Panagiotis, Giannelou Polina, Papapetrou Christina, Kalampokas Theodoros, Rapani Anna, Chatzaki Ekaterini, Lambropoulou Maria, Lourida Chrysoula, Deligeoroglou Efthymios, Pantos Konstantinos, Koutsilieris Michael

机构信息

Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece.

Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, Greece.

出版信息

Medicina (Kaunas). 2018 Oct 25;54(5):76. doi: 10.3390/medicina54050076.

Abstract

Oocyte freezing for 'social reasons' refers to women of reproductive age who are aiming to prolong, protect and secure their fertility. The term emerged to describe application of the highly promising technique, namely vitrification on oocytes retrieved through controlled ovarian stimulation (COS) from women intending to preserve their fertility for social reasons. These women opt to cryopreserve their oocytes at a point in their life when they need to postpone childbearing on the grounds of so called 'social' reasons. These reasons may include a highly driven career, absence of an adequate partner, financial instability, or personal reasons that make them feel unprepared for motherhood. This is a sensitive and multifaceted issue that entails medical, bioethical and socio-psychological components. The latest trend and the apparent increase noted on oocyte freezing for 'social reasons' has prompted our team of fertility specialists, embryologists, obstetricians, gynecologists and psychologists to proceed with a thorough, critical and all-inclusive comprehensive analysis. The wide range of findings of this analysis involve concerns of embryology and epigenetics that shape decisions made in the IVF laboratory, issues regarding obstetric and perinatal concerns on the pregnancy concluding from these oocytes and the respective delivery management and neonatal data, to the social and bioethical impact of this trend's application. This literature review refers to matters rising from the moment the 'idea' of this option is 'birthed' in a woman's thoughts, to proceeding and executing it clinically, up until the point of the pediatric follow up of the children born. We aim to shed light to the controversial issue of oocyte freezing, while objectively exhibit all aspects regarding this complex matter, as well as to respectfully approach how could the prospect of our future expectations be shaped from the impact of its application.

摘要

“社会原因”导致的卵母细胞冷冻是指育龄女性旨在延长、保护和确保自身生育能力。这个术语出现是为了描述一项极具前景的技术的应用,即对通过控制性卵巢刺激(COS)从有社会原因希望保留生育能力的女性体内获取的卵母细胞进行玻璃化冷冻。这些女性选择在人生中的某个时刻冷冻她们的卵母细胞,原因是所谓的“社会”因素使她们需要推迟生育。这些原因可能包括事业高度繁忙、没有合适的伴侣、经济不稳定,或者个人原因使她们觉得没有做好为人母的准备。这是一个敏感且多方面的问题,涉及医学、生物伦理和社会心理等多个层面。“社会原因”导致的卵母细胞冷冻的最新趋势及明显增加促使我们的生育专家、胚胎学家、产科医生、妇科医生和心理学家团队进行全面、批判性且涵盖所有方面的综合分析。该分析的广泛发现涉及影响体外受精实验室决策的胚胎学和表观遗传学问题、由这些卵母细胞受孕导致的产科和围产期问题以及相应的分娩管理和新生儿数据,还涉及这一趋势应用所带来的社会和生物伦理影响。这篇文献综述涉及从女性脑海中萌生这种选择的“想法”,到临床实施并执行,直至对所生孩子进行儿科随访这一过程中出现的各种问题。我们旨在阐明卵母细胞冷冻这一有争议的问题,客观展示这一复杂问题的所有方面,并以尊重的态度探讨其应用影响将如何塑造我们对未来期望的前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39b3/6262467/2bb12cd34499/medicina-54-00076-g001.jpg

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