BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.
The Ethics of Sperm Freezing for Teenage Boys
Author: Lisa Campo-Engelstein, PhD
BIOETHICS TODAY, October 23, 2014
A few weeks ago, I attended the annual Oncofertility Consortium conference where Dr. Angel Petropanagos and I presented our poster “Teen Boys and Fertility Preservation: An Ethical Analysis.” The vast majority of discussions about fertility preservation (FP), particularly FP for “social” (aka nonmedical) reasons, are focused on women in part because FP for women raises more ethical issues. For instance, egg freezing carries more health risks and is generally less effective than sperm freezing. Furthermore, whereas sperm freezing has been an established method of FP for decades, it was only two years ago that the American Society for Reproductive Medicine lifted the experimental label from egg freezing.
Yet, even established technologies can raise ethical concerns when used in vulnerable groups, such as children. Our research project examines the ethical issues FP raises when used by teenage boys. In order to undergo sperm freezing, males must produce a sperm sample and this is usually done through masturbation. However, discussions about masturbation can be embarrassing and difficult for adolescent males (as well as for healthcare providers), particularly if they have never masturbated or never masturbated and achieved an ejaculation. Some parents and healthcare providers place a high value on preserving patients’ future option of genetic reproduction, but FP discussions with teen males can be especially challenging due to the sensitive and private nature of sexuality and reproduction. In many cases, the embarrassment experienced by teens who consider FP can serve as a serious barrier to the effective delivery of FP information, can undermine informed decision-making, and can also be a deterrent from choosing FP technologies. There is considerable debate over the extent to which teenager’s dissent to FP should be respected, especially in light of the likelihood that they may eventually come to regret opting out of FP.