human errors
Ethical issues: egg freezing
As I’ve mentioned before, it’s rarely that the subject of medical ethics is far from the news. Just in the last couple of weeks we’ve had assisted dying, gender identity, abortion. But the one that jumped out at me was fertility treatment.
Last month patients at two clinics were told that their embryos might not be viable because a faulty solution was used. Now we learn that a major NHS fertility centre near London has been reported to the police and had their license suspended because of fears that embryos have been destroyed due to potential contamination of processes and equipment. Investigations by police and fertility regulators are underway; new security measures are in place, and affected patients have been contacted.
Given the high degree of control and regulation and safety checks, it’s hard to see how this could have happened on the scale alleged. Given the huge significance of what is being done in the creation of new lives, can there be any more serious breach?
Imagine … going through all the trauma of retrieving eggs, creating embryos, perhaps knowing this is your last ditch hope of ever being a parent, and then finding it has all been in vain. All hope has gone. Because of clinical or human error. And then finding the NHS staff are also accused of a cover up.
Aside from the actual news, there has also been airing of a fascinating BBC programme on the subject: Egg freezing and me.
As many as one in six women struggle with their fertility in the UK, and egg freezing is one of the fastest growing treatments. Nowadays patients are seeking the procedure for a whole variety of reasons: when they are not ready to become mothers; when there is no suitable partner on the horizon; when their biological click is ticking too fast; when medical conditions mean their fertility is compromised; when they are about to undergo treatment that will render them infertile; when they have transitioned. But simply wanting help is no guarantee that it will be available: access varies. Clinics vary. The accuracy of statistics provided to patients varies. The number of rounds of treatment on offer varies. The cost alone puts the treatment beyond the reach of many.
There are immensely complex questions relating to this treatment.
Should there be age limits?
Should there be a limit to the number of rounds offered, the number of eggs retrieved or frozen or thawed or used?
Should single parenthood be encouraged?
How honest about efficacy should clinicians be?
Should healthy fertile women be encouraged to keep their options open in this way?
Is it kind to encourage hope when the odds of success are very poor?
Should the service be available to trans men?
How honest should clinicians be when mistakes happen?
The list goes on.
I’m impressed that the BBC tackled this subject, and that a number of women were prepared to share their experiences so openly. These are highly sensitive treatments with life-altering consequences. Society must keep asking the hard questions.
NB. For anyone contemplating fertility treatment the Human Fertilisation and Embryology Authority has issued a statement in response to the BBC programme.