title: Fertility preservation for non-medical reasons: controversial, but increasingly common.
abstract: BACKGROUND
  Fertility-preserving measures for women are increasingly being performed for non-medical reasons in Germany. This is now a controversial matter.
  
  
  METHODS
  The authors searched the PubMed database for pertinent publications on the basis of their clinical and scientific experience and evaluated relevant data from the registry of the German FertiPROTEKT network (www.fertiprotekt. com). The various fertility-preserving measures that are available are described and critically discussed.
  
  
  RESULTS
  In most cases, the creation of a fertility reserve currently involves the cryopreservation of unfertilized oocytes, rather than of ovarian tissue. Most of the women who decide to undergo this procedure are over 35 years old. According to data from the FertiPROTEKT registry, most such procedures carried out in the years 2012 and 2013 involved a single stimulation cycle. The theoretical probability of childbirth per stimulation is 40% in women under age 35 and 30% in women aged 35 to 39. If the oocytes are kept for use at a later date, rather than at once, the maternal risk is higher, because the mother is older during pregnancy. The risk to the child may be higher as well because of the need for in vitro fertilization (IVF). Pregnancy over age 40 often leads to complications such as gestational diabetes and pre-eclampsia. IVF may be associated with a higher risk of epigenetic abnormalities. Ethicists have upheld women's reproductive freedom while pointing out that so-called social freezing merely postpones social problems, rather than solving them.
  
  
  CONCLUSIONS
  Fertility preservation for non-medical reasons should be critically discussed, and decisions should be made on a case-by-case basis.
authors: Division of Gynecologic Endocrinology and Reproductive Medicine, University Women's Hospital, Bern, Switzerland, Department of Gynecologic Endocrinology and Fertility Disorders at Heidelberg University Women's Hospital, Center for Fertility, Prenatal Medicine, Endocrinology and Osteology, amedes Hamburg, FertiPROTEKT network.
authors: Michael
authors: M
authors: von Wolff
authors: Ariane
authors: A
authors: Germeyer
authors: Frank
authors: F
authors: Nawroth
mesh_terms: D000328:Adult; D017677:Age Distribution; D015925:Cryopreservation / Q000941:ethics* / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D059247:Fertility Preservation / Q000941:ethics* / Q000706:statistics & numerical data* / Q000639:trends; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D054315:Oocyte Retrieval / Q000941:ethics* / Q000706:statistics & numerical data* / Q000639:trends; D011247:Pregnancy
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