Fertility preservation for children treated for cancer (2): ethics of consent for gamete storage and experimentation.

Infertility causes significant psychosocial morbidity by reducing both personal sense of wellbeing (health) and capacity to exercise self determination over reproduction (autonomy). As the primary moral responsibilities of health professionals are restoration of health and respecting patients’ autonomy, it follows that preserving fertility or treating infertility has sound ethical justification in adults. These arguments also apply to children. Children who develop cancer suVer misfortune; for this to be compounded by the burden of potentially treatable infertility seems doubly unjust. However, intervention to preserve fertility must have a sound evidence base as well as moral provenance. It should neither raise unrealistic expectations nor have long term adverse eVects on the patient or their oVspring.