Fertility of tomorrow: Are there any restrictions left?

Abstract

As the concepts of society, parenthood and family evolve, the French law on bioethics has recently been updated by authorizing oocyte and sperm cryopreservation for all individuals who wish to do so, in the absence of medical indications. For women, aging irremediably impairs reproductive competence, both quantitatively and qualitatively. For men, aging has a negative impact on sperm parameters. Hence, this possibility of social oocyte/sperm freezing is a real breakthrough, offering to all the opportunity to better anticipate age-related fertility decline and be better actors of one's reproductive life. In its current form, the new French bioethics law allows unrestricted access to fertility preservation techniques to all women and men that fulfill the age criteria. In light of the lack of official recommendations, many questions remain. In clinical practice, it is therefore up to centers to determine on a case-by-case basis the limits of these procedures, notably to define when to stop fertility preservation. This also questions the place of the patient as a decision maker in the procedure and to which extent these procedures should be performed according to patient preference. Altogether, despite the wide range of possibilities enabled by these major legal and technical advances, it is essential to make clear to all that undergoing fertility preservation procedures is not a guarantee of future pregnancy and does not replace timely care of fertility issues.