The ethical dilemmas created by this latest fertility breakthrough

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The Independent Online

The successful freezing and transplanting of ovaries in rats, reported today, is potentially the latest stage in the brave new world of fertility treatment. If the technique can be applied successfully in humans, many young women will have reason for gratitude. Those who could benefit include women who are at risk of premature menopause and those who receive life-saving treatment for cancer – at the risk of sterility.

The successful freezing and transplanting of ovaries in rats, reported today, is potentially the latest stage in the brave new world of fertility treatment. If the technique can be applied successfully in humans, many young women will have reason for gratitude. Those who could benefit include women who are at risk of premature menopause and those who receive life-saving treatment for cancer – at the risk of sterility.

The prospect is that the ovaries could be removed and frozen for the duration of the cancer treatment, and replaced later for child-bearing. Ovarian "banking" (where a healthy young woman has an ovary removed and preserved for future use) or transplants, could also become possible, enabling post-menopausal women to become pregnant. Which is where the controversy will undoubtedly begin.

No one could begrudge a young woman who has been treated for cancer or passed the menopause while her contemporaries are still of child-bearing age the chance to produce her own child. Relieving a woman of the invidious choice between her life and her fertility is without doubt a good thing.

The possibility of ovarian "banking" or transplants, however, opens the way for much older women – women who have long passed normal child-bearing age – to reinstate their fertility and become pregnant. A women who has one healthy ovary removed at age 20 and then has it reinstated in her forties could postpone menopause – and extend her child-bearing – for more than 20 years.

This raises all the same ethical and practical questions as other types of fertility treatment for older women. Should a woman in her late fifties or sixties – or beyond – be helped to produce a baby when nature by itself renders it impossible? Who should pay? And where does such research and treatment fit into the priorities of the country's health care? One argument is that ovarian transplants, like other fertility treatments, serve to advance the equality between men and women. If men can father children into their eighties, why should women not have similar freedom? Should they be denied the chance to defer childbearing until they are established in their career or even retired?

The principle is hard to argue against; the practicalities – the risk, above all, that a young child will be orphaned – are a different matter. And at a time when the NHS is widely perceived to be short of money, there is a case for at least discussing whether resources might be better spent on poorly-funded sectors, such as geriatric medicine or mental health, which affect so many more people. The same strictures would apply to the balance of media attention, too.

Fortunately, in real life, the number of older women who want to bear children is tiny, and adding ovarian transplants to the available treatments would probably not increase the number substantially. Most women, especially those who have reached a certain age, are too well aware of the responsibilities that a child entails to embark on such a project lightly. And the risks of major surgery would probably be sufficient to deter those women whose motive was less to bear children than to postpone the menopause – to reduce their discomfort and feel and look younger. They would have less drastic remedies at their disposal, such as hormone replacement therapy.

The restrictions currently in place on tax-payer-funded fertility treatment for older women should certainly be extended to any new form of treatment. In the meantime, for the sake of those younger women who do not have the luxury of choice and with all the caveats about priorities and cost, we wish the scientists "God speed".

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