Evidence map›Paper›PMID 29084865›Full record

ArticleJournal of medical ethics2018

Ethics of fertility preservation for prepubertal children: should clinicians offer procedures where efficacy is largely unproven?

Rosalind J McDougall, Lynn Gillam, Clare Delany, Yasmin Jayasinghe

Registry-linked trialOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of medical ethics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06894810 (A Double Blind Randomised Controlled Trial of a Paediatric Fertility Preservation Decision Aid in Parents and Adolescents and Young Adults), which is not on this map. Cited by 22 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 1 pooled it
5.2field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06894810 narecruitingnot on this mapstarted 2025, after this paper: background citation

A Double Blind Randomised Controlled Trial of a Paediatric Fertility Preservation Decision Aid in Parents and Adolescents and Young Adults (CAYA) Cancer Survivors

TypeinterventionalSponsorMurdoch Childrens Research InstituteRan2025 to 2027Enrolled358ConditionsUnmet Fertility Information NeedsArmsDecision-aid
3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.

  1. Pooled it
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  17. Fertility considerations in men with testicular cancer.Translational andrology and urology · 2020
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Rosalind J McDougallMelbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
Lynn GillamMelbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
Clare DelanyChildren's Bioethics Centre, Royal Children's Hospital, Melbourne, Victoria, Australia.
Yasmin JayasinghePaediatric and Adolescent Gynaecology, Royal Children's Hospital, Melbourne, Victoria, Australia.
Royal Children's Hospital · AURoyal Women's Hospital · AUUniversity of Melbourne · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Young children with cancer are treated with interventions that can have a high risk of compromising their reproductive potential. 'Fertility preservation' for children who have not yet reached puberty involves surgically removing and cryopreserving reproductive tissue prior to treatment in the expectation that strategies for the use of this tissue will be developed in the future. Fertility preservation for prepubertal children is ethically complex because the techniques largely lack proven efficacy for this age group. There is professional difference of opinion about whether it is ethical to offer such 'experimental' procedures. The question addressed in this paper is: when, if ever, is it ethically justifiable to offer fertility preservation surgery to prepubertal children? We present the ethical concerns about prepubertal fertility preservation, drawing both on existing literature and our experience discussing this issue with clinicians in clinical ethics case consultations. We argue that offering the procedure is ethically justifiable in certain circumstances. For many children, the balance of benefits and burdens is such that the procedure is ethically permissible but not ethically required; when the procedure is medically safe, it is the parents' decision to make, with appropriate information and guidance from the treating clinicians. We suggest that clinical ethics support processes are necessary to assist clinicians to engage with the ethical complexity of prepubertal fertility preservation and describe the framework that has been integrated into the pathway of care for patients and families attending the Royal Children's Hospital in Melbourne, Australia.

Indexed as

Ethics, ClinicalParental ConsentAustraliaChildChild, PreschoolCryopreservationDecision MakingEthics, MedicalFemaleFertilityFertility PreservationHealth ServicesHospitalsHumansInfertilityMalechildrenclinical ethicscryobanking of spermethics committees/consultationova or embryospaediatrics

Identifiers

PMID29084865
PMCPMC5749308
OpenAlexW2767137325

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.