The lessons of oncofertility for assisted reproduction.

Young children, adolescents, and men and women in their prime reproductive years may now survive for decades after cancer. They and their families celebrate these medical advances and hope that after cancer treatment ends, they can resume what Kathlyn Conway described as “ordinary life” [1]. When patients and their families learn that the treatments for some cancers can impair their fertility, they may feel that they will not be able to look forward to that ordinary life. No wonder, then, that many adult patients and parents of adolescents will rejoice at the medical and scientific developments that someday might permit them to have their own genetic children. Like the symposium out of which it grew, this volume addresses the science and the ethics of dealing with cancer-related infertility. If the science and the medicine work, and 5, 10, or 20 years after surviving cancer some people are raising their own children, they may feel that they have had two miracles. They lived when once they might have died; and they have managed to create a new life and to extend themselves into a new generation. But as everyone in this volume acknowledges, there are no guarantees. Even the standard techniques using banked sperm and embryos do not always result in a baby, and using frozen oocytes and cryo-preserved ovarian tissue is still considered experimental. Several contributors to this volume have explored a host of ethical and psychosocial issues that arise when people face both cancer and infertility. In what follows I extend their ideas and seek to make three main points: first, a great many of the concerns about handling cancer-related infertility apply to people whose infertility stems from other biological factors. Second, the medical response to cancer-related infertility should not remain the primary response, lest it perpetuate an unfortunate societal tendency to use technology to solve non-technological problems. Last, our