Motherhood, Fairness, and Flourishing: Widening Reproductive Choices in Saudi Arabia

Introduction

In 2019, a landmark Fatwa, or religious decree, issued by Saudi Arabia’s highest religious authority—The Council of Senior Scholars—declared the permissibility of oocyte and ovarian tissue cryopreservation under Islamic law. ¹ The fatwa sanctioned the retrieval, preservation, and future use of oocytes, ovarian tissue, and whole ovaries from cancer patients whose therapeutic courses require the administration of gonadotoxic agents that may result in infertility. This was a revolutionary decision; not only did it advance assisted reproductive technology (ART) in the country, but it also gave hope to a group of patients undergoing essential, albeit infertility-inducing, therapeutic interventions.

The fatwa’s specification of cancer patients, however, effectively rendered this technology unavailable to others to whom it may be similarly beneficial, including patients receiving gonadotoxic medications for other diseases, patients with infertility resulting from congenital conditions, or indeed those without ailments but who desire cryopreservation for so-called “social” reasons, that is, elective cryopreservation to protect against the natural, age-related decline of fertility. ²

This article argues in favor of widening reproductive choices in Saudi Arabia through expanded access to oocyte cryopreservation—regardless of the underlying cause of infertility—on three grounds. First, there is no indication of an inherent conflict between oocyte cryopreservation and Islamic law. In fact, since the fatwa does not explicitly prohibit other patients from benefiting from cryopreservation, widened permissibility is amenable to further exploration. Second, as a matter of fairness, harm caused by fertility loss in cancer patients should not be deemed morally distinct from the harm caused by fertility loss due to other conditions, including age-related fertility decline. Third, expanded access enhances the well-being and flourishing of Saudi women by enabling them to make informed decisions about when to have children and with whom, without compromising education and career opportunities. This is particularly salient in the context of Saudi Arabia’s ambitious transformative development strategy, Vision 2030, which emphasizes women’s participation in the workforce as a central requirement of a thriving economy and a sustainable future. ³

The article begins with an account of oocyte cryopreservation and some of the ethical concerns raised by this technology, including challenges to elective cryopreservation. Next, cryopreservation is examined through the lens of Islamic law. Finding no conflict, agreements are presented in support of expanded access, including those...