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Childless by circumstance – Using an online survey to explore the experiences of childless women who had wanted children 没有孩子的情况-使用在线调查来探索想要孩子的没有孩子的女性的经历
Q1 Social Sciences Pub Date : 2021-03-01 DOI: 10.1016/j.rbms.2020.09.006
Dilan Chauhan , Emily Jackson , Joyce C Harper

Childlessness is increasing globally. This study aimed to explore the experiences of childless women who had wanted children. An online survey study was promoted through social media to recruit women aged ≥46 years who were childless by circumstance. The survey remained open for 15 days. In total, 303 survey responses were collected, 176 of which were complete surveys. In total, 15.3% (27/176) of women who had wanted children reported that they had not tried to have children, most commonly due to the lack of a partner (40.7%, 11/27). Of the 139 women who had tried to have children, 70.5% (98/139) had used calendar-based menstrual cycle tracking methods to identify their fertile window, and many had undergone fertility checks including hormone tests (75.5%, 105/139) and ultrasound scans (71.2%, 99/139). A significant proportion of women had experienced a miscarriage (40.2%, 56/139). Many women had decided not to have any fertility treatment (43.2%, 60/139). For those who did, the majority had tried in-vitro fertilization (74.6%, 59/79). The most common reason that women gave for stopping fertility treatment was due to emotional reasons (74.7%, 59/79). When asked how women felt now about their childlessness, the most common issues identified were unhappiness (85/158, 54%), acceptance (43/158, 27%) and happiness (30/158, 19%). There should be more support for unsuccessful fertility patients and other childless women, and more emphasis should be placed upon fertility education in order to ensure that women are better informed about fertility issues.

全球范围内,无子女现象正在增加。这项研究旨在探讨想要孩子的无子女妇女的经历。通过社交媒体推广一项在线调查研究,招募年龄≥46岁 、因环境原因无子女的女性。调查持续了15 天。共收集问卷303份,其中完整问卷176份。总的来说,15.3%(27/176)想要孩子的女性报告说她们没有尝试过要孩子,最常见的原因是缺乏伴侣(40.7%,11/27)。在139名试图生育的妇女中,70.5%(98/139)使用基于日历的月经周期跟踪方法来确定其生育窗口,许多人接受了生育检查,包括激素测试(75.5%,105/139)和超声扫描(71.2%,99/139)。有相当比例的妇女经历过流产(40.2%,56/139)。许多妇女决定不接受任何生育治疗(43.2%,60/139)。在这些人中,大多数人尝试过体外受精(74.6%,59/79)。妇女停止生育治疗的最常见原因是情感原因(74.7%,59/79)。当被问及女性现在对自己没有孩子的感受时,最常见的问题是不快乐(85/158,54%),接受(43/158,27%)和快乐(30/158,19%)。应更多地支持不孕不育患者和其他无子女妇女,并应更加强调生育教育,以确保妇女更好地了解生育问题。
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引用次数: 9
‘A caesarean section is like you've never delivered a baby’: a mixed methods study of the experience of childbirth among French women “剖腹产就像你从未生过孩子一样”:一项针对法国女性分娩经历的综合研究
Q1 Social Sciences Pub Date : 2021-03-01 DOI: 10.1016/j.rbms.2020.10.003
Clémence Schantz , Anne-Charlotte Pantelias , Myriam de Loenzien , Marion Ravit , Patrick Rozenberg , Christine Louis-Sylvestre , Sophie Goyet

The experience of childbirth has been technologized worldwide, leading to major social changes. In France, childbirth occurs almost exclusively in hospitals. Few studies have been published on the opinions of French women regarding obstetric technology and, in particular, caesarean section. In 2017–2018, we used a mixed methods approach to determine French women’s preferences regarding the mode of delivery, and captured their experiences and satisfaction in relation to childbirth in two maternity settings. Of 284 pregnant women, 277 (97.5%) expressed a preference for vaginal birth, while seven (2.5%) women expressed a preference for caesarean section. Vaginal birth was also preferred among 26 women who underwent an in-depth interview. Vaginal birth was perceived as more natural, less risky and less painful, and to favour mother–child bonding. This vision was shared by caregivers. The women who expressed a preference for vaginal birth tended to remain sexually active late in their pregnancy, to find sexual intercourse pleasurable, and to believe that vaginal birth would not enlarge their vagina. A large majority (94.5%) of women who gave birth vaginally were satisfied with their childbirth experience, compared with 24.3% of those who underwent caesarean section. The caring attitude of the caregivers contributed to increasing this satisfaction. The notion of women’s ‘empowerment’ emerged spontaneously in women’s discourse in this research: women who gave birth vaginally felt satisfied and empowered. The vision shared by caregivers and women that vaginal birth is a natural process contributes to the stability of caesarean section rates in France.

分娩的经历已经在世界范围内被技术化,导致了重大的社会变化。在法国,分娩几乎只在医院进行。关于法国妇女对产科技术,特别是剖腹产的意见的研究报告很少发表。2017-2018年,我们采用混合方法确定了法国女性对分娩方式的偏好,并捕捉了她们在两种产科环境下分娩的经历和满意度。284名孕妇中,277名(97.5%)表示偏爱顺产,7名(2.5%)表示偏爱剖腹产。在接受深度采访的26名女性中,阴道分娩也更受欢迎。阴道分娩被认为更自然,风险更小,痛苦更少,有利于母子关系。这一愿景得到了护理人员的认同。那些表示喜欢顺产的妇女在怀孕后期往往保持性活跃,觉得性交很愉快,并且相信顺产不会扩大她们的阴道。绝大多数(94.5%)顺产妇女对分娩体验感到满意,而剖腹产妇女的这一比例为24.3%。照顾者的关心态度有助于提高这种满意度。在这项研究中,女性“赋权”的概念自然而然地出现在女性话语中:阴道分娩的女性感到满足和赋权。护理人员和妇女都认为阴道分娩是一个自然过程,这有助于法国剖腹产率的稳定。
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引用次数: 5
Religious and non-religious issues of medically assisted reproduction in France: sexuality, incest and descent 法国医疗辅助生殖的宗教和非宗教问题:性、乱伦和世袭
Q1 Social Sciences Pub Date : 2020-11-01 DOI: 10.1016/j.rbms.2020.10.002
Corinne Fortier

It is generally held that assisted reproductive technology has dissociated procreation from sexuality — just as the advent of the pill dissociated sexuality from procreation. My study will show, on the contrary, that sexuality in all its dimensions, including the physical dimension of the circulation of bodily substances as well as the psychological dimension of fantasy, is far from having been removed from new methods of reproduction, even if they do indeed dispense with sexual intercourse, because sexuality cannot be reduced to the sexual act. The circulation of gametes has an often-denied sexual dimension which is revealed in the questions raised by monotheistic religions concerning these techniques. I analyse the position of Sunni Muslim jurists with regard to different reproductive techniques. Using a cross-disciplinary approach, I combine this specific study with a comparative analysis from a religious viewpoint, putting Sunni Islam into perspective with other monotheisms, specifically Judaism and Roman Catholicism, as well as the other branch of Islam represented by Shi’ism. As an anthropologist, I performed a field survey in France on medically assisted reproduction, particularly at the Centre for the Study and Preservation of Human Eggs and Sperm in Paris on the donation of gametes. I will show that the questions raised by monotheist religions regarding medically assisted reproduction are very often the same questions that individuals resorting to these techniques in France ask themselves about the concepts of adultery, incest and descent, particularly when the reproductive process involves a third-party donor.

人们普遍认为,辅助生殖技术将生殖与性行为分离开来——就像避孕药的出现将性行为与生殖行为分离开来一样。相反,我的研究将表明,性的所有维度,包括身体物质循环的物理维度以及幻想的心理维度,远没有从新的生殖方法中移除,即使它们确实免除了性交,因为性不能被简化为性行为。配子的循环有一个经常被否认的性维度,这在一神论宗教提出的关于这些技术的问题中得到了揭示。我分析了逊尼派穆斯林法学家关于不同生殖技术的立场。使用跨学科的方法,我将这一具体研究与宗教观点的比较分析结合起来,将逊尼派伊斯兰教与其他一神教,特别是犹太教和罗马天主教,以及以什叶派为代表的伊斯兰教的另一个分支相结合。作为一名人类学家,我在法国进行了一次关于医学辅助生殖的实地调查,特别是在巴黎的人类卵子和精子研究和保存中心进行了一次关于配子捐赠的实地调查。我要说明的是,一神论宗教提出的关于医疗辅助生殖的问题,往往与法国使用这些技术的个人对通奸、乱伦和世袭的概念提出的问题相同,特别是在生殖过程涉及第三方捐助者的情况下。
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引用次数: 3
‘Our family picture is a little hint of heaven’: race, religion and selective reproduction in US ‘embryo adoption’ “我们的家庭照片是天堂的一点暗示”:美国“胚胎收养”中的种族、宗教和选择性生殖
Q1 Social Sciences Pub Date : 2020-11-01 DOI: 10.1016/j.rbms.2020.08.002
Risa Cromer

People use selective reproductive technologies (SRT) in various family-making practices to assist with decisions about which children should be born. The practice of ‘embryo adoption’, a form of embryo donation developed by white American evangelical Christians in the late 1990s, is a novel site for reconceptualizing SRT and examining how they function among users. Based on ethnographic research conducted between 2008 and 2018 on US ‘embryo adoption’, this study provides an anthropological analysis of media produced by and about one white evangelical couple's race-specific preferences for embryos from donors of colour. This article shows how racializing processes and religious beliefs function as mutually reinforcing SRT for some ‘embryo adoption’ participants. Evangelical convictions justify racialized preferences, and racializing processes within and beyond the church reinforce religious acts. Race-specific preferences for embryos among white evangelicals promote selective decision-making not for particular kinds of children, a current focus in studies of SRT, but for particular kinds of families. This study expands the framework of SRT to include selection for wanted family forms and technologies beyond biomedical techniques, such as social technologies like racial constructs and religious convictions. Broadly, this article encourages greater attention to religion within analyses about race and reproduction by revealing how they are deeply entwined with Christianity, especially in the USA. Wherever constructions of race and religious convictions co-exist with selective reptroductive decision-making, scholars should consider race, reproduction and religion as inextricable, rather than distinct, domains of analysis.

人们在各种家庭实践中使用选择性生殖技术(SRT)来帮助决定应该生哪个孩子。“胚胎收养”是20世纪90年代末由美国白人福音派基督徒开发的一种胚胎捐赠形式,它是一个重新定义SRT并研究它们在用户中如何发挥作用的新网站。基于2008年至2018年对美国“胚胎收养”进行的人种学研究,本研究对一对白人福音派夫妇制作的媒体进行了人类学分析,并分析了他们对有色人种捐赠者胚胎的种族偏好。这篇文章展示了种族化过程和宗教信仰如何在一些“胚胎收养”参与者中相互加强SRT。福音派的信仰为种族化的偏好辩护,教会内外的种族化过程强化了宗教行为。白人福音派教徒对胚胎的种族偏好促进了选择性决策,而不是针对特定类型的孩子,这是目前SRT研究的重点,而是针对特定类型的家庭。本研究扩展了SRT的框架,包括对想要的家庭形式和技术的选择,而不是生物医学技术,如种族结构和宗教信仰等社会技术。从广义上讲,这篇文章鼓励人们在分析种族和生殖时更多地关注宗教,通过揭示它们是如何与基督教深深纠缠在一起的,尤其是在美国。只要种族和宗教信仰的构建与选择性生殖决策共存,学者们就应该将种族、生殖和宗教视为不可分割的分析领域,而不是截然不同的分析领域。
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引用次数: 7
Doing and undoing nation through ART: a Franco–American comparison 通过艺术成就和毁灭国家:法美比较
Q1 Social Sciences Pub Date : 2020-11-01 DOI: 10.1016/j.rbms.2020.09.005
Rajani Bhatia

This article explores a Franco–American comparison of assisted reproductive technology (ART), specifically as it relates to sex selection and cross-border reproduction. As a basis for comparison, the nation can materialize in the form of state structure just as much as in cultural–economic assemblages or ideologies that breach geopolitical boundaries. By juxtaposing many contrasts between the French and US contexts – departure versus destination country, highly regulated versus deregulated governance, medical versus social applications, and access (or lack thereof) via public versus private health insurance sectors – it may be difficult to imagine how these extremes occupy a common continuum of globalized market channels. I suggest that invisible or semi-visible reproductive practices along with ART governance provide an avenue to stake out or protect the ‘French’ way of being and doing ART just as much as they make the ‘American’ way simultaneously elusive and easy to appropriate. Ultimately, both the French and American approaches to ART collude in the institutionalization of globalized markets. Through the case of cross-border and (sex) selective ART, it is possible to see how both the French and the Americans are involved in the undoing and doing of nation via ART as global assemblage.

本文探讨了法美辅助生殖技术(ART)的比较,特别是与性别选择和跨国界生殖有关的技术。作为比较的基础,国家既可以以国家结构的形式出现,也可以以超越地缘政治界限的文化-经济组合或意识形态的形式出现。通过将法国和美国背景之间的许多对比——出发地与目的地国、高度管制与放松管制的治理、医疗与社会应用、通过公共与私人健康保险部门获得(或缺乏)——并置于一起,可能很难想象这些极端是如何占据全球化市场渠道的共同连续体的。我认为,不可见或半可见的生殖实践以及ART治理提供了一种途径,可以监视或保护“法国”的存在方式和进行ART的方式,就像它们同时使“美国”的方式难以捉摸且易于适用一样。最终,法国和美国的ART方法在全球化市场的制度化中相互勾结。通过跨国界和(性别)选择性ART的案例,我们可以看到法国人和美国人是如何通过ART作为全球集合参与国家的毁灭和发展的。
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引用次数: 1
Inclusion, exclusion: comparative public policy (France/USA) in access to assisted reproductive technology 包容与排斥:获得辅助生殖技术的比较公共政策(法国/美国)
Q1 Social Sciences Pub Date : 2020-11-01 DOI: 10.1016/j.rbms.2020.09.004
Jennifer Merchant

This article examines what French and American societies mean by the principle of personal autonomy/‘right to privacy’ and the concept of solidarity/‘the best interest of the society at large’. It will attempt to show how these two countries translate these concepts into different public policies, more specifically in the field of access to sexual and reproductive rights of women and men. In order to better highlight these differences, I observe what citizens actually experience on the ground, and in so doing, it becomes clear that each country does not fully meet the principles they purport to defend.

本文考察了法国和美国社会对个人自主原则/“隐私权”和团结概念/“整个社会的最大利益”的理解。它将试图说明这两个国家如何将这些概念转化为不同的公共政策,更具体地说,是在男女享有性权利和生殖权利领域。为了更好地强调这些差异,我观察了公民在实地的实际经历,通过这样做,很明显,每个国家都没有完全实现他们声称要捍卫的原则。
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引用次数: 1
Exploring reproduction (or is it procreation?) over language boundaries: the challenges and hidden opportunities of translation 跨越语言界限探索再生产(或者是再生产?):翻译的挑战和隐藏的机遇
Q1 Social Sciences Pub Date : 2020-11-01 DOI: 10.1016/j.rbms.2020.09.002
Simone Bateman

This article addresses the challenges and benefits derived from having to present social science research in another language than one’s usual working language. As objects of study are, in part, moulded by language, translation becomes an invaluable opportunity for critical reflection on our epistemic choices. The article thus proposes a brief inquiry into the words we use, in French and in English, to describe and discuss issues in assisted reproductive technology, or medically assisted procreation as one would say in French. The article first explores similarities and differences in the generic terms used in each language to refer to this area, and discusses the verbs used to describe different facets of the reproductive process. It then proposes a short discussion of two terms often used interchangeably in both languages, ‘reproduction’ and ‘procreation’, and introduces a third term, engendrement (‘engendering’) that has recently emerged in France as an alternative concept. The conclusion points to the impact that technology may have on the issues considered worthy of attention, and on the meaning of certain words, as reproductive acts are displaced from the body to the laboratory. It also urges greater attention to how language affects the way we conceptualize reproductive practices and issues, and to how we deal with these differences in international encounters.

本文讨论了必须用另一种语言而不是通常的工作语言来展示社会科学研究所带来的挑战和好处。由于研究对象在某种程度上是由语言塑造的,翻译成为对我们的认知选择进行批判性反思的宝贵机会。因此,本文建议对我们用法语和英语描述和讨论辅助生殖技术或用法语说的医学辅助生殖问题时使用的词语进行简要调查。本文首先探讨了每种语言中用于指代这一领域的通用术语的异同,并讨论了用于描述生殖过程不同方面的动词。然后对两种语言中经常互换使用的两个术语“reproduction”和“procreation”进行了简短的讨论,并介绍了第三个术语“engendrement”(“gendering”),这是最近在法国出现的一个替代概念。结论指出,随着生殖行为从身体转移到实验室,技术可能对被认为值得注意的问题和某些词语的含义产生影响。它还敦促人们更多地关注语言如何影响我们对生殖实践和问题的概念化方式,以及我们如何在国际接触中处理这些差异。
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引用次数: 3
‘We are all in the image of God’: reproductive imaginaries and prenatal genetic testing in American Jewish communities “我们都是上帝的形象”:美国犹太社区的生殖想象和产前基因检测
Q1 Social Sciences Pub Date : 2020-11-01 DOI: 10.1016/j.rbms.2020.06.001
Faye Ginsburg, Rayna Rapp

How are we to understand the complexities of prenatal genetic testing across social and cultural worlds? Availability and uptake of this biotechnology is variable, deeply influenced not only by national frameworks but also by local regimes of value. We argue that these intersections of genetic testing and local cultural worlds must be understood as part of broader 'reproductive imaginaries', including everything from kinship, pregnancy and gender norms to children’s links to specific community norms of national and cultural futures. In the USA, preconceptual/prenatal genetic testing is widely available, driven by a neoliberal market-based model of consumer choice. In contrast, such tests are far more restricted by bioethical laws and medical regulations in France. This article will examine how particular cultural and religious communities – primarily American orthodox Jewish communities – shape prenatal genetic testing in their own distinct ways.

我们如何理解跨社会和文化世界的产前基因检测的复杂性?这种生物技术的可得性和吸收程度是多变的,不仅深受国家框架的影响,也深受地方价值制度的影响。我们认为,这些基因检测和当地文化世界的交集必须被理解为更广泛的“生殖想象”的一部分,包括从亲属关系、怀孕和性别规范到儿童与国家和文化未来的特定社区规范的联系。在美国,在消费者选择的新自由主义市场模式的推动下,孕前/产前基因检测是广泛可用的。相比之下,这类测试在法国受到生物伦理法律和医疗法规的限制要大得多。本文将研究特定的文化和宗教团体——主要是美国正统犹太社区——如何以自己独特的方式塑造产前基因检测。
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引用次数: 2
Reproducing while Black: the crisis of Black maternal health, obstetric racism and assisted reproductive technology 黑人生育:黑人孕产妇健康危机、产科种族主义和辅助生殖技术。
Q1 Social Sciences Pub Date : 2020-11-01 DOI: 10.1016/j.rbms.2020.10.001
Dána-Ain Davis

Black women bear the burden of a number of crises related to reproduction. Historically, their reproduction has been governed in relation to the slave economy, and connected to this, they have been experimented upon and subjected to exploitative medical interventions and policies. Even now, they are more likely to experience premature births and more likely to die from pregnancy-related complications. Their reproductive lives have been beleaguered by racism. This reality, as this article points out, shapes the use of assisted reproductive technology (ART) by Black women. Using the framework of obstetric racism, I suggest that, in addition to the crisis of adverse maternal health outcomes, such as premature birth, low-birthweight infants and maternal death, Black women also face the crisis of racism in their medical encounters as they attempt to conceive through ART. Obstetric racism is enacted on racialized bodies that have historically experienced subjugation, especially, but not solely, reproductive subjugation. In my prior work, I delineated four dimensions of obstetric racism: diagnostic lapses; neglect, dismissiveness or disrespect; intentionally causing pain; and coercion. In this article, I extend that framework and explore three additional dimensions of obstetric racism: ceremonies of degradation; medical abuse; and racial reconnaissance. This article is based on ethnographic work from 2011 to 2019, during which time I collected narratives of US-based Black women and documented the circumstances under which they experienced obstetric racism in their interactions with medical personnel while attempting conception through ART.

黑人妇女承受着与生育有关的一系列危机的负担。从历史上看,他们的繁殖受到奴隶经济的控制,与此相关的是,他们被实验并受到剥削性的医疗干预和政策的影响。即使是现在,她们也更有可能经历早产,更有可能死于与妊娠有关的并发症。她们的生育生活一直受到种族主义的困扰。这篇文章指出,这一现实影响了黑人女性对辅助生殖技术(ART)的使用。利用产科种族主义的框架,我建议,除了不良孕产妇健康结果的危机,如早产、低出生体重婴儿和孕产妇死亡,黑人妇女在试图通过抗逆转录病毒治疗怀孕时,在医疗接触中也面临种族主义危机。产科种族主义是在种族化的机构中实施的,这些机构在历史上经历过征服,特别是但不只是生殖方面的征服。在我之前的工作中,我描述了产科种族主义的四个方面:诊断失误;轻视:忽视、轻视或不尊重;故意引起疼痛的;和胁迫。在本文中,我扩展了这一框架,并探讨了产科种族主义的三个额外方面:退化仪式;医疗滥用;还有种族侦察。本文基于2011年至2019年的民族志工作,在此期间,我收集了美国黑人妇女的叙述,并记录了她们在通过ART尝试受孕时与医务人员互动时遭遇产科种族主义的情况。
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引用次数: 37
Relational surrogacies excluded from the French bioethics model: a euro-american perspective in the light of Marcel Mauss and Louis Dumont 被排除在法国生命伦理模式之外的关系代孕:马塞尔·莫斯和路易·杜蒙的欧美视角
Q1 Social Sciences Pub Date : 2020-11-01 DOI: 10.1016/j.rbms.2020.09.001
Hélène Malmanche

In the French context of prohibition of surrogacy by a legislative framework established in 1994, couples are using surrogacy abroad to create their family. Why does surrogacy not find room in the landscape of donor-conceived families in France? Based on a survey among French intended parents using surrogacy in the USA and Belgium, and a 2-year ethnography on medical practice in a fertility centre in Belgium, this study shows that surrogacy is, in fact, a particular type of gift: the gift of gestational capacity. The preconceptional journey in Belgium or in the USA is a relational process that allows complementary places and statuses to be acquired. This process will transform applicants into intended parents (recipients), and candidates into surrogates (donors). The relationships created by the gift have the particularity of being woven around responsibility towards the fetus. It is the hierarchy of encompassing and encompassed responsibilities in relation to the fetus that organizes the relationships and actions of each protagonist: parents, grandparents, surrogate, surrogate’s partner and children, etc. The article thus shows that surrogacy, because it is a gift of a particular type, has no place in the French bioethics model, which is, in fact, built entirely on the notion of ‘donation without a donor’ in a therapeutic and medicalized view of reproductive donations.

在1994年建立的法律框架禁止代孕的法国背景下,夫妇们正在国外使用代孕来建立他们的家庭。为什么代孕不能在法国的捐赠者受孕家庭中找到一席之地?根据对在美国和比利时使用代孕的法国准父母的调查,以及对比利时生育中心医疗实践的2年民族志的研究,这项研究表明,代孕实际上是一种特殊类型的礼物:妊娠能力的礼物。在比利时或美国的先入为主的旅行是一个关系过程,允许获得互补的位置和地位。这个过程将把申请人变成意向父母(接受者),把候选人变成代孕者(捐赠者)。礼物所创造的关系有一种特殊性,那就是围绕着对胎儿的责任编织而成。与胎儿相关的包含和包含责任的层次结构组织了每个主角的关系和行动:父母、祖父母、代理人、代理人的伴侣和孩子等等。因此,这篇文章表明,由于代孕是一种特殊类型的礼物,因此在法国的生物伦理模式中没有地位。事实上,法国的生物伦理模式完全建立在生殖捐赠的治疗和医学观点中“没有捐赠者的捐赠”的概念之上。
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引用次数: 3
期刊
Reproductive Biomedicine and Society Online
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