Reproductive Biomedicine and Society Online最新文献

This study examined the nature and accuracy of information available across online platforms for couples trying to conceive. A consumer simulation-based investigation of English websites and social media (Facebook, Twitter, Instagram) was undertaken using common search terms identified in a pilot study. Claims about fertility and pregnancy health were then extracted from the results and analysed thematically. The accuracy of each claim was assessed independently by six fertility and conception experts, rated on a scale of 1 (not factual) to 4 (highly factual), with scores collated to produce a median rating. Claims with a median score < 3 were classified as inaccurate. The use of the terms 'trying to conceive' and '#TTC' were common identifiers on online platforms. Claims were extracted predominantly from websites (n = 89) rather than social media, with Twitter and Instagram comprising commercial elements and Facebook focused on community-based support. Thematic analysis revealed three major themes among the claims across all platforms: conception behaviour and monitoring, lifestyle and exposures, and medical. Fact-checking by the experts revealed that 40% of the information assessed was inaccurate, and that inaccuracies were more likely to be present in the conception behaviour and monitoring advice, the topics most amenable to modification. Since online information is a readily accessible and commonly utilized resource, there is opportunity for improved dissemination of evidence-based material to reach interested couples. Further cross-disciplinary and consumer-based research, such as a user survey, is required to understand how best to provide the 'trying to conceive' community with accurate information.

In this paper I pay tribute to four named women and 280 unidentified women patients for their essential roles in supporting Bob Edwards and Patrick Steptoe during the pioneering early days of IVF. The four named women are Jean Purdy, Muriel Harris, Lillian Lincoln Howell and Ruth Fowler.

This commentary addresses one aspect of the early history of IVF in Britain. Specific data are re-examined from the recently published, anonymized database of medical records from the Oldham period of research conducted by Robert Edwards, Patrick Steptoe and their team of assistants between 1969 and 1978. By focusing on a reformulation of the ‘scheduled treatment cycles per patient’, attention is drawn to the small, but nevertheless not insignificant, number of subjects who returned to Oldham at least five times or more to undergo innovative procedures and/or receive other experimental treatments over the duration of the research project. These multiple efforts are contrasted with the single or double treatment cycles received by the majority of the infertile women involved, including the only two experiencing live births, Lesley Brown and Grace Montgomery. The re-presented data facilitates new interpretations and raises fresh research questions about the nature of contemporary and present characterisations of the major protagonists in the ‘IVF story’, the identity of those women who originally took part and the origin of and reasons for discrepancies in the records maintained about research subjects.

This article undertakes a close reading of the parliamentary debates associated with the topic of embryo cryopreservation in Aotearoa New Zealand. From our critical readings, we argue that there is a lack of transparency over the ethical reasons for enforcing a maximum storage limit. We demonstrate that arguments for the retention of this limit are associated (in New Zealand) with arguments based upon ‘build-up avoidance’ and ‘conflict avoidance’ as social goods based on Pākehā [New Zealander of European descent] cultural world views rather than identifiable universal ethical principles. We illustrate that the avoidance of embryo accumulation and related conflict was only achieved by the denial of indigenous spiritual and cultural concerns, while also shifting the ethical burdens of disposition on to clinic staff and those members of the public who protested against enforced cryopreserved embryo disposal. The Pākehā cultural concept of ‘tidy housekeeping’ emerges as a presumed ethical and social good in the New Zealand situation. This is despite abundant literature documenting the suffering created through forced decision-making upon disposition.

An analysis of national registry data for 5 years of in-vitro fertilization (IVF) funding in Quebec, Canada was compared with the previous complete year of non-funded IVF cycles, as well as the first complete year following the end of funding. The number of cycles, livebirth rates, age group of patients treated, use of donor gametes, multiple pregnancy rates and cycle cancellation rates were assessed. The total number of IVF cycles performed increased dramatically during the funded period, averaging over 10,000 cycles per year. There was no change in the age group distribution of patients treated, but less egg donation was performed. Interestingly, funding was also associated with an increase in the IVF cycle cancellation rate (17.0% versus 34.4%, P < 0.001), a dramatic decline in the multiple pregnancy rate (25.6% versus 4.9%, P < 0.001), and a decline in the livebirth rate per fresh embryo transfer in stimulated IVF cycles (32.3% versus 25.5%, P < 0.001). Although the livebirth rate for stimulated IVF declined, over 9000 babies were born as a result of the coverage. Lessons learned from this experience could help develop a more fiscally responsible programme that still facilitates access to IVF care.

This qualitative interview study sought to gather and better understand heterosexual parents' experiences of managing resemblance and non-resemblance between child and parent in an identity-release donor programme. The study is part of the prospective longitudinal Swedish Study on Gamete Donation (SSGD), including all fertility clinics performing gamete donation in Sweden. A sample of participants in the SSGD, consisting of 30 heterosexual parents with children aged 7–8 years following identity-release sperm donation, participated in individual semi-structured interviews. This study concerns a secondary analysis of the interview data. The results show how donor-conceiving parents experience the presence and absence of child–parent resemblance, and how they navigate between the importance of genetic connectedness and of ‘doing parenthood’ through social interactions. The analysis resulted in three categories: ‘resemblance through nature or nurture’, ‘non-resemblance brings the donor to the front’ and ‘feelings about and coping with resemblance talk’. The first two categories deal with the intrapersonal aspects of physical and non-physical resemblance, while the last category includes aspects of resemblance in relation to persons outside the core family. The presence or absence of parent–child resemblance regarding both physical and non-physical characteristics appears to constitute a considerable challenge for heterosexual couples with school-aged children following sperm donation.

This study sought to explore how Swedish parents who had commissioned surrogacy abroad experienced the process of parenthood recognition. The study consisted of in-depth interviews with five couples and 10 individuals representing 10 additional couples who had used surrogacy abroad, mainly in India. The construction of motherhood and fatherhood in the Swedish system contradicts how parenthood is defined in the surrogacy process. This study found that the formal recognition of parenthood involved a complex and frustrating process where the presumption of fatherhood and step-child adoption as grounds for parenthood make people feel questioned as parents, negatively affecting parental welfare. Policy makers need to take into account the consequences of an unregulated situation regarding surrogacy, and focus more on the child–parent relationship when regulating surrogacy.