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Fertility and Sterility Apr 2019The advent of third party parenting ushered in the era of artificial stimulation of the endometrium. Initially intended only for patients with ovarian failure, exogenous... (Review)
Review
The advent of third party parenting ushered in the era of artificial stimulation of the endometrium. Initially intended only for patients with ovarian failure, exogenous induction of endometrial receptivity was quickly shown to be as good as natural endometrial preparation, with the advantage that the timing of embryo transfer could be controlled. It is perhaps surprising that even though the ovary produces a variety of steroids, that estradiol (E) and progesterone (P) alone would be needed to achieve optimal receptivity; no other substance has ever been shown to improve on the basic regimen of E and P. A variety of routes of administration are available for both E and P and physiologic (or supraphysiologic) serum or endometrial tissue levels of both can be achieved. The optimal duration of E stimulation and the timing of the onset of P administration continue to be debated, but it appears that imitating the sequence that normally occurs in nature leads to optimal results. The poorly responsive endometrium and cases of recurrent implantation failure remain a challenge, but the clear majority of patients can successfully achieve pregnancy as long as embryos of adequate quality are transferred.
Topics: Cryopreservation; Embryo Implantation; Embryo Transfer; Endometrium; Estradiol; Female; Fertility Agents, Female; Humans; Luteinization; Pregnancy; Pregnancy Rate; Reproductive Techniques, Assisted; Surrogate Mothers
PubMed: 30929721
DOI: 10.1016/j.fertnstert.2019.02.010 -
The Medico-legal Journal Sep 2020A consideration of the concept, law and practice of surrogacy, and the merits and demerits of the concept. A discussion of payments, foreign surrogacies, delay in...
A consideration of the concept, law and practice of surrogacy, and the merits and demerits of the concept. A discussion of payments, foreign surrogacies, delay in finality, and the need for control and regulation.
Topics: Health Care Costs; Health Expenditures; Humans; Surrogate Mothers; United Kingdom
PubMed: 32437632
DOI: 10.1177/0025817220923688 -
Social Science & Medicine (1982) Jul 2020Childbirth practices shed light on cultural values, ideologies of gender and motherhood, and social inequalities. Transnational, commercial surrogacy presents a useful...
Childbirth practices shed light on cultural values, ideologies of gender and motherhood, and social inequalities. Transnational, commercial surrogacy presents a useful lens through which to view the social dynamics that shape childbirth experiences. Surrogacy challenges dominant views on the naturalness and inevitability of maternal-fetal bonds because it involves the separation of gestation from motherhood. What ideologies inform childbirth practices in the consumer-driven context of surrogacy in which the woman giving birth is neither the consumer nor the "mother"? Based on multi-sited ethnographic research between 2014 and 2017 and in-depth interviews with 120 participants in the Mexican surrogacy industry, I argue that doctors draw on normative ideologies of kinship, gender, and maternal-child bonding to justify and normalize the use of Caesarean sections among surrogates. The ideology espoused by these doctors reinforces the notion that maternal-fetal bonding is natural and inevitable, constructs women as irrational and driven by hormones, and presumes that bonding between surrogate mothers and the children they gestate is detrimental to the surrogacy process. Furthermore, the proffered justifications for the Caesarean sections reproduces stereotypes about poor Mexican women as risky patients, contributes to the "disposability" of their labor, and reinforces a hierarchy in which the perceived interests of intended parents and children are elevated above those of surrogate mothers. This article contributes to social science studies of medicine by demonstrating how classist and racist stereotypes, and folk notions of kinship, gender, and maternal-child bonding are biologized in medical practice.
Topics: Cesarean Section; Child; Female; Humans; Parturition; Pregnancy; Surrogate Mothers
PubMed: 32464414
DOI: 10.1016/j.socscimed.2020.113063 -
Fertility and Sterility Dec 2018Oocyte donation has played an increasingly important role in assisted reproductive technologies since the early 1980s. Over the past 30 years, unique legal standards... (Review)
Review
Oocyte donation has played an increasingly important role in assisted reproductive technologies since the early 1980s. Over the past 30 years, unique legal standards have evolved to address issues in the oocyte donation procedure itself as well as the disputes over issues, such as parentage, that inevitably arise with new technologies, particularly for individuals seeking to build nontraditional families. This essay will explore oocyte donation's legal aspects as well as seminal law concerning the procedure, including statutory law (uniform and model provisions and enacted state laws) and selected judicial opinions concerning surrogacy and parentage, testing of oocyte donors, mix-ups of donated oocytes, and donor compensation.
Topics: Compensation and Redress; Donor Conception; Female; Humans; Jurisprudence; Oocyte Donation; Parents; Pregnancy; Reproductive Techniques, Assisted; Surrogate Mothers; Tissue Donors
PubMed: 30503107
DOI: 10.1016/j.fertnstert.2018.08.041 -
Fertility and Sterility Nov 2018Intended parents engage with gestational carriers in an attempt to achieve their personal reproductive goals. All gestational carriers have a right to be fully informed... (Review)
Review
Intended parents engage with gestational carriers in an attempt to achieve their personal reproductive goals. All gestational carriers have a right to be fully informed of the risks as well as the contractual and legal aspects of the gestational-carrier process. Gestational carriers have autonomy in making their own decisions regarding medical care and should be free from undue influences by the stakeholders involved. They should have free access to and receive psychological evaluation and counseling before, during, and after participating. Gestational carriers require independent legal counsel regarding the execution of contracts. This document replaces the document of the same name, last published in 2013 (Fertil Steril 2013;99:1838-1841).
Topics: Ethics Committees; Female; Humans; Informed Consent; Pregnancy; Surrogate Mothers
PubMed: 30396538
DOI: 10.1016/j.fertnstert.2018.08.029 -
Journal of Assisted Reproduction and... Jun 2022Pregnancies conceived as contracted gestational carriers are a relatively new phenomenon for reproductive medicine. Since the intended parents control genetic screening...
OBJECTIVE
Pregnancies conceived as contracted gestational carriers are a relatively new phenomenon for reproductive medicine. Since the intended parents control genetic screening decisions, there may be differences in genetic decisions made for gestational carrier (GC) in vitro fertilization (IVF) pregnancies as compared to traditional non-gestational carrier IVF pregnancies. Our goal was to investigate the frequency and types of these genetic testing decisions.
METHODS
We performed a retrospective study of GC pregnancies counseled at a private maternal-fetal medicine practice between January 2006 and January 2021. Inclusion criteria were pregnancies that completed counseling with a certified genetic counselor and obtained high-resolution imaging. Controls were non-GC IVF pregnancies seen in the same period matched by parity, estimated delivery date (EDD), and the oocyte age utilized in conception. Statistical analysis included patient demographics, pre-implantation genetic testing (PGT-A) frequency and results, ultrasound imaging results, and the frequency with results of prenatal genetic screening (first or second-trimester serum screens), non-invasive prenatal testing (NIPT), or diagnostic testing (chorionic venous sampling (CVS) or amniocentesis).
RESULTS
One hundred and ninety one gestational carrier pregnancies were identified and 167 met inclusion criteria. Gestational carrier pregnancies were significantly more likely to pursue PGT-A, PGT-A with NIPT, first-trimester screening, and second-trimester screening. There were no differences in rates of amniocentesis or CVS over controls.
CONCLUSIONS
Regarding genetic counseling and screening options, our series is the first to demonstrate that gestational carrier parents seek additional genetic counseling resources, even with reassuring PGT-A and ultrasound.
Topics: Aneuploidy; Female; Fertilization in Vitro; Genetic Counseling; Genetic Testing; Humans; Pregnancy; Preimplantation Diagnosis; Retrospective Studies; Surrogate Mothers
PubMed: 35377088
DOI: 10.1007/s10815-022-02483-3 -
Journal of Medical Ethics Jun 2015
Topics: Advertising; Bioethical Issues; Clothing; Dietary Supplements; Disabled Persons; Health Care Sector; Humans; Kidney Transplantation; Morals; Physician's Role; Professional Competence; Sex Work; Social Perception; Social Responsibility; Socioeconomic Factors; Sports; Surrogate Mothers; United Kingdom
PubMed: 26002918
DOI: 10.1136/medethics-2015-102879 -
Developing World Bioethics Jun 2023This article examines the construction of parenthood, drawing on Brazilian cisgender, heterosexual, and homosexual couples' experiences in using assisted reproduction...
Assisted reproduction technologies and reproductive justice in the production of parenthood and origin: Uses and meanings of the co-produced gestation and the surrogacy in Brazil.
This article examines the construction of parenthood, drawing on Brazilian cisgender, heterosexual, and homosexual couples' experiences in using assisted reproduction technologies (ART), particularly the surrogacy. For that purpose, we interviewed: 1) a lesbian woman who had her daughter through her partner's pregnancy, using ART with anonymous donor semen; 2) a gay man who, together with his partner, used a surrogacy service under contract via a specialised offshore agency; 3) a woman who was a surrogate, in Brazil, for her sister-in-law and brother who lived abroad and, from abroad, sent an embryo fertilised for surrogacy; 4) a woman who resorted to her sister-in-law in order to be a mother by surrogacy, with ovules from the woman herself fertilised with semen from her husband; and 5) the sister-in-law mentioned in 4), who acted as surrogate for her brother and his wife. These interviews made it possible to think about the discursive construction of the legitimacy of such parenthoods, as it is produced by access to, and manipulation and circulation of, reproductive technologies and persons. This biomedical management of bodies sets up a material and discursive circuit that, in turn, produces a complex web of personal, normative, legal, professional and market relationships, particularly with a view to construction of a parenthood anchored in a notion of biologically-constituted origin. In this respect, biological, affective and social bonds merge to produce a precise placement of who is the father and/or who is the mother, as well as who are the important others and how they are linked to the child in a broader web of parenthood.
Topics: Male; Pregnancy; Female; Child; Humans; Brazil; Surrogate Mothers; Reproduction; Sexual and Gender Minorities; Reproductive Techniques, Assisted
PubMed: 35332999
DOI: 10.1111/dewb.12350 -
International Journal of Reproductive... Sep 2022The social and cultural challenges facing surrogate mothers have been explored in several studies. However, few studies have discussed the motivations of surrogate...
BACKGROUND
The social and cultural challenges facing surrogate mothers have been explored in several studies. However, few studies have discussed the motivations of surrogate mothers, their expressions and interpretations of their lived experiences, and their feelings of personal and spiritual satisfaction.
OBJECTIVE
This study aims to present the positive experiences of surrogate mothers from a phenomenological perspective.
MATERIALS AND METHODS
Using a phenomenological approach, this study was conducted from September 2020 to January 2021 in the city of Yazd, Iran. Participant observation and semi-structured interviews were used to collect the data among 12 participants with at least 1 experience of surrogate motherhood.
RESULTS
Our findings showed that, despite having had harsh physical and socio-cultural experiences such as fear of social labeling and stigma, participants felt a kind of inner satisfaction and a positive view of their actions. A core theme found in the study was mothers' satisfaction. The main categories included feminine self-sacrifice and positive rewards. Feminine self-sacrifice included 2 sub-categories: creating happiness and conveying motherly feelings, while positive rewards included good childbirth, family acceptance, and halal income.
CONCLUSION
This study showed that surrogate mothers experience conflicting feelings of inner satisfaction and social stigma during surrogacy. Some of those interviewed were willing to go through surrogacy again, but they feared social labeling and stigma, being misunderstood by others who are not fully informed about surrogacy, and being subjected to family and social disapproval.
PubMed: 36340669
DOI: 10.18502/ijrm.v20i9.12067 -
Fertility and Sterility Sep 2015Third-party reproduction has introduced a host of changing family constellations. Research has shown that children conceived through third-party reproduction are doing... (Review)
Review
Third-party reproduction has introduced a host of changing family constellations. Research has shown that children conceived through third-party reproduction are doing well psychologically and developmentally, but what about their parents? How have they coped with the transition to third-party reproduction? Has the experience impacted their marital stability or the quality of their parenting? This review will address parents of children conceived through oocyte donation, parents of children conceived through gestational surrogacy, and gay male parents of children conceived through oocyte donation and gestational surrogacy.
Topics: Adaptation, Psychological; Counseling; Donor Selection; Emotions; Female; Fertility; Humans; Infertility; Male; Mental Health; Oocyte Donation; Parent-Child Relations; Parents; Patient Care Team; Pregnancy; Reproductive Techniques, Assisted; Surrogate Mothers; Tissue Donors
PubMed: 26232745
DOI: 10.1016/j.fertnstert.2015.07.1128