The role of anticipated decision regret and the patient's best interest in sterilisation and medically assisted reproduction

2016 ◽  
Vol 43 (5) ◽  
pp. 314-318 ◽  
Author(s):  
Heidi Mertes
2019 ◽  
Vol 15 (1) ◽  
pp. 101-109 ◽  
Author(s):  
Andrea Pozza ◽  
Davide Dèttore ◽  
Maria Elisabetta Coccia

Background: Depressive and anxious symptoms are common psychological reactions to infertility and Medically Assisted Reproduction (MAR). No study compared depressive and anxious symptoms and infertility stress dimensions across homologous and heterologous MAR, nor explored the specific role of the infertility stress dimensions in the two pathways. Homologous MAR may be associated with higher distress as the couple feel that the responsibility to reproduce and carry on the family line falls on them, and they feel inadequate if they are unable to bear children. Objective: We compared depressive/anxious symptoms and infertility stress dimensions between individuals undergoing homologous and heterologous MAR. We also explored the association between the infertility stress dimensions and depressive/anxious symptoms separately in two MAR pathways. Methods: Two-hundred twenty-six individuals participated [mean age = 39.71 years; 54.45% women]: 118 (52.2%) in homologous and 108 (47.8%) in heterologous MAR. The Fertility Problem Inventory, Beck Depression Inventory-II, and State and Trait Anxiety Inventory-Y form were administered. Results: Individuals in homologous MAR had higher depressive/state-trait anxious symptoms, general infertility stress, and infertility-related sexual concerns than those in heterologous MAR. In homologous MAR, social and sexual concerns were associated with depressive/trait anxious symptoms while gender had no effect. In heterologous MAR, male gender was associated with lower state anxious symptoms while infertility stress dimensions had no effect. Conclusion: Individuals in homologous MAR are a more distressed subgroup which requires a tailored supportive psychological intervention specifically on sexual and social concerns.


2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Nathalie Vermeulen ◽  
◽  
Eduard Hambartsoumian ◽  
Kazem Nouri ◽  
Thomas Ebner ◽  
...  

Abstract STUDY QUESTION How did coronavirus disease 2019 (COVID-19) impact on medically assisted reproduction (MAR) services in Europe during the COVID-19 pandemic (March to May 2020)? SUMMARY ANSWER MAR services, and hence treatments for infertile couples, were stopped in most European countries for a mean of 7 weeks. WHAT IS KNOWN ALREADY With the outbreak of COVID-19 in Europe, non-urgent medical care was reduced by local authorities to preserve health resources and maintain social distancing. Furthermore, ESHRE and other societies recommended to postpone ART pregnancies as of 14 March 2020. STUDY DESIGN, SIZE, DURATION A structured questionnaire was distributed in April among the ESHRE Committee of National Representatives, followed by further information collection through email. PARTICIPANTS/MATERIALS, SETTING, METHODS The information was collected through the questionnaire and afterwards summarised and aligned with data from the European Centre for Disease Control on the number of COVID-19 cases per country. MAIN RESULTS AND THE ROLE OF CHANCE By aligning the data for each country with respective epidemiological data, we show a large variation in the time and the phase in the epidemic in the curve when MAR/ART treatments were suspended and restarted. Similarly, the duration of interruption varied. Fertility preservation treatments and patient supportive care for patients remained available during the pandemic. LARGE SCALE DATA N/A LIMITATIONS, REASONS FOR CAUTION Data collection was prone to misinterpretation of the questions and replies, and required further follow-up to check the accuracy. Some representatives reported that they, themselves, were not always aware of the situation throughout the country or reported difficulties with providing single generalised replies, for instance when there were regional differences within their country. WIDER IMPLICATIONS OF THE FINDINGS The current article provides a basis for further research of the different strategies developed in response to the COVID-19 crisis. Such conclusions will be invaluable for health authorities and healthcare professionals with respect to future similar situations. STUDY FUNDING/COMPETING INTEREST(S) There was no funding for the study, apart from technical support from ESHRE. The authors had no COI to disclose.


2019 ◽  
Vol 39 (4) ◽  
pp. 649-657
Author(s):  
Parnaz Borjian Boroujeni ◽  
Somayeh Ebrahimian ◽  
Maryam Abedini ◽  
Maral Rostami Chayjan ◽  
Mahdye Hassani ◽  
...  

Author(s):  
Judith Daar

The need for infertility treatment brings professionals into reproductive decisions that are important private matters for patients. In medically assisted reproduction, providers are brought into roles traditionally regarded as occupied only by nature and into a position to determine which embryos are suitable for transfer in the effort to achieve pregnancy. These powers of judgment present ethical challenges for professionals providing assisted reproduction services. Among these challenges is the potential conflictual involvement of multiple patients in the process: intended parents, gamete donors, and gestational surrogates. Other challenges include the obligation to avoid discrimination in selecting embryos for transfer or in making decisions about which patients to serve. Providers must be informed by ethical discussions such as the ethics opinions of the American Society for Reproductive Medicine. Important ethical considerations include respect for patient choice, the best interests of offspring, nondiscrimination, and social justice.


2021 ◽  
Vol 3 (1) ◽  
pp. 123-132
Author(s):  
Itziar Alkorta

Europe accounts for the largest number of assisted reproduction treatments (ARTs) in the world, with 56 percent of the global reproductive market quota, followed by Asia (23 percent) and North America (15 percent). However, Europe’s legal landscape of reproductive bio-commodities is a patchwork of permissive and restrictive countries, one of the main reasons for the transnational movement to access ARTs. Spain is the main destination for European middle- and upper-class couples seeking egg donation. The use of legislation has been a significant feature in making Spain a leading country in the global reproscape. This paper aims to understand the specific role of several undetermined legal concepts used by the Spanish regulation, such as “compensation” or “best interest of the child” in making global reproductive bio-commodities.  


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