Hope and anxiety: The study of female embodied experience with assisted reproductive technology

2021 ◽  
Vol 7 (2) ◽  
pp. 138-170
Author(s):  
Chengpu Yu ◽  
Wanlin Li ◽  
Mingfen Deng

Assisted reproductive technology (ART) is hailed as “the holy grail” for infertile patients in the mainstream narrative. The existing studies have clearly demonstrated how external social factors shape how ART is to be used, but they ignore the recipients of the technologies, and especially the experiences of women. Based on an investigation conducted in Z hospital’s reproductive center, this article regards embodiment as the methodological orientation for integrating socio-cultural context with female embodied experience in order to show their bio-social entanglement. As fieldwork evidence indicates, ART in practice is far from simple “hope technology”; instead, it throws women into a paradoxical world in which hope and anxiety coexist. Embodied experience, hope, and anxiety are transmitted through the bodies of women, which reveals the inscription of social-cultural context and technical uncertainty on the female body and, meanwhile, women actively learn strategies by which to cope with the technical uncertainty and moral pressures from local culture (including healing the body, folk religion, etc.), so as to hold onto infertility treatment with hope.

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 76-79
Author(s):  
Anastasia G Syrkasheva ◽  
Yana A Petrosyan ◽  
Natalia V Dolgushina

Background. Luteal phase (LP) drug support is an important step in assisted reproductive technology (ART) programs efficacy. Aim. To present up-to-date data on an efficacy of LP hormonal support during ART cycles as well as to conduct a comparative analysis of various gestagen drug effectiveness. Materials and methods. To write this review domestic and foreign publications were searched in Russian and international search systems (PubMed, eLibrary, etc.) for the last 8 years. The review includs articles from peer-reviewed literature. Results. LP drug support becomes an essential step in infertility treatment in various ART programs. Although human chorionic gonadotropin drug injections in the posttransfer period leads to an activation of endogenous steroid hormones synthesis, exogenous hormones use is currently preferred because of not having a risk of ovarian hyperstimulation syndrome. Conclusions. The variety of progesterone drugs is accompanied by a lack of algorithms for their use in various clinical situations. Further studies are required to evaluate progesterone drugs efficacy for various subgroups of patients.


2014 ◽  
Vol 5 (2) ◽  
pp. 44-57
Author(s):  
Rochelle Heroina Gracias ◽  
Louis Fessy Thalakottoor ◽  
Parasuram Gopinath ◽  
Gopinathan Kannoly Karunakaran

ABSTRACT Background About 15% of all couples are infertile and require fertility treatment. With constantly improving clinical and laboratory procedures, pregnancy rates of about 30% per transfer are routinely reported. In non-donor-oocyte cycles, the percentage of in vitro fertilization/intracytoplasmic sperm injection (IVF/ ICSI) cycles that result in pregnancy ranges from 18 to 45%, depending on several factors (Society for Assisted Reproductive Technology 2009). But a patients concern is about the success rate—‘What is my chance of getting pregnant’? For the success in IVF/ICSI—embryo transfer cycle there are many variables thought to be directly related to the implantation and successful outcome. Aims and objectives To identify independent predictors ICSI outcome. To make a composite predictive scoring system— For patient selection and counseling for assisted reproductive technology (ART). That may prove critical in counseling poor prognosis patients, about their prognosis or against IVF treatment (e.g. patients with least benefits in undergoing IVF can opt for donor oocytes/surrogacy, etc. without wasting a cycle in trial and error). Optimizing treatment by developing more customized individually tailored treatment plan with consideration to predictive factors. Study design The research was approved by the institutional review board. A retrospective ongoing study was performed, over a period of 3 years at a well established infertility institution. A sample size of 1020 patients was considered from two hospitals of the same institution. The patients were stimulated by different protocols specific to each patients age, AFC, etc [Polycystic ovarian syndrome (PCOS) patients showing hyperresponse in follicular study-antagonist protocol]; though a majority underwent long agonist protocol. They were evaluated and the outcome was assessed through logistic regression analysis. Several variables were taken into consideration—to name a few; age, previous pregnancy outcome, previous ART treatment if any, E2/LH/P4 [baseline values and on the day of human chorionic gonadotropin (hCG)], etc. A preferential scoring was derived to obtain a predictive scoring for pregnancy outcome. Results A pregnancy predicting scoring was arrived at. On considering several variables, the cut off score represented a 50% success rate of IVF/ICSI cycle. Conclusion Bearing in mind that fertility is independent of hospital protocols and primarily dependent on the individual woman, the derived predictive scoring can be applied to individual cohort of patients under infertility treatment and has excellent discrimination ability for assessing the likelihood of pregnancy outcome. Application of this scoring will allow individualized treatment decision-making for patients under infertility treatment. How to cite this article Gracias RH, Thalakottoor LF, Gopinath P, Karunakaran GK. Fertility Scoring Index: Cimar's Novel System to Predict Assisted Reproductive Technology Success. Int J Infertil Fetal Med 2014;5(2):44-57.


2018 ◽  
Author(s):  
Jessica R Zolton ◽  
Rhea Chattopadhyay ◽  
Alan H. DeCherney

Assisted reproductive technology (ART) encompasses all procedures that manipulate the oocytes, sperm, and embryos outside of the body. Decades of research have allowed the field to emerge as a reliable and safe treatment for infertile men and women. Indications for in vitro fertilization (IVF) include tubal factor infertility, anovulation, male factor infertility, and decreased ovarian reserve. Treatment is not limited to the infertile population, as IVF with preimplantation genetic diagnosis also offers patients an opportunity to prevent transmission of a genetic condition for which they have been found to carry. The field of ART continues to rapidly evolve, as more knowledge is gained from studies reporting on ovarian stimulation protocols, reproductive techniques such as intracytoplasmic sperm injection, and blastocyst transfer. Techniques are aimed to improve live birth rates while ensuring the optimal health of children conceived using IVF. This review contains 8 figures, 5 tables and 63 references Key Words: assisted reproductive technology, blastocyst, decreased ovarian reserve, embryo transfer, gonadotropin-releasing hormone agonist, gonadotropin-releasing hormone antagonist, intracytoplasmic sperm injection, luteal phase support, ovarian hyperstimulation syndrome, vitrification


2020 ◽  
Vol 69 (4) ◽  
pp. 83-88
Author(s):  
Svetlana S. Paskar ◽  
Alla S. Kalugina ◽  
Anna G. Tkachuk

The expansion of indications for assisted reproductive technology has led to significant implications for assisted reproductive technology (ART) programs worldwide. More than 7 million children in the world were born using ART. Modern clinical practice in the field of reproductive sciences is aimed not only at increasing the effectiveness, but also at the safety of treatment. ART, like any other type of therapy, may be combined with negative side effects. Both the correct prediction of the risks associated with treatment and a personalized approach ensure the absolute safety of infertility treatment using in vitro fertilization. In this regard, over the past decade, a number of new research approaches have been noted that use ART methods integrated into clinical practice: cycle segmentation with subsequent embryo transfer and the elective transfer of one embryo. New approaches provide a control in relation to ovarian stimulation and a reduction in the number of transferred embryos, which helps to minimize primarily adverse perinatal outcomes. Predicting the risks and outcomes of treatment using mathematical modeling is the application of good clinical practice.


2003 ◽  
Vol 31 (2) ◽  
pp. 272-282 ◽  
Author(s):  
Carson Strong

Assisted reproductive technology has enabled thousands of infertile couples to experience the joys of parenthood. At various times, however, significant problems have come to light concerning the providing of infertility treatment in the United States. An early problem was misleading advertising by some infertility programs, particularly in regard to pregnancy success rates. This unacceptable activity suggested the need for more oversight of assisted reproductive technology and prompted the passage of a federal law requiring the reporting of success rates in a standardized format. Another problem, one that was especially disturbing, was the transfer of preembryos to infertile women at the University of California, Irvine, without the consent of the progenitor couples. Disclosure of these events added fuel to the debate over whether assisted reproductive technology should be subject to greater governmental regulation.


2020 ◽  
pp. oemed-2020-106745
Author(s):  
Yuya Imai ◽  
Motoki Endo ◽  
Keiji Kuroda ◽  
Kiyohide Tomooka ◽  
Yuko Ikemoto ◽  
...  

ObjectiveTo elucidate the risk factors associated with resignation from work of Japanese women undergoing infertility treatment.MethodsA total of 1727 female patients who attended a private fertility clinic in Japan participated in the Japan-Female Employment and Mental health in Assisted reproductive technology study. Questions related to demographic, clinical and socioeconomic characteristics were employed in the questionnaire. Out of the 1727 patients, 1075 patients who were working at the time of initiating infertility treatment and felt infertility treatment incompatible with work were included in the analysis. Risk factors for resignation were assessed by using multivariable logistic regression models.ResultsAmong 1075 working women who started infertility treatment, 179 (16.7%) subsequently resigned. Multivariable-adjusted ORs for resignation in those with lower educational background and infertility for ≥2 years were 1.58 (95% CI: 1.07 to 2.34) and 1.82 (95% CI: 1.15 to 2.89), respectively. The OR for resignation in non-permanent workers undergoing infertility treatment was 2.65 (95% CI: 1.61 to 4.37). While experiencing harassment in the workplace approached significance, lack of support from the company was significantly associated with resignation after starting infertility treatment, with ORs of 1.71 (95% CI: 0.98 to 2.99) and 1.91 (95% CI: 1.28 to 2.86), respectively.ConclusionOne-sixth of women resigned after starting infertility treatments. It was found that factors related to education, infertility duration and work environment were significantly associated with resignation. Reducing the physical and psychological burden endured by women, for example, by increasing employer-provided support, is vitally important in balancing infertility treatment with maintenance of work life.


2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Mei-Zen Huang ◽  
Yi-Chin Sun ◽  
Meei-Ling Gau ◽  
Shuby Puthussery ◽  
Chien-Huei Kao

Abstract Background Foetal reduction—removal of one or more foetuses to reduce the number of foetuses in multiple conceptions—is a procedure used for improving pregnancy outcomes following assisted reproductive technology (ART) treatment. While there is a recognition of the importance of understanding the experiences of women who undergo foetal reduction to offer appropriate help and support, studies that provide relevant insights are sparse. Our aim was to gain an in-depth understanding about first-time mothers’ experiences of foetal reduction following ART treatment in Taiwan. Methods We adopted a qualitative design based on a phenomenological approach for this study. In-depth semi-structured interviews were conducted with seven first-time mothers who underwent foetal reduction following ART treatment at a fertility centre in Taipei, Taiwan. All interviews were recorded, transcribed and analysed using the Colaizzi strategy. Results The views and experiences relating to foetal reduction reflected five key themes: hesitation, ambivalence and distress; the guilt of knowingly terminating a life; rituals and ceremonies to ease the sense of guilt; persuading oneself to consider the ‘big picture’; and wishing for a reunion in next pregnancy. Mothers often regretted that they took clinical advice to implant multiple embryos and then having had to resort to foetal reduction. There was a sense of hesitation, ambivalence and distress reflected in the views from all participants. They believed that they ended the fetuses’ lives knowingly and expressed strong feelings of guilt. Mothers often tried to persuade themselves to look at foetal reduction within the ‘big picture’ of the overall pregnancy outcome. Losing their unborn babies was as an unforgettable incident for most mothers, and they wished for a reunion with the lost baby in the next pregnancy. Conclusion Findings indicate the need for ART providers to undertake a more sensitive approach that involves detailed discussions with women and their families to tailor the embryo transfer processes to suit individual needs. Women who undergo foetal reduction should be provided with tailored interventions towards enhancing their coping strategies before and after foetal reduction taking into account the cultural and religious context.


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