scholarly journals ‘I feel that injustice is being done to me’: a qualitative study of women’s viewpoints on the (lack of) reimbursement for social egg freezing

2021 ◽  
Author(s):  
Michiel De Proost ◽  
Gily Coene ◽  
Julie Nekkebroeck ◽  
Veerle Provoost
Keyword(s):  
Qualitative Study ◽  
Lived Experience ◽  
Common Denominator ◽  
Age Related ◽  
Elective Treatment ◽  
Freezing Cycle ◽  
Public Responsibility ◽  
The Cost ◽  
Egg Freezing ◽  
Social Egg Freezing

Abstract Background During the last decade, the possibility for women to cryopreserve oocytes in anticipation of age-related fertility loss, also referred to as social egg freezing, has become an established practice at fertility clinics around the globe. In Europe, there is extensive variation in the costs for this procedure, with the common denominator that there are almost no funding arrangements or reimbursement policies. This is the first qualitative study that specifically explores viewpoints on the (lack of) reimbursement for women who had considered to uptake at least one social egg freezing cycle in Belgium. Methods To understand the moral considerations of these women, drawing from twenty-one interviews, this paper integrates elements of a symbiotic empirical ethics approach and thematic analysis. Results We identify three themes: (1) From ongoing concern to non-issue; (2) Negotiating the reimbursement for social egg freezing; (3) From fully out-of-pocket to (partial) free good. In the first theme, we found that some women were concerned about the cost of social egg freezing and the lack of clear information about it. Furthermore, they reported moral sentiments of injustice which they attributed to their lack of acknowledgement for their struggles and needs. Other women perceived the reimbursement controversy of social egg freezing as something far removed from their lived experience. The second theme illustrates diverse views on reimbursement, ranging from viewing social egg freezing as an elective treatment unbefitting reimbursement to preferences for greater public responsibility and wider access. Finally, we describe the participants’ varying proposals for partial reimbursement and the idea that it should not be made available for free. Conclusions This research adds important empirical insights to the bioethics debate on social egg freezing, in particular by presenting (potential) users’ views on the lack of reimbursement. Based on our results, it seems an oversimplification to portray social egg freezers as merely affluent women who are not concerned about the coverage of egg freezing costs. While there is much more to say about the ethical and political complexities of the reimbursement of this procedure, our study highlighted the voices of (potential) users and showed that at least some of them express a preference or a need for reimbursement.

scholarly journals ‘At least I have done something’: A qualitative study of women's social egg freezing experiences

2021 ◽  
pp. 147775092110572
Author(s):  
Michiel De Proost ◽  
Gily Coene ◽  
Julie Nekkebroeck ◽  
Veerle Provoost
Keyword(s):  
Qualitative Study ◽  
Individual Responsibility ◽  
Empirical Literature ◽  
Peace Of Mind ◽  
Context Sensitive ◽  
Ethical Debate ◽  
Starting Point ◽  
Freezing Cycle ◽  
Egg Freezing ◽  
Social Egg Freezing

Social egg freezing has become an expanding clinical practice and there is a growing body of empirical literature on women's attitudes and the sociocultural implications of this phenomenon. Yet, its impact remains subject to ethical controversy. This article reports on a qualitative study, drawing on 18 interviews with women who had elected to initiate at least one egg freezing cycle in Belgium. Our findings, facilitated by a ‘symbiotic empirical ethics’ approach, shed light on the concerns and perceptions that accompany women's decisions while supporting a more context-sensitive reading of the ethical debate. We identified three key themes: feeling overwhelmed with uncertainty and a threatening future, bodily discomfort and distress during the medical process, and the endless pursuit of peace of mind. One of the issues that emerges from these findings is the risk ritual function of social egg freezing, referring to routine actions of risk anticipation that mitigate uncertainty and express a sense of individual responsibility. While more research is needed, this conceptualisation provides a starting point to flesh out the wider context of this moral practice and its symbolic meaning for women.

scholarly journals Social egg freezing under public health perspective: Just a medical reality or a women’s right? An ethical case analysis

2018 ◽  
Author(s):  
Ana Borovecki ◽  
Pamela Tozzo ◽  
Nicoletta Cerri ◽  
Luciana Caenazzo
Keyword(s):  
Public Health ◽  
Point Of View ◽  
Reproductive Age ◽  
Public Healthcare ◽  
Proper Solution ◽  
Public Health Perspective ◽  
Age Related ◽  
The Impact ◽  
Egg Freezing ◽  
Social Egg Freezing

In recent years, a social trend toward delaying childbearing has been observed in women of reproductive age. A novel technomedical innovation was commercialized for non-medical reasons to healthy, ostensibly fertile women, who wished to postpone motherhood for various reasons such as educational or career demands, or because they had not yet found a partner. As a consequence, these women may be affected by age-related infertility when they decide to conceive, and fertility preservation techniques can be obtained through the so-called social egg freezing. This paper examines, from an ethical point of view, the impact of social egg freezing under some aspects that can involve policy making and resources allocation in public health. Due to the increasing demand for this procedure, some debated issues regard if it is reasonable to include social egg freezing in Public Healthcare System and consequently how to manage the storage of cryopreserved oocytes also from individual donors, how to support these egg banks and how to face, in the future, with the possibility that egg freezing will play a role in enabling childbearing for gays, lesbians, and unmarried persons. Social freezing may be advertised to harmonise gender differences, but we wonder if it is the proper solution to the problem or if it could also create further challenges. An ethical argumentation on these topics should address some questions that will be discussed.

scholarly journals Case Report: Successful delivery in a 44-year-old woman using vitrified human oocytes taken from the woman at 41 years of age

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 862
Author(s):  
Miyako Funabiki ◽  
Yoshitaka Nakamura ◽  
Sagiri Taguchi
Keyword(s):  
Decision Making ◽  
Case Report ◽  
Female Infant ◽  
Decision Making Process ◽  
Apgar Scores ◽  
Live Births ◽  
The Cost ◽  
Over 40 Years ◽  
Egg Freezing ◽  
Social Egg Freezing

Successful pregnancies and deliveries are rare in women over 40 years of age. To date, no case report has been published about a successful delivery in a woman over 40 years of age using vitrified oocytes obtained through social egg freezing from a woman over 40 years of age. Here we report a case of a successful live birth from a 44-year-old woman using vitrified oocytes taken from the woman at 41 years of age; the patient used the technique for social reasons. The 44-year-old patient delivered a 2534 g female infant by Caesarean section in the 37th week of pregnancy. The female infant’s Apgar scores were 9 at 1 min and 9 at 5 min. The female infant exhibited no anomalies and is developing normally under the close surveillance of pediatricians.However, the concept of social egg freezing has medical, ethical and social problems. Furthermore, the rate of live births differs among clinics and/or hospitals due to variations in the vitrification and warming techniques used. Therefore, information from individual clinics and/or hospitals about the risks, the rates of successful live births and the cost of social egg freezing should be provided to patients to aid in the patient’s decision-making process.

scholarly journals Social Freezing: Pressing Pause on Fertility

2021 ◽  
Vol 18 (15) ◽  
pp. 8088
Author(s):  
Valentin Nicolae Varlas ◽  
Roxana Georgiana Bors ◽  
Dragos Albu ◽  
Ovidiu Nicolae Penes ◽  
Bogdana Adriana Nasui ◽  
...  
Keyword(s):  
Ovarian Tissue ◽  
Oocyte Cryopreservation ◽  
Ovarian Tissue Cryopreservation ◽  
Oocyte Vitrification ◽  
Fertility Treatments ◽  
Age Related ◽  
Optimal Approach ◽  
Tissue Cryopreservation ◽  
Egg Freezing ◽  
Social Egg Freezing

Increasing numbers of women are undergoing oocyte or tissue cryopreservation for medical or social reasons to increase their chances of having genetic children. Social egg freezing (SEF) allows women to preserve their fertility in anticipation of age-related fertility decline and ineffective fertility treatments at older ages. The purpose of this study was to summarize recent findings focusing on the challenges of elective egg freezing. We performed a systematic literature review on social egg freezing published during the last ten years. From the systematically screened literature, we identified and analyzed five main topics of interest during the last decade: (a) different fertility preservation techniques, (b) safety of freezing, (c) usage rate of frozen oocytes, (d) ethical considerations, and (e) cost-effectiveness of SEF. Fertility can be preserved for non-medical reasons through oocyte, embryos, or ovarian tissue cryopreservation, with oocyte vitrification being a new and optimal approach. Elective oocyte cryopreservation is better accepted, supports social gender equality, and enhances women’s reproductive autonomy. Despite controversies, planned oocyte cryopreservation appears as a chosen strategy against age-related infertility and may allow women to feel that they are more socially, psychologically, and financially stable before motherhood.

‘I Suppose I Think to Myself, That's the Best Way to Be a Mother’: How Ideologies of Parenthood Shape Women's Use of Social Egg Freezing Technology

2017 ◽  
Vol 22 (2) ◽  
pp. 20-34 ◽  
Author(s):  
Kylie Baldwin
Keyword(s):  
Age Distribution ◽  
Older Age ◽  
Media Representations ◽  
Age Related ◽  
Increased Risk ◽  
Mother And Child ◽  
Experiences Of Women ◽  
Pregnancy And Birth ◽  
Egg Freezing ◽  
Social Egg Freezing

The age distribution of women giving birth in England and Wales, as well as many other Western countries, has changed significantly in recent decades with growing numbers of women having children later in their reproductive lives. However, motherhood at an older age is positively associated with greater risks to mother and child including complications during pregnancy and birth as well as an increased risk of age-related infertility. In response to the increasing numbers of women attempting childbearing at an older age, a new form of technology has emerged, one which has the promissory potential to enable women to preserve a number of healthy young eggs for potential future use after the decline of their nature fertility. This technology is egg freezing, or as it is often referred, egg freezing for social reasons. This paper will examine the technology of egg freezing and its use for social reasons and will argue that current lay and media representations of this technology which infer a deliberative ‘choice’ on behalf of the user to delay motherhood, to pursue career advancement, does not adequately or accurately reflect the experiences of women engaging with this technology. Instead, and by drawing on data collected in 31 interviews with female users of this technology, this paper will suggest that women's decision to engage in egg freezing as well as their perceptions about the timing of motherhood can be seen as being shaped by contemporary parenting culture and ideologies of parenthood. Furthermore, this paper will examine how these ideologies and expectations about parenthood are shaped by the demographic profile of the users of this technology.

scholarly journals Patients’ views about screening for atrial fibrillation (AF): a qualitative study in primary care

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e033061
Author(s):  
Mark Lown ◽  
Christopher R Wilcox ◽  
Stephanie Hughes ◽  
Miriam Santer ◽  
George Lewith ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Qualitative Study ◽  
Decision Aids ◽  
Care Practice ◽  
Semistructured Interview ◽  
Interview Guide ◽  
Registration Number ◽  
The Cost ◽  
Inductive Thematic Analysis

ObjectivesThere has been increased interest in screening for atrial fibrillation (AF) with commissioned pilot schemes, ongoing large clinical trials and the emergence of inexpensive consumer single-lead ECG devices that can be used to detect AF. This qualitative study aimed to explore patients’ views and understanding of AF and AF screening to determine acceptability and inform future recommendations.SettingA single primary care practice in Hampshire, UK.Participants15 participants (11 female) were interviewed from primary care who had taken part in an AF screening trial. A semistructured interview guide was used flexibly to enable the interviewer to explore any relevant topics raised by the participants. Interviews were recorded, transcribed verbatim and analysed using inductive thematic analysis.ResultsParticipants generally had an incomplete understanding of AF and conflated it with other heart problems or with raised blood pressure. With regards to potential drawbacks from screening, some participants considered anxiety and the cost of implementation, but none acknowledged potential harms associated with screening such as side effects of anticoagulation treatment or the risk of further investigations. The screening was generally well accepted, and participants were generally in favour of engaging with prolonged screening.ConclusionsOur study highlights that there may be poor understanding (of both the nature of AF and potential negatives of screening) among patients who have been screened for AF. Further work is required to determine if resources including decision aids can address this important knowledge gap and improve clinical informed consent for AF screening.Trial registration numberISRCTN 17495003.

scholarly journals Long COVID and the role of physical activity: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e047632
Author(s):  
Helen Humphreys ◽  
Laura Kilby ◽  
Nik Kudiersky ◽  
Robert Copeland
Keyword(s):  
Physical Activity ◽  
Qualitative Study ◽  
Lived Experience ◽  
Well Being ◽  
Telephone Interviews ◽  
Semistructured Interviews ◽  
The Usa ◽  
The Uk ◽  
Insight Into

ObjectivesTo explore the lived experience of long COVID with particular focus on the role of physical activity.DesignQualitative study using semistructured interviews.Participants18 people living with long COVID (9 men, 9 women; aged between 18–74 years; 10 white British, 3 white Other, 3 Asian, 1 black, 1 mixed ethnicity) recruited via a UK-based research interest database for people with long COVID.SettingTelephone interviews with 17 participants living in the UK and 1 participant living in the USA.ResultsFour themes were generated. Theme 1 describes how participants struggled with drastically reduced physical function, compounded by the cognitive and psychological effects of long COVID. Theme 2 highlights challenges associated with finding and interpreting advice about physical activity that was appropriately tailored. Theme 3 describes individual approaches to managing symptoms including fatigue and ‘brain fog’ while trying to resume and maintain activities of daily living and other forms of exercise. Theme 4 illustrates the battle with self-concept to accept reduced function (even temporarily) and the fear of permanent reduction in physical and cognitive ability.ConclusionsThis study provides insight into the challenges of managing physical activity alongside the extended symptoms associated with long COVID. Findings highlight the need for greater clarity and tailoring of physical activity-related advice for people with long COVID and improved support to resume activities important to individual well-being.

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