The ‘Selfish Element’: How Sperm and Egg Donors Construct Plausibly Moral Accounts of the Decision to Donate

Multiple sociological studies have demonstrated how talk of ‘good’ motives enables people to maintain the presentation of a moral self in the context of stigmatised behaviours. Far fewer have examined why people sometimes describe acting for the ‘wrong reasons’ or choose to qualify, or reject, assumptions that they are motivated by a desire to ‘do good’. In this article, I analyse one such situation: sperm donors who describe being partially motivated by a ‘selfish’ desire to procreate, a motive which these same men frame as morally questionable. I argue that such accounts are explicable if we consider the (gendered) interactional and cultural contexts in which they are produced, particularly the way interactive contexts shape the desirability and achievability of plausibility and authenticity. I suggest that analysis of similar social phenomena can support sociologists in better understanding the complex ways in which moral practices are woven into social interactions.

P–563 Assessing ovarian age: Could we use leukocyte telomere length as a surrogate marker of cumulus cells telomere content?

Study question Is leukocyte telomere length (LTL) correlated with cumulus cells telomere length (CCTL) in an age-heterogeneous women population? Summary answer LTL showed a positive correlation with CCTL in the studied population. Hence, its potential value as indicator of ovarian age would deserve further evaluation. What is known already Progressive telomere shortening has been related to ovarian aging and genomic instability during early development. A positive correlation between short telomere length of the first polar body and aneuploidy rate has been reported. CCTL has shown to be a biomarker of oocyte and embryo quality, but its assessment is impractical. LTL has been proposed as a surrogate of TL of follicular cells, but telomere lengthening through folliculogenesis could be controlled by different mechanisms. Thus, we aimed to determine if LTL in an age-heterogeneous population is correlated with CCTL and therefore considered an accurate surrogate for telomere length in the ovary. Study design, size, duration In this prospective non-interventional cohort study, 35 egg donors and 17 women undergoing Preimplantation Genetic Testing for Aneuploidy (PGT-A) treatment were included during sixteen months. Following controlled ovarian stimulation determined by treating physicians, oocyte retrieval was performed 36 hours after final maturation induction. Cumulus cells (CC) for telomere length (TL) measurement were obtained after the pick-up and oocyte stripping. A blood sample was collected through peripheral venous access for LTL measurement. Participants/materials, setting, methods Genomic DNA of CC and leukocytes from the 52 subjects was isolated. Average delta cycle threshold (ΔCt) was determined using a SYBR green quantitative real-time PCR protocol for relative TL. For normalization of measurements, a Taqman assay for the multicopy gene Alu was performed. ΔCtL and ΔCtCC were compared by a paired t-test analysis and the fold change was calculated. Additionally, the association between them and patient age was analyzed by a Pearson correlation test. Main results and the role of chance Mean participant’s age was 29.94 ± 7.55 years and mean values for ΔCtL and ΔCtCC were 7.99 ± 0.53 and 7.46 ± 0.75, respectively. A positive significant correlation was found between age and ΔCt (ΔCtL: R2=0.71, p-value=5.18e–09; ΔCtCC: R2=0.47, p-value=0.00049). Since ΔCt values are inversely proportional to the amount of nucleic acids amplified and, therefore, to the telomere length, this correlation means that TL in both cell types decreases as women age. Additionally, ΔCtL was significantly higher than ΔCtCC (ΔCt fold change: 0.93, p-value=9e–07), meaning that CC showed significantly longer telomeres than leukocytes, thus supporting our previous published results in young egg donors. When analyzing the ΔCtL and ΔCtCC in these age-heterogeneous sample, a positive moderate and significant correlation was observed (R2=0.42, p-value=0.002). Thus, LTL could be suggested as a potential indicator of CCTL and therefore as a candidate for a biological marker of ovarian aging. Limitations, reasons for caution The sample size of this study was moderate and perhaps increasing the number of subjects might give additional strength to our findings. In addition, although relative telomere length allowed for adequate comparison between subjects, this method did not allow for absolute TL measurement. Wider implications of the findings: While reproductive implications of LTL measurement need to be further studied, our results support the potential usefulness of LTL measurement as an indicator of CCTL and ovarian aging when analyzing an age-heterogeneous population. Further, our findings suggest that CC could possess different mechanisms to cope against telomere length shortening. Trial registration number Not applicable

O-097 The presentation of medical risks and incentives in egg donation: an analysis of Belgian, Spanish and UK fertility clinic websites

Study question How do fertility clinics’ websites of the UK, Belgium and Spain present the medical risks of egg donation and incentives? Summary answer Spanish and UK websites typically included more incentives to recruit egg donors compared to the Belgian websites. OHSS was overall the most discussed risk. What is known already People commonly turn to the internet for initial information. Primary presentations of information of a subject co-determine how an individual interprets the topic and thus influence later decisions. Considering the growing demand and clinics’ dependency on egg donors, some scholars have expressed concerns that clinics might (initially) misrepresent risks to recruit more egg donors. Offering appealing incentives may also encourage potential donors to dismiss possible risks and side-effects. Therefore, it is important to see how incentives (both monetary and non-monetary rewards) and risks are presented on the websites of fertility clinics, the first source of information for egg donors. Study design, size, duration This study is part of the EDNA-project, a multi-phased comparative study (2017-2021), that aims to explore the social, political, economic and moral configuration of egg donation in the United Kingdom, Belgium and Spain. In this study, we only focused on the medical risks of egg donation and incentives presented on the fertility clinics’ websites of the three countries. Participants/materials, setting, methods We analysed the websites of all Belgian fertility clinics (n = 18), and a maximum variation sample in the UK (n = 21) and Spain (n = 23). The sampling was based on the geographical location of the clinic, size/number of cycles performed each year, the clinic’s status (independent or part of a larger clinical group) and whether the clinic was public or privately funded in the UK. Frame analysis and content analysis were used for analysis in Nvivo12. Main results and the role of chance No misrepresentation of risks was found. There was an extensive variety in the representation of risks. There were differences between the websites of the three countries (e.g. the risks of having acne was only discussed on Spanish websites), but also remarkable differences within the websites of a particular country (of the 40 risks, 13 were one-off mentions, each found on a single website). A description of a risk was generally accompanied by a minimization or normalization of the risk, or a statement about the fertility clinic’s excellent care for their egg donors. These three approaches were often combined. Our analysis differentiated between incentives (i.e. external rewards) and emotional appeals. An appeal to emotions (e.g. empathy) can also motivate behavioural action (e.g. donation) but was not considered as an incentive since there is no external reward. While Belgian websites used almost no incentives, Spanish and UK websites used gratitude and a rewarding experience as incentives. However, only Spanish websites used free medical tests as incentives, while UK websites were the only ones that used discounts received with egg sharing as an incentive. All countries’ websites used emotional appeals by enticing feelings of empathy for the recipients. Limitations, reasons for caution Not all UK and Spanish fertility clinics’ websites were analysed. However, our international team of researchers applied a maximum variation sampling strategy. This generated samples of clinics per country that were as diversified as possible. Wider implications of the findings The study shows that incentives are more often used on the UK and Spanish websites than on the Belgian websites. All three countries’ websites used emotional appeals. It should be studied how effective these incentives and emotional appeals are, and if there is a correlation with the potential donors’ risk-perceptions. Trial registration number not applicable

Psychological and Societal Impacts of Unknown Descent and The Islamic Objective of Nasab. A Preliminary Study of Chosen Biomedical Technologies

This paper is a preliminary study on the expected implications of some chosen biomedical developments on the loss of descent (nasab), its psychological effects on children and parents, and sociological effects generally. In the first part, this paper elaborates the meaning and importance of nasab (descent) in Islamic law, under consideration of the Higher Objectives of Shari’a, and explanation of some related legal rules. The second part investigates psychological impacts of unknown descent and reviews existing research in the field. The third and final part, presents five chosen scenarios i) human cloning through somatic cell nuclear transfer (SCNT); ii) surrogate motherhood; iii) IVF with sperm or egg donors; iv) anonymous milk banks; and v) mitochondria (mt) transplantation; in the light of the Islamic objective of nasab, its existence or non-existence, and possible consequences.