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Khosravi S, Kazemi A, Ahmadi SM. Emotions towards potential genetic offspring among oocyte donors: a cross-sectional study. Reprod Health 2021; 18:255. [PMID: 34930363 PMCID: PMC8691081 DOI: 10.1186/s12978-021-01311-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 12/14/2021] [Indexed: 11/24/2022] Open
Abstract
Background The presence of maternal emotions towards the offspring resulting from assisted reproductive techniques (ART) has been previously reported in oocyte donors. However, there is limited information about the presence of these emotions in oocyte donors during the ART process and before pregnancy. The aim of this study was to evaluate the emotions of oocyte donor women towards the potential genetic offspring and to compare them with women treated with ART by using own oocytes. Methods A cross-sectional study was conducted on 100 women who were divided into two groups of oocyte donors and those treated with ART and using autologous oocyte. At the time of oocyte retrieval. Using a validated questionnaire, the emotions toward potential offspring (EPO) resulting from ART and its three dimensions (including imagination, sense of ownership, and importance of treatment outcome) were measured and compared in two groups. Results Comparison of the EPO in the two groups showed that the emotions in all three dimensions were lower in oocyte donors than the other group (p < 0.001). Moreover, in oocyte donors, the mean score of the scale of the importance of treatment outcome dimension was higher than the other two scales (p < 0.001). Conclusion The results of the study showed that there is a significant emotion toward the potential offspring in oocyte donors. The presence of these emotions thus should be considered in formulating the ethical charter of ART by using oocyte donation. There is limited information about the presence of maternal emotions in egg donor women during the assisted reproductive techniques (ART) process and before pregnancy. The aim of this study was to evaluate these emotions of women towards the potential genetic offspring and to compare them with women treated with ART by using own oocytes. A cross-sectional study was conducted on 100 women who were divided into two groups of egg donor and those treated with ART and using autologous oocyte. At the time of oocyte retrieval and using a validated questionnaire, the emotions toward potential offspring (EPO) resulting from ART and its three dimensions (including imagination, sense of ownership, and importance of treatment outcome) were measured and compared in two groups. Out of 100 women. Comparison of the EPO in the two groups showed that the emotions in all three dimensions were lower in egg donors than the other group. Moreover, in egg donors, the mean score of the scale of the importance of treatment outcome dimension was higher than the other two scales. The results of the study showed that there is a significant emotion toward the potential offspring in oocyte donors. The presence of these emotions thus should be considered in formulating the ethical charter of ART by using oocyte donation.
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Affiliation(s)
- Sahar Khosravi
- Reproductive Health Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Kazemi
- Reproductive Health Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Hezarjerib AV, Isfahan, Iran.
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2
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Financial compensation of oocyte donors: an Ethics Committee opinion. Fertil Steril 2021; 116:319-325. [PMID: 33910756 DOI: 10.1016/j.fertnstert.2021.03.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 10/21/2022]
Abstract
Financial compensation of women donating oocytes for reproductive or research purposes is justified on ethical grounds and should acknowledge the time, inconvenience, and discomfort associated with screening, ovarian stimulation, oocyte retrieval, and postretrieval recovery and not vary according to the planned use of the oocytes or the number or quality of oocytes retrieved. This document replaces the document of the same name published in 2016.
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Affiliation(s)
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- American Society for Reproductive Medicine, Birmingham, Alabama
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3
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Tober D, Garibaldi C, Blair A, Baltzell K. Alignment between expectations and experiences of egg donors: what does it mean to be informed? REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2021; 12:1-13. [PMID: 33024845 PMCID: PMC7530253 DOI: 10.1016/j.rbms.2020.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 07/24/2020] [Accepted: 08/24/2020] [Indexed: 05/31/2023]
Abstract
This study evaluated the retrospective perceptions of egg donors regarding information communicated about immediate and long-term risks during the process of becoming an egg donor, and the alignment of that perception with their experiences and expectations of egg donation. Data were collected using an anonymous online survey. Egg donors' demographics, perceptions of being informed about immediate complications and long-term risks, and alignment between their expectations and experiences were analysed. In total, 375 current and former egg donors participated in an online survey about their decisions and experiences. Participants ranged in age from 18 to 57 years, with a median age of 24 years at first donation for compensated donors. The majority of the participants (81%) provided eggs in the USA, and 86.1% reported being compensated beyond direct reimbursement. Overall, 66% of egg donors surveyed reported feeling that their experiences matched their expectations based upon what they had been told during the informed consent process. While most participants (64.8%) felt well informed about potential short-term risks, 55.2% did not feel well informed about potential long-term risks. The findings indicate that while the majority of egg donors felt informed about immediate complications, there are gaps in knowledge about potential long-term risks. Results from this research provide insight into how egg donors understand risks and benefits, and can be used to improve counselling and informed consent forms and processes. The findings also indicate that longitudinal research on the health and well-being of egg donors is needed in order to improve informed consent.
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Affiliation(s)
- Diane Tober
- Institute for Health and Aging, Bixby Center for Global Reproductive Health and Department of Anthropology, History and Social Medicine, University of California, San Francisco, CA, USA
| | - Christina Garibaldi
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA
| | - Alden Blair
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA
| | - Kimberly Baltzell
- Department of Family Health Care Nursing, University of California, San Francisco, CA, USA
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4
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Cordier C, Ducrocq B, Fry J, Catteau-Jonard S. Views of French oocyte donors at least 3 years after donation. Reprod Biomed Online 2020; 40:819-826. [PMID: 32295744 DOI: 10.1016/j.rbmo.2020.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 01/28/2020] [Accepted: 02/06/2020] [Indexed: 10/25/2022]
Abstract
RESEARCH QUESTION The study aimed to evaluate the percentage of oocyte donors who regretted their donation at least 3 years later. DESIGN Between December 2018 and January 2019, this single-centre study sought to contact by telephone all women who had donated oocytes during the 6-year period from 2010 to 2015 at the Lille Centre for the study and storage of eggs and spermatozoa (CECOS). RESULTS Among 118 women, 72 responded to the questionnaire by telephone and were included in the study. The response rate was 61%. No woman regretted having donated an oocyte, and 89% said that they would do it again in the same situation. The survey distinguished two types of donors: 'relational' (58%) and 'altruistic' (42%); some of their responses differed. Ninety per cent of the women had talked about the donation to family and friends. Among them, 74% felt supported by their family and friends, and 72% by their partner. The donation was something that 76% of the women sometimes thought about; 83% felt that this donation was something useful that they had accomplished. Finally, most donors felt that oocyte donation should remain unremunerated and anonymous. CONCLUSIONS None of the donors we interviewed regretted their donation. In France, the current principles governing this donation appear satisfactory to oocyte donors.
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Affiliation(s)
- Camille Cordier
- Université de Lille, CHU Lille, Department of Reproductive Medicine, Lille, France.
| | | | - Julie Fry
- Cellules d'Urgence Médico-Psychologiques SAMU 62, CECOS de Lille, Lille, France
| | - Sophie Catteau-Jonard
- Université de Lille, CHU Lille, Department of Reproductive Medicine, Lille, France; Université de Lille, CHU Lille, INSERM U1172, Lille, France
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5
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Decisional authority of gamete donors over embryos created with their gametes. J Assist Reprod Genet 2020; 37:281-286. [PMID: 31909445 DOI: 10.1007/s10815-019-01678-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 12/22/2019] [Indexed: 10/25/2022] Open
Abstract
In the ongoing discussion on the rights and obligations of gamete donors, scant attention has been paid to the decisional authority of gamete donors over the disposition of the embryos created with their gametes. This paper analyses four different positions: three cases relate to the disposition options for surplus or unused embryos by the first recipients, and one case relates to the use of the embryos stored by the first recipients for procreation.We conclude that the gamete donor causally contributes to the creation of the embryos and thus becomes indirectly responsible. To avoid that donors would become accomplices to an activity to which they morally object, a qualified generic consent mentioning types of research should be obtained. No consent from the donor is required for the destruction of the embryos.The cancellation of the agreement by anonymous or identifiable gamete donors should not be possible for embryos in storage for reproduction by the recipients. The interests in not becoming a genetic parent against one's wishes do not outweigh the damage done to recipients who would no longer be able to use their embryos. Known donors, on the contrary, should be able to withdraw their consent up to the moment of transfer of the embryos based on the greater harm caused to them as a consequence of attributional parenthood. They should also be able to veto transfer of the embryos to other people than the original recipients.
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6
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Interests, obligations, and rights in gamete and embryo donation: an Ethics Committee opinion. Fertil Steril 2019; 111:664-670. [DOI: 10.1016/j.fertnstert.2019.01.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 11/23/2022]
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Borgstrøm MB, Nygaard SS, Danielsen AK, Kesmodel US. Exploring motivations, attitudes and experiences of oocyte donors: A qualitative study. Acta Obstet Gynecol Scand 2019; 98:1055-1062. [DOI: 10.1111/aogs.13583] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 02/13/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Maria Buhl Borgstrøm
- The Fertility Clinic, Department of Obstetrics and Gynecology Herlev Gentofte HospitalUniversity of Copenhagen Herlev Denmark
| | - Siv S. Nygaard
- Department of Obstetrics and Gynecology Herlev Gentofte HospitalUniversity of Copenhagen Herlev Denmark
| | - Anne K. Danielsen
- Department of Gastroenterology Herlev Gentofte HospitalUniversity of Copenhagen Herlev Denmark
| | - Ulrik S. Kesmodel
- Department of Obstetrics and Gynecology Herlev Gentofte HospitalUniversity of Copenhagen Herlev Denmark
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8
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Kool EM, Bos AME, van der Graaf R, Fauser BCJM, Bredenoord AL. Ethics of oocyte banking for third-party assisted reproduction: a systematic review. Hum Reprod Update 2018; 24:615-635. [DOI: 10.1093/humupd/dmy016] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 04/20/2018] [Indexed: 12/29/2022] Open
Affiliation(s)
- E M Kool
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Universiteitsweg 100, GA Utrecht, The Netherlands
- Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, Heidelberglaan 100, CX Utrecht, The Netherlands
| | - A M E Bos
- Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, Heidelberglaan 100, CX Utrecht, The Netherlands
| | - R van der Graaf
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Universiteitsweg 100, GA Utrecht, The Netherlands
| | - B C J M Fauser
- Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, Heidelberglaan 100, CX Utrecht, The Netherlands
| | - A L Bredenoord
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Universiteitsweg 100, GA Utrecht, The Netherlands
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9
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Vesali SV, Karimi E, Mohammadi M, Omani-Samani R. Attitude of Law and Medical Students to Oocyte Donation. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2018; 12:114-118. [PMID: 29707926 PMCID: PMC5936607 DOI: 10.22074/ijfs.2018.5178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 06/19/2017] [Indexed: 11/07/2022]
Abstract
Background Among the young generation, medical and law students’ attitude towards third party reproduction is
very important because they will be directly involved in restricting or developing the programs that will support it in
the future. The aim of this survey was to investigate attitude of law and medical students to oocyte donation and key
aspects of this kind of third party. Materials and Methods In analytical cross-sectional study, 345 medical and law students were randomly selected
using stratified sampling. Data was collected using attitude toward donation- oocyte (ATOD-O) questionnaire. Re-
sponses were on a 5-point Likert scale. Data were analyzed according to established statistical approach by Heeren
and D'Agostino. Results The majority of the participants agreed with oocyte donation being the last choice for infertility treatment.
There was a significant difference between medical students and law students regarding the acceptance of oocyte
donation (3.23 vs. 3.53, P=0.025). In addition, female participants were more tolerant on receiving donated oocytes
from their sisters than male participants (3.01 vs. 2.58, P=0.002) and finally, a higher number of the participants had
a positive attitude towards anonymity of the donor and the recipient to one another (3.93 vs. 3.86, P=0.580). The vast
majority of female students believed that the oocyte recipient naturally likes that child (P<0.0001). Conclusion In the current study, a great majority of law and medical students support oocyte donation as an alternative
way of starting a family. There is an interest among female students in donating oocytes anonymously. The majority
believed that the oocyte recipient family will like the donor oocyte child naturally.
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Affiliation(s)
- Samira Vesali Vesali
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedical, ACECR, Tehran, Iran
| | - Elaheh Karimi
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedical, ACECR, Tehran, Iran
| | - Maryam Mohammadi
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedical, ACECR, Tehran, Iran
| | - Reza Omani-Samani
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedical, ACECR, Tehran, Iran. Electronic Address:
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10
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Blyth E, Crawshaw M, Frith L, van den Akker O. Gamete donors' reasons for, and expectations and experiences of, registration with a voluntary donor linking register. HUM FERTIL 2017. [PMID: 28635412 DOI: 10.1080/14647273.2017.1292005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This paper reports on a study of the views and experiences of 21 sperm donors and five egg donors registered with UK DonorLink (UKDL), a voluntary DNA-based contact register established to facilitate contact between adults who wish to identify and locate others to whom they are genetically related following donor conception. Specifically, the paper examines donors' reasons for searching for, or making information about themselves available to donor-conceived offspring. Their expectations of registration with UKDL, experiences of being registered and finally, the experiences of those who had contacted donor-conceived offspring and other genetic relatives are investigated. While most respondents reported largely positive experiences of registration, the study found significant issues relating to concerns about donation, DNA testing, possible linking with offspring and expectations of any relationship that might be established with offspring that have implications for support, mediation and counselling. Research that puts the experiences, perceptions and interests of gamete donors as the central focus of study is a relatively recent phenomenon. This study contributes to this debate and highlights directions for future research in this area.
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Affiliation(s)
- Eric Blyth
- a School of Human and Health Sciences, University of Huddersfield , Huddersfield , UK
| | - Marilyn Crawshaw
- b Department of Social Policy and Social Work , University of York , York , UK
| | - Lucy Frith
- c Department of Health Services Research , University of Liverpool , Liverpool , UK
| | - Olga van den Akker
- d Department of Psychology, Faculty of Science and Technology , Middlesex University , London , UK
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11
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Financial compensation of oocyte donors: an Ethics Committee opinion. Fertil Steril 2016; 106:e15-e19. [DOI: 10.1016/j.fertnstert.2016.09.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 09/22/2016] [Indexed: 11/19/2022]
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12
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Graham S, Jadva V, Freeman T, Ahuja K, Golombok S. Being an identity-release donor: a qualitative study exploring the motivations, experiences and future expectations of current UK egg donors. HUM FERTIL 2016; 19:230-241. [PMID: 27563721 DOI: 10.1080/14647273.2016.1221148] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The objective of this study was to examine the motivations, experiences and future expectations of identity-release egg donors in the UK following the removal of donor anonymity and the increase in financial compensation for egg donation. This exploratory, in-depth qualitative study comprised semi-structured interviews with 11 women who had attended an egg donation screening appointment at a UK clinic during a four-month period in 2014. Interviews were conducted two to six weeks after the woman had donated or had withdrawn/been rejected from the donation process. Participants' primary motivation for donating was to help infertile women have their 'own child', and the recent increase in financial compensation did not seem to play a significant role in their decision. All were happy to be identifiable and contacted by children born as a result of their donation. However, some were hesitant about providing non-identifying information about themselves for these offspring and wished for further information about the recipient(s) of their eggs and the outcome of their donation. Whilst this study was limited due to the small sample size, it is the first study of UK egg donors following the rise in donor compensation and suggests that other strategies may be more effective in increasing donor numbers.
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Affiliation(s)
- Susanna Graham
- a Centre for Family Research, University of Cambridge , Cambridge , UK
| | - Vasanti Jadva
- a Centre for Family Research, University of Cambridge , Cambridge , UK
| | - Tabitha Freeman
- a Centre for Family Research, University of Cambridge , Cambridge , UK
| | | | - Susan Golombok
- a Centre for Family Research, University of Cambridge , Cambridge , UK
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13
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Cattapan AR. Good eggs? Evaluating consent forms for egg donation. JOURNAL OF MEDICAL ETHICS 2016; 42:455-459. [PMID: 26951214 DOI: 10.1136/medethics-2015-102964] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 02/16/2016] [Indexed: 06/05/2023]
Abstract
Beyond gaps in the provision of information, the informed consent process for egg donation is complicated by conflicts of interest, payment and a lack of longitudinal data about physiological and psychological risks. Recent scholarship has suggested that egg donation programmes could improve the informed consent process by revising consent documents. At a minimum, these documents should include information about eight key criteria: the nature and objectives of treatment; the benefits, risks and inconveniences of egg donation; the privacy of donors and their anonymity (where applicable); disclosure that participation is voluntary (withdrawal); the availability of counselling; financial considerations; the possibility of an unsuccessful cycle and potential uses of the eggs retrieved. This study evaluates the incorporation of these minimum criteria in consent forms for egg donation, obtained through requests to Canadian fertility clinics. Even when clinics were considered to have met criteria simply by mentioning them, among the eight consent forms assessed, none met the minimum standards. Only half of clinics addressed privacy/anonymity concerns, financial issues and the possibility of a future cycle. Improving the quality of consent documentation to meet the minimum standards established by this study may not be an onerous task. For some, this will include re-evaluating how they include one or two elements of disclosure, and for others, this will require a substantial overhaul. Using the criteria provided by this study as the minimum standard for consent could ensure that donors have the basic information they need to make informed decisions.
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14
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Bracewell-Milnes T, Saso S, Bora S, Ismail AM, Al-Memar M, Hamed AH, Abdalla H, Thum MY. Investigating psychosocial attitudes, motivations and experiences of oocyte donors, recipients and egg sharers: a systematic review. Hum Reprod Update 2016; 22:450-65. [DOI: 10.1093/humupd/dmw006] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 02/15/2016] [Indexed: 11/12/2022] Open
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15
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Interests, obligations, and rights in gamete donation: a committee opinion. Fertil Steril 2014; 102:675-81. [DOI: 10.1016/j.fertnstert.2014.06.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 06/02/2014] [Indexed: 11/24/2022]
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16
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Sydsjö G, Lampic C, Bladh M, Svanberg AS. Oocyte and sperm donors' opinions on the acceptable number of offspring. Acta Obstet Gynecol Scand 2014; 93:634-9. [DOI: 10.1111/aogs.12395] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 04/14/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Gunilla Sydsjö
- Obstetrics and Gynecology; Department of Clinical and Experimental Medicine; Faculty of Health Sciences; Linköping University; Linköping Sweden
| | - Claudia Lampic
- Department of Neurobiology, Care Sciences and Society; Karolinska Institute; Stockholm Sweden
| | - Marie Bladh
- Obstetrics and Gynecology; Department of Clinical and Experimental Medicine; Faculty of Health Sciences; Linköping University; Linköping Sweden
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17
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Making families: Organizational boundary work in US egg and sperm donation. Soc Sci Med 2013; 99:64-71. [DOI: 10.1016/j.socscimed.2013.10.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 10/09/2013] [Accepted: 10/18/2013] [Indexed: 11/19/2022]
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18
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Skoog Svanberg A, Lampic C, Gejerwall AL, Gudmundsson J, Karlström PO, Solensten NG, Sydsjö G. Gamete donors' satisfaction; gender differences and similarities among oocyte and sperm donors in a national sample. Acta Obstet Gynecol Scand 2013; 92:1049-56. [PMID: 23611727 PMCID: PMC3933731 DOI: 10.1111/aogs.12156] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 04/17/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To explore oocyte and sperm donors' emotional stress, experiences of care and satisfaction after donation. DESIGN Prospective multicenter study. SETTINGS All fertility clinics performing gamete donation in Sweden during the period 2005 to 2008. POPULATION Of 220 eligible oocyte donors who were approached, 181 agreed to complete the first questionnaire and 165 completed the second questionnaire 2 months after oocyte donation. Of 156 eligible sperm donors 119 accepted to complete the first questionnaire before donation. Eighty-nine participants completed the second questionnaire 2 months after sperm donation. METHODS Standardized and study-specific questionnaires. MAIN OUTCOME MEASURES Satisfaction with the donation, respondents' mental health and overall care. RESULTS A larger percentage of sperm donors (97.8%) were satisfied with their overall experience of being a donor than oocyte donors (85.9%, p = 0.003). Some oocyte and sperm donors did not receive sufficient information about practical issues (9.1% and 13.5%, respectively) and future consequences (12.8% and 3.4%, respectively, p = 0.014). The donors' symptoms of anxiety and depression did not show any differences in relation to negative or positive perceptions of satisfaction. The donors who did not indicate ambivalence before treatment were on average almost five times more satisfied compared with those who did indicate ambivalence (odds ratio 4.71; 95% CI 1.34-16.51). CONCLUSIONS Most donors were satisfied with their contribution after the donation. Oocyte and sperm donors who expressed ambivalence before donation were less satisfied after donation. In vitro fertilization staff fulfilled most of the donors' needs for information and care.
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Raes I, Ravelingien A, Pennings G. The right of the donor to information about children conceived from his or her gametes. Hum Reprod 2013; 28:560-5. [DOI: 10.1093/humrep/des444] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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SVANBERG AGNETASKOOG, LAMPIC CLAUDIA, GEIJERWALL ANNLOUISE, GUDMUNDSSON JOHANNES, KARLSTRÖM PEROLOF, SOLENSTEN NILSGUNNAR, SYDSJÖ GUNILLA. Gamete donors’ motivation in a Swedish national sample: is there any ambivalence? A descriptive study. Acta Obstet Gynecol Scand 2012; 91:944-51. [DOI: 10.1111/j.1600-0412.2012.01430.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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21
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Ressler IB, Jaeger AS, Lindheim SR. Evolving ethical issues in third party reproduction: Local and global considerations. World J Med Genet 2012; 2:1-8. [DOI: 10.5496/wjmg.v2.i1.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
There continues to be an increase in utilization of assisted reproductive technology (ART), including the use of third party gametes. Specifically, the use of third party oocytes, most recently reported in 2010 by the United States (US) Center for Disease Control and Society of Reproductive Medicine, accounted for 15 504 cycles and 7334 live births. This translates into approximately 11% of all the in vitro fertilization cases performed in the US. As utilization increases and the technological tools advance, they have created underappreciated and unforeseen ethical quandaries. As such, many practitioners think they “have heard it all”. However, each ART scenario is novel with the potential to pose complex unforeseen issues, potentially creating global challenges that could impact broad social and legal questions and test the moral consciousness’ of practitioners, policymakers and patients. While there are published US national guidelines to assist practitioners, we have identified new complex issues in assisted reproduction that present unique challenges, and we give a perspective from our eyes in the Western Hemisphere looking out to a global level. Specifically, this review focuses on some of the more recent and evolving issues that currently are and will be confronting us in the upcoming years. Particular attention focuses on discrepancies between third party legal contracts and ART consents regarding level of information sharing, and oocyte and embryo directives and management; dilemmas and obligations surrounding disclosure of medical outcomes especially in the context of growing access to Direct to Consumer genetic testing and Reproductive Tourism-Exile. Given the complexity of these and other ethical questions, finding answers may be achieved by ending the isolation of reproductive professionals and instead promoting increased and consistent communication among physicians, embryologists, therapists and reproductive attorneys to confront these evolving ethical quandaries.
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Jaeger AS, Ross LS, Lindheim SR. Observed Discrepancies in Donors’ Information Sharing and Oocyte-Embryo Management and Disposition Reported to Reproductive Health Professionals: A Call for Programmatic Improvement. ACTA ACUST UNITED AC 2012. [DOI: 10.1080/21507716.2011.639125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Schaefer GO, Sinaii N, Grady C. Informing egg donors of the potential for embryonic research: a survey of consent forms from U.S. in vitro fertilization clinics. Fertil Steril 2011; 97:427-33. [PMID: 22196714 DOI: 10.1016/j.fertnstert.2011.11.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2011] [Revised: 11/19/2011] [Accepted: 11/28/2011] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To understand whether and to what extent U.S. IVF clinics inform egg donors that resultant embryos initially intended to be implanted for reproductive purposes may in fact be used for research instead. DESIGN Four hundred seventy U.S. IVF clinics were asked to respond to a questionnaire and provide a copy of the egg donor consent form(s) used at the clinic. SETTING Four hundred seventy U.S. IVF clinics listed in a Centers for Disease Control and Prevention database; only forms from clinics that both accepted donor eggs and provided excess embryos for research were analyzed for content. PATIENT(S) Not applicable. INTERVENTION(S) Not applicable. MAIN OUTCOME MEASURE(S) Responses to the questionnaire, demographic data from a Centers for Disease Control and Prevention database, and the content of egg donor consent forms. RESULT(S) Of 222 U.S. IVF clinics that responded to our query, 100 clinics both accepted donor eggs and provided some excess embryos for research. We received 66 consent forms from these 100 clinics, which showed that although most egg donor consent forms inform donors that they will not have control over embryos resulting from their eggs, 30% inform them that some embryos may be used for research, and even fewer mention stem cell research. CONCLUSION(S) Egg donors in the United States, including some who may have a moral objection to research and stem cell research, are not being informed that embryos created with their donated eggs may in fact be used for these purposes. This can be corrected with the inclusion of succinct, nontechnical language in egg donor consent forms.
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Affiliation(s)
- Gerald Owen Schaefer
- Department of Bioethics, National Institutes of Health Clinical Center, Bethesda, Maryland 20892-1156, USA
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Views of donors and recipients regarding disclosure to children following altruistic known oocyte donation. Reprod Biomed Online 2011; 23:851-9. [DOI: 10.1016/j.rbmo.2011.06.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Revised: 06/03/2011] [Accepted: 06/07/2011] [Indexed: 11/18/2022]
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Blyth E, Yee S, Tsang AKT. “They Were My Eggs; They Were Her Babies”: Known Oocyte Donors’ Conceptualizations of Their Reproductive Material. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2011; 33:1134-40. [PMID: 22082787 DOI: 10.1016/s1701-2163(16)35081-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Eric Blyth
- University of Huddersfield, Queensgate, Huddersfield UK
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Lindheim SR, Porat N, Jaeger AS. Survey report of gamete donors' and recipients' preferences regarding disclosure of third party reproduction outcomes and genetic risk information. J Obstet Gynaecol Res 2011; 37:292-9. [PMID: 21349122 DOI: 10.1111/j.1447-0756.2010.01333.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
AIM Issues surrounding egg donation informed consent have recently been spotlighted due to advances in medical genetics. We sought information on attitudes and desires of donors and recipients to craft a program policy on counseling, disclosures, and re-contacting participants. METHODS Between April 2003 and September 2006 we conducted a questionnaire-based evaluation in our oocyte donor program. Donors pre-donation (n=265) and those undergoing the process (n=60), and recipients either ante- or postpartum (n=57), were asked about their desire to know/disclose obstetric outcomes (Question 1); willingness for contact in the event of a medical emergency (Question 2); and wish to know/disclose a liveborn's medical condition (Question 3). RESULTS Pre-donation questioning among all donors generally revealed reticence to Question 1 (31% [n=83]), but were overall amenable with Questions 2 and 3 (83% [n=220] and 83% [n=219]). Following the donation process, no differences in Questions 1 and 2 were noted, but fewer donors were amenable with Question 3 (pre-donation 93% [n=56] versus post-donation 38% [n=23]; P<0.01). Overall, recipients were amenable to all three questions (88% [n=50], 74% [n=42] and 88% [n=50]), with similar responses both ante- and postpartum. CONCLUSION All programs participating in gamete donation should establish a comprehensive disclosure policy, including consents that are built upon effective lines of communication between clinical staff and legal counsel assuring that parentage, relinquishment, and re-contact information in donor-recipient agreements are consistent with clinic consent documents and desires of both parties; All decisions must be adequately documented and honored and long-term counseling needs should be addressed.
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Lo B, Parham L, Cedars M, Fisher S, Gates E, Giudice L, Halme DG, Hershon W, Kriegstein A, Rao R, Roberts C, Wagner R. Research ethics. NIH guidelines for stem cell research and gamete donors. Science 2010; 327:962-3. [PMID: 20167773 PMCID: PMC2892655 DOI: 10.1126/science.1180725] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Rather than informed consent, dispositional authorization may be the preferred strategy in obtaining gamete donations for embryonic stem cell research.
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Affiliation(s)
- Bernard Lo
- Program in Medical Ethics, University of California, San Francisco (UCSF), San Francisco, CA 94143, USA.
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Sachs P, Covington SN, Toll C, Richter KS, Purcell M, Chang FE. Demographic variables related to successful anonymous oocyte donor recruitment. Fertil Steril 2010; 93:311-3. [DOI: 10.1016/j.fertnstert.2009.06.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2009] [Revised: 06/12/2009] [Accepted: 06/25/2009] [Indexed: 10/20/2022]
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McGowan ML. Participation in investigational fertility preservation research: a feminist research ethics approach. Cancer Treat Res 2010; 156:209-21. [PMID: 20811836 PMCID: PMC3071553 DOI: 10.1007/978-1-4419-6518-9_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Michelle L McGowan
- Department of Bioethics, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
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Purewal S, Vanden Akker O. 'I feel like they were mine and I should be looking after them': an exploration of non-patient women's attitudes towards oocyte donation. J Psychosom Obstet Gynaecol 2009; 30:215-22. [PMID: 19883292 DOI: 10.3109/01674820903348732] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aims of this study were to qualitatively assess the meaning of oocytes and oocyte donation for treatment and research among non-patient women in the UK using Interpretative Phenomenological Analysis. This study also assessed the application of components of the Theory of Planned Behaviour (TPB) in intentions and attitudes towards oocyte donation. Eight parous and nulliparous women from White and South Asian backgrounds, who reported no fertility problems, were interviewed. Four interrelated super-ordinate themes were identified: (1) oocytes as 'Just a cell' and 'Potential life'; (2) oocyte donation as 'Altruism' and 'Not normal behaviour'; (3) 'Importance of motherhood' and the 'Importance of a genetic link'. Ethnic differences were observed in the final theme (4) which identified the importance of 'Social Support' and 'Reproductive Control' in women's discourses of oocyte donation. Analysis revealed participant's beliefs and thoughts about oocyte donation were complex, interwoven and paradoxical. Previous quantitative studies that have assessed components of the TPB in relation to oocyte donation have failed to identity important alternative explanations of oocyte donation and subtle complexities in attitudes.
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Affiliation(s)
- Satvinder Purewal
- Department of Psychology, Middlesex University, The Burroughs, Hendon, London NW4 4BT, UK.
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Kramer W, Schneider J, Schultz N. US oocyte donors: a retrospective study of medical and psychosocial issues. Hum Reprod 2009; 24:3144-9. [DOI: 10.1093/humrep/dep309] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Daniels K. Anonymity and openness and the recruitment of gamete donors. Part 2: Oocyte donors. HUM FERTIL 2009; 10:223-31. [DOI: 10.1080/14647270701624792] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Purewal S, van den Akker O. Systematic review of oocyte donation: investigating attitudes, motivations and experiences. Hum Reprod Update 2009; 15:499-515. [DOI: 10.1093/humupd/dmp018] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
Stem cell research offers great promise for understanding basic mechanisms of human development and differentiation, as well as the hope for new treatments for diseases such as diabetes, spinal cord injury, Parkinson's disease, and myocardial infarction. However, human stem cell (hSC) research also raises sharp ethical and political controversies. The derivation of pluripotent stem cell lines from oocytes and embryos is fraught with disputes about the onset of human personhood. The reprogramming of somatic cells to produce induced pluripotent stem cells avoids the ethical problems specific to embryonic stem cell research. In any hSC research, however, difficult dilemmas arise regarding sensitive downstream research, consent to donate materials for hSC research, early clinical trials of hSC therapies, and oversight of hSC research. These ethical and policy issues need to be discussed along with scientific challenges to ensure that stem cell research is carried out in an ethically appropriate manner. This article provides a critical analysis of these issues and how they are addressed in current policies.
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Affiliation(s)
- Bernard Lo
- University of California San Francisco Program in Medical Ethics, San Francisco, California 94143, USA.
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Zweifel JE, Biaggio B, Schouweiler C, Lindheim SR. Follow-up assessment of excluded oocyte donor candidates. J Obstet Gynaecol Res 2009; 35:320-5. [DOI: 10.1111/j.1447-0756.2008.00942.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Interests, obligations, and rights of the donor in gamete donation. Fertil Steril 2008; 91:22-7. [PMID: 19084224 DOI: 10.1016/j.fertnstert.2008.09.062] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2008] [Accepted: 09/19/2008] [Indexed: 01/13/2023]
Abstract
This Ethics Committee report outlines the interests, obligations, and rights of both male and female donors who choose to provide gametes for use by others.
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38
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Purewal S, van den Akker OBA. British women's attitudes towards oocyte donation: ethnic differences and altruism. PATIENT EDUCATION AND COUNSELING 2006; 64:43-9. [PMID: 16427244 DOI: 10.1016/j.pec.2005.11.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2005] [Revised: 10/22/2005] [Accepted: 11/04/2005] [Indexed: 05/06/2023]
Abstract
OBJECTIVE This study assessed the importance of altruism and willingness to donate oocytes in British Asian and Caucasian samples. The Theory of Planned Behaviour (TPB) was used to test the importance of attitudes towards oocyte donation, normative and control beliefs to attitudes to donate oocytes. METHOD One hundred and one participants (55% Asian, 45% Caucasian) completed questionnaires measuring altruism and attitudes to Oocyte donation. There were no socio-demographic differences between ethnic groups. RESULTS Few women were willing to donate oocytes, Asian women were least likely to donate oocytes, and altruism was not related to willingness to donate. Forty-one participants considered themselves 'possible' oocyte donors and 54 as definite 'non' donors. Possible donors reported significantly more positive attitudes towards egg donation; asking women to donate under various circumstances; to the consequences of donating their eggs; positively experiencing egg donation and to factors that would induce women to donate. Subjective norms and behavioural control also influenced intention to donate. CONCLUSION A number of components of the TPB were able to predict possible oocyte donation, and non-oocyte donation. PRACTICE IMPLICATIONS This study provides some empirical support for specific factors influencing cultural differences in gamete donation in the UK. A future culturally appropriate targeted approach to donation education could redress the present imbalance in supply and demand of gametes in infertility treatment.
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Affiliation(s)
- S Purewal
- School of Life and Health Sciences, Aston University, Aston Triangle, Birmingham B4 7ET, UK
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Zweifel JE, Rathert MA, Klock SC, Walaski HP, Pritts EA, Olive DL, Lindheim SR. Comparative assessment of pre- and post-donation attitudes towards potential oocyte and embryo disposition and management among ovum donors in an oocyte donation programme. Hum Reprod 2006; 21:1325-7. [PMID: 16410332 DOI: 10.1093/humrep/dei468] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND In anonymous oocyte donation programmes, the disposition of retrieved oocytes and subsequent embryo management are at the discretion of the IVF programme and the oocyte recipients, as donors waive all rights following their donation. Nonetheless, donors are routinely made aware of ways in which oocytes and resulting embryos may be used and elect to proceed with the process even in the presence of reservations to some clinical scenarios before their donation. The aim of our study was to examine oocyte donors' attitudes to oocyte and embryo disposition and management and how initial reservations change over the course of the donation process. METHODS Oocyte donors in a university-based IVF programme were asked about their willingness to donate in relation to various clinical scenarios during the initial screening interview and at the post-donation exit interview. Results were tabulated as 'yes' or 'no'. RESULTS At the pre-donation interview, 72% of donor candidates expressed reservations to one or more clinical scenarios. More reservations were expressed at the post-donation interview compared with the pre-donation interview. The greatest reservations were donating to recipients >50 years of age (P < 0.05). Despite this, 97% of donors were willing to donate again. CONCLUSION Oocyte donors' attitudes towards various clinical scenarios changed following their donation, reflecting overall greater reservations following the donation process. Although speculative, donors may be more willing to assert their opinions or donor attitudes become more restrictive.
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Affiliation(s)
- Julianne E Zweifel
- Department of Obstetrics and Gynecology, University of Wisconsin, Madison, WI 53792, USA
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40
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van den Akker O. A review of family donor constructs: current research and future directions. Hum Reprod Update 2005; 12:91-101. [PMID: 16172110 DOI: 10.1093/humupd/dmi038] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This review addresses research on gamete donors, recipients, and offspring and demonstrates that the foci on all three within the triad are largely directed at disclosure or anonymity; and each in turn centers on the perceived importance of the genetic link. The importance attached to genetics has led some countries to review the ethics of anonymous gamete donation (e.g. New Zealand's 'open system' of information sharing) and has led other countries (Sweden, Austria, Victoria, Australia; the Netherlands, the UK) to change their laws allowing donor gamete offspring the right to obtain identifying information about their genetic parent. This review demonstrates that genealogical inconsistencies between and within members of the triad are common regardless of legislation. A discussion of future trends and concerns, relating to the use of gamete donation and the effects legislation is likely to have on the donor triads in the UK following 2005, is provided. The review also addresses the importance of testing theoretical models within future research, and argues this would lead to a better understanding of the underlying problems encountered at a psychosocial level, such as continued preference for anonymity in donors and denial in large numbers of users of the involvement of a donor in conception. Lack of disclosure effectively prevents true implementation of legislation; if a child is not informed, it is the result of donated gametes, it cannot take up the legally available option of finding out identifiable information about their genetic parent(s).
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Affiliation(s)
- Olga van den Akker
- School of Life and Health Sciences, Aston University, Aston Triangle, Birmingham, UK.
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41
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Westphal L, Bendikson K. Evaluation of Urine Toxicology Screens in an Oocyte Donor Population. J Assist Reprod Genet 2005. [DOI: 10.1007/s10815-005-1500-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Lo B, Chou V, Cedars MI, Gates E, Taylor RN, Wagner RM, Wolf L, Yamamoto KR. Informed consent in human oocyte, embryo, and embryonic stem cell research. Fertil Steril 2004; 82:559-63. [PMID: 15374695 DOI: 10.1016/j.fertnstert.2004.01.040] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2003] [Revised: 01/21/2004] [Accepted: 01/21/2004] [Indexed: 10/26/2022]
Abstract
Research with human oocytes, embryos, and additional embryonic stem cell lines is needed to address important scientific questions and to fulfill the promise of stem cell transplantation for degenerative diseases. Proponents need to develop guidelines for the appropriate conduct of embryonic stem cell research. Such guidelines will help build public trust and acceptance for this research. In this article, we offer recommendations for informed consent, discussing who should give consent, what the consent process should cover, when consent should be obtained, and who should obtain consent. Consent to use embryos for research should be obtained from oocyte and sperm donors as well as from the woman or couple undergoing infertility treatment. The consent discussion must cover information that donors need to know to make an informed decision about various types of research. Donations for research should be discussed at the initiation of advanced infertility treatment and reconfirmed if possible at the time of actual donation for research. Treating assisted reproduction technology physicians can help with the consent process, provided that they are not involved in the research.
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Affiliation(s)
- Bernard Lo
- Program in Medical Ethics and the Division of General Internal Medicine, Department of Medicine, University of California at San Francisco, 521 Parnassus Avenue, San Francisco, CA 94143-0903, USA.
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Jordan CB, Belar CD, Williams RS. Anonymous oocyte donation: a follow-up analysis of donors' experiences. J Psychosom Obstet Gynaecol 2004; 25:145-51. [PMID: 15715037 DOI: 10.1080/1674820400002261] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND this study was conducted to assess oocyte donors' satisfaction after the procedure and to obtain information on base rates of various experiences associated with oocyte donation. METHODS volunteer anonymous oocyte donors seen at a university-based IVF programs were identified (N = 54). The follow-up questionnaire asked donors to rate aspects of clinic interactions, medical procedures and experiences during and after the process, as well as expectations and level of fulfillment. RESULTS ten individuals were lost to follow-up and 20 donors did not respond. The typical oocyte donor respondent (N = 24) was 26.5 years old, Caucasian, single with no children and had experienced some college education. Mean follow-up time was 21 months. Overall, 79% were satisfied or extremely satisfied with their experience, 42 % would be an oocyte donor again and 50% would recommend that a friend consider being an oocyte donor. Donors tolerated procedures well, but most did experience cramping and injection site pain. A significant proportion experienced anxiety and negative emotional experiences during the process. Expectations were fulfilled regarding helping another woman and sense of satisfaction, but most (87.5%) expressed the desire to know the outcome for the recipient. CONCLUSIONS the data demonstrate that oocyte donation was a positive experience for the majority of women in the program, although emotional symptoms are normative.
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Affiliation(s)
- Caren B Jordan
- Department of Psychology, East Carolina University, Greenville, NC 27858, USA
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Lo B, Chou V, Cedars MI, Gates E, Taylor RN, Wagner RM, Wolf L, Yamamoto KR. Medicine. Consent from donors for embryo and stem cell research. Science 2003; 301:921. [PMID: 12920284 DOI: 10.1126/science.1087038] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
As research with human embryos and embryonic stem cells proceeds, the authors of this Policy Forum argue that all donors of biological materials should give informed consent, including oocyte and sperm donors. Informed consent is particularly important because of the diverse opinions and strong emotions that surround such research. Some gamete donors who are willing to help women and couples bear children may object to the use of their genetic materials for certain types of research.
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Affiliation(s)
- Bernard Lo
- Program in Medical Ethics, School of Medicine at the University of California, San Francisco, CA 94143, USA.
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45
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Klock SC, Stout JE, Davidson M. Psychological characteristics and factors related to willingness to donate again among anonymous oocyte donors. Fertil Steril 2003; 79:1312-6. [PMID: 12798876 DOI: 10.1016/s0015-0282(03)00348-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To assess post-donation psychological status of a large sample of professionally recruited, paid anonymous donors and to determine whether there were any differences between those who were willing to donate again and those who were not. DESIGN Cross-sectional survey. SETTING Healthy donors who were recruited by two private groups. SUBJECT(S) One hundred fifteen donors who had completed at least one donation cycle at one of six IVF programs in a large Midwestern city. INTERVENTION(S) None. MAIN OUTCOME MEASURES Self-report questionnaire assessing psychological symptoms, self-esteem, expectations, satisfaction, and attitudes toward donation. RESULT(S) Psychological symptomatology and self-esteem were in the normal range. Altruism and compensation were the two most frequently cited motivators for donation. Of the donors, 82% were moderately to very satisfied with the donation experience. First-time donors were significantly younger, reported more post-donation psychiatric symptoms, and had slightly lower self-esteem. Of the donors, 35% stated they would donate again; 37% would not, and 28% were undecided. Donors who were willing to donate again reported significantly less ambivalence about donation and significantly greater satisfaction with the medical aspects of donation. CONCLUSION(S) Approximately one third of donors are willing to donate more than once. These women report less ambivalence and greater satisfaction with the donation experience.
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Affiliation(s)
- Susan Caruso Klock
- Departments of Obstetrics and Gynecology and Psychiatry, Northwestern University Medical School, Chicago, Illinois 60611, USA.
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Abstract
As part of a larger study on donor-assisted conception, this paper reports research which explored the ways in which women who have donated or received eggs or embryos interpret such donations in the context of motherhood. Narrative analysis of women's accounts revealed that egg and embryo donations are not interpreted as incompatible with motherhood; that they may be explained as contributing to the significance of motherhood through the desire to assist some women to whom motherhood has been denied; and that the welfare of offspring of donated eggs and embryos is considered by donors. Differences were found between the meanings of egg donation and embryo donation, including likening eggs to cells and embryos to children, and in donors the expression of stronger maternal connection to the offspring of donated embryos. These accounts reveal individual variation, complexity, and change, reflecting (among other things) the dynamic process of narrative revision.
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Affiliation(s)
- Maggie Kirkman
- Key Centre for Women's Health in Society, The University of Melbourne, Australia.
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Chliaoutakis JE, Koukouli S, Papadakaki M. Using attitudinal indicators to explain the public's intention to have recourse to gamete donation and surrogacy. Hum Reprod 2002; 17:2995-3002. [PMID: 12407063 DOI: 10.1093/humrep/17.11.2995] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Although the donation and receipt of gametes has become an integral part of infertility management, previous research in the field of social attitudes and intention to use medical technologies is limited. This study aimed to investigate attitudinal indicators and their potential relationship with the public's intention to have recourse to gamete donation and surrogacy. METHODS A total of 365 individuals of reproductive age (49.3% men and 50.7% women) completed a questionnaire referring to their intention to receive or donate sperm/oocytes and their acceptance of becoming a commissioning couple or surrogate mother, and also to explore their attitudes towards gamete donation and surrogacy. Two attitudinal indicators emerged from the principal component analysis identifying (i). recipients' and donors' choice for anonymity, donors' renunciation of parental obligations and refusal of children's rights to know their biological parents and (ii). favourable attitudes towards legislative and financial measures to be adopted by the Government for the promotion of reproductive technologies. RESULTS It was found that the indicator of 'Donors Anonymity and Refusal of Children's Rights' (DARCR) and the 'Legislative and Financial Support' (LFS) scale are positively associated with intention to have recourse to Gamete Donation and Surrogacy (GDS) (regression coefficients 0.31 and 1.08 respectively). Moreover, among the other variables used in the analysis only the 'church attendance' variable is negatively related with reported rates of intention to have recourse to GDS (P = 0.029), suggesting that the more religious respondents are less willing to use GDS. CONCLUSION Social, legislative and financial implications provide a convenient rationale for adopting a favourable intention towards reproductive technologies. The findings of the present research should be given close consideration by policy makers and health education campaigns.
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Affiliation(s)
- Joannes E Chliaoutakis
- Department of Social Work, Technological Educational Institute (TEI) of Crete, Estavromenos 71500, Heraklion, Greece.
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Stanton AL, Lobel M, Sears S, DeLuca RS. Psychosocial aspects of selected issues in women's reproductive health: current status and future directions. J Consult Clin Psychol 2002; 70:751-70. [PMID: 12090381 DOI: 10.1037/0022-006x.70.3.751] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Emphasizing research published in the past decade, this article presents a summary and evaluation of psychosocial investigations of women's reproductive health, with a focus on selected aspects of menstruation, pregnancy and birth, infertility, and menopause. In some areas, studies have focused on negative physical and psychological concomitants of these health issues. However, research reveals substantial individual variability, with most women adapting well to reproductive health changes. Although methodological and conceptual shortcomings have limited firm conclusions, research has advanced our understanding of the multivariate biological, psychological, and social influences on women's reproductive health and associated outcomes. Understanding and promoting women's reproductive health across the lifespan requires biopsychosocial approaches to research.
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Affiliation(s)
- Annette L Stanton
- Department of Psychology, University of Kansas, Lawrence 66045-2160, USA.
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Abstract
A growing number of children around the world are conceived through third-party reproductive techniques. The increased demand for these programs has resulted in an ongoing trend towards greater openness and less anonymity in gamete donation. This has led to changes in public policy regarding the identity of donors, to a greater concern for the well-being of donors, and to calls for disclosure to offspring about their donor gamete conception.
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Affiliation(s)
- Dorothy A Greenfeld
- Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut 06520-8063, USA.
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