Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 25
Filtrar
Mais filtros

Base de dados
País/Região como assunto
Tipo de documento
País de afiliação
Intervalo de ano de publicação
1.
Scand J Clin Lab Invest ; 82(1): 50-57, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34941478

RESUMO

OBJECTIVES: We wanted to have a more substantiated idea about the extreme values which are possible in patients not dying or being moribund. METHODS: for nine regular analytes the five most extreme results registered between 2014 and 2018 in our database were searched. Results had to have been confirmed by multiple analyses in different samples. Patients should have lived at least 28 days after the extreme analyte value was observed. Patient diagnoses and symptoms were checked to understand the pathology and apparent consequences of the extreme values. RESULTS: most extreme values (lowest and highest; mmol/L): sodium 100/178, potassium 1.2/9.8, chloride 58/138, total calcium 1.02/4.98, ionized calcium 0.37/2.44, magnesium 0.07/3.31, phosphate <0.1/7.3, pH <6.8/7.81, hemoglobin 1.3/14.9 in non-newborns; not determined/16.4 in newborns. CONCLUSION: All extreme values deviated 7 s.d. or more from the means. Patients obviously can survive rather deviant analyte values.


Assuntos
Cálcio , Magnésio , Humanos , Recém-Nascido , Fosfatos , Potássio , Sódio
2.
Clin Chem Lab Med ; 56(11): 1878-1885, 2018 10 25.
Artigo em Inglês | MEDLINE | ID: mdl-29729143

RESUMO

BACKGROUND: Practical application of prospective risk analysis (PRA) in clinical laboratories should reflect processes as they are carried out, while making the PRA results obtained from different processes comparable. This means that not only STAT and standard testing and testing for critical and less critical parameters should be distinguished (as published), but also that the throughput in processes and process steps should be taken into account. METHODS: Building on our previously published PRA, a method was developed to compensate for the throughput in processes and process steps. A factor T, related to the actually observed throughput, was introduced in the risk score calculation. Introduction of this compensation factor leads to different overall risk scores. The criteria by which the risk scores are evaluated were modified accordingly. RESULTS: Introduction of a factor in the PRA to compensate for throughput leads to a change in the risk score for various conceivable failures in process steps. As compared to the PRA in which no compensation for throughput is made, in a process with low throughput the risk score for various conceivable failures in process steps comes out higher after introduction of the compensation factor, while in a process with high throughput various risk scores come out lower. CONCLUSIONS: Introduction of a factor to account for the throughput in a process (and process steps) leads to an improved, more realistic PRA, the results of which makes the risk scores of different processes (and process steps) better comparable to each other.


Assuntos
Serviços de Laboratório Clínico/normas , Técnicas de Laboratório Clínico/normas , Medição de Risco
3.
Clin Chem Lab Med ; 55(10): 1523-1529, 2017 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-28222019

RESUMO

BACKGROUND: Laboratory test ordering under time pressure may impact test-ordering behavior. METHODS: To investigate the test-ordering behavior of doctors working under such pressure, we designed a questionnaire for trainees and staff in the Emergency Department (ED). This questionnaire addressed topics such as necessity of requested tests, time spent on ordering, costs and availability of tests, and the time of the day. We hypothesized that ordering behavior would be guided predominantly by the medical need of tests and aimed at identifying practical motives that also have an effect. RESULTS: Remarkably, two-third of the respondents (67%) admitted that tests were ordered that would not influence treatment policy directly and 48% of the doctors stated that tests were ordered that do not impact treatment at all. The frequency of such orders was "sometimes" and "frequent" in a 50:50 ratio. Interestingly, tests that could prove relevant at a later stage are often ordered simultaneously to reduce burden on the patient. None of the respondents spent more than 3 min on the ordering process and very few (8%) desired more time for ordering. Most respondents (81%) declared to have limited knowledge of the costs of laboratory tests. A random survey covering four tests confirmed this. Generally, turnaround time did influence ordering behavior while time of the day did not. CONCLUSIONS: In conclusion, doctors in an ED - besides first of all medical motives - heavily exploit practical (non-medical) reasoning for laboratory test ordering, e.g. taking availability of tests into account and ordering non-immediate tests.


Assuntos
Testes Diagnósticos de Rotina/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Creatinina/sangue , Testes Diagnósticos de Rotina/economia , Hemoglobinas/análise , Humanos , Padrões de Prática Médica/estatística & dados numéricos , Fatores de Tempo
4.
Psychol Health Med ; 21(4): 424-430, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26339943

RESUMO

To investigate why men offer sperm donation via the internet, a questionnaire was disseminated via 39 Dutch-language websites thought to be visited by potential sperm donors. Nine internet donors completed the survey, men who typically knew the women they were donating to. Their responses were compared with those of a control group of 35 general sperm bank donors who were recruited using flyers in Dutch sperm banks, and who were typically unaware of the identity of the eventual recipients. The findings shed light on the motives and attitudes of internet donors. Both groups of donors indicated that their primary motivation for donating was altruism (>80% of all respondents). However, internet donors had a more pronounced desire to procreate than sperm bank donors (6 out of 9, i.e. 66 vs. 22%, respectively) and more often felt that they had good genes they wished to pass on (5 out of 9, i.e. 55 vs. 31%, respectively). The main reason internet donors gave for donating via the internet was that they wanted to know the prospective parents and be kept up to date on the progress of the offspring conceived from their donations. This distinguishes them significantly from sperm bank donors. A further finding was that they were not prompted to avoid the formal donation circuit for which, by law in the Netherlands, pregnancies resulting from donations have to be registered in a central database. This study is subject to several, in some cases inevitable, limitations, but it provides an interesting starting point that future studies can seek to confirm and extend.

5.
Reprod Biomed Online ; 30(6): 568-80, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25817048

RESUMO

An international working group was established with the aim of making recommendations on the number of offspring for a sperm donor that should be allowable in cases of international use of his sperm. Considerations from genetic, psychosocial, operational and ethical points of view were debated. For these considerations, it was assumed that current developments in genetic testing and Internet possibilities mean that, now, all donors are potentially identifiable by their offspring, so no distinction was made between anonymous and non-anonymous donation. Genetic considerations did not lead to restrictive limits (indicating that up to 200 offspring or more per donor may be acceptable except in isolated social-minority situations). Psychosocial considerations on the other hand led to proposals of rather restrictive limits (10 families per donor or less). Operational and ethical considerations did not lead to more or less concrete limits per donor, but seemed to lie in-between those resulting from the aforementioned ways of viewing the issue. In the end, no unifying agreed figure could be reached; however the consensus was that the number should never exceed 100 families. The conclusions of the group are summarized in three recommendations.


Assuntos
Espermatozoides , Doadores de Tecidos , Consanguinidade , Humanos , Masculino , Psicologia , Doadores de Tecidos/psicologia
6.
Clin Chem Lab Med ; 53(5): 731-42, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25301675

RESUMO

BACKGROUND: Ordering laboratory tests by means of test panels is a convenient way of requesting tests, preventing necessary tests from being forgotten. However, it also leads to redundant test ordering, as not all tests in a given panel are required for each patient. As test panels proposed by doctors may contain redundant, overlapping or infrequently used tests, the active involvement of knowledgeable laboratory staff in the organisation of test panels is advisable to promote efficient test use. METHODS: Laboratory staff initiated an intervention in the organisation of test panels at our hospital in 2009. After a review of the existing panels and the proposals for new panels, we established a total of 60 panels (down from 171 previously). We also stipulated that the laboratory is to be involved with all proposals for new test panels in the future. RESULTS: The reorganisation reduced the number of tests in the test panels by 17.7% (n=60), which theoretically should have resulted in 4.5% fewer tests being ordered. However, as an estimated 14% of the tests removed were then ordered individually in addition to the panels, 3.9% fewer tests were ordered, yielding an annual saving of about €58,000 (4.5% of the costs of all tests ordered in test panels). The savings amount to 7-8% if the frequently ordered metabolic panel (which was left unchanged) was excluded from the survey. CONCLUSIONS: Active intervention by the laboratory in the organisation of test panels results in a reduction in the use of tests and in interesting savings.


Assuntos
Técnicas de Laboratório Clínico/economia , Hospitais , Procedimentos Desnecessários/economia , Redução de Custos , Humanos
7.
Clin Chem Lab Med ; 51(6): 1207-15, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23454715

RESUMO

BACKGROUND: Modern computer systems allow limits to be set on the periods allowed for repetitive testing. We investigated a computerised system for managing potentially overtly frequent laboratory testing, calculating the financial savings obtained. METHODS: In consultation with hospital physicians, tests were selected for which 'spare periods' (periods during which tests are barred) might be set to control repetitive testing. The tests were selected and spare periods determined based on known analyte variations in health and disease, variety of tissues or cells giving rise to analytes, clinical conditions and rate of change determining analyte levels, frequency with which doctors need information about the analytes and the logistical needs of the clinic. RESULTS: The operation and acceptance of the system was explored with 23 analytes. Frequency filtering was subsequently introduced for 44 tests, each with their own spare periods. The proportion of tests barred was 0.56%, the most frequent of these being for total cholesterol, uric acid and HDL-cholesterol. The financial savings were 0.33% of the costs of all testing, with HbA1c, HDL-cholesterol and vitamin B12 yielding the largest savings. Following the introduction of the system the number of barred tests ultimately decreased, suggesting accommodation by the test requestors. CONCLUSIONS: Managing laboratory testing through computerised limits to prevent overtly frequent testing is feasible. The savings were relatively low, but sustaining the system takes little effort, giving little reason not to apply it. The findings will serve as a basis for improving the system and may guide others in introducing similar systems.


Assuntos
Sistemas de Informação em Laboratório Clínico , Técnicas de Laboratório Clínico/métodos , Laboratórios Hospitalares/organização & administração , Técnicas de Laboratório Clínico/economia , Controle de Custos , Humanos
8.
Acta Obstet Gynecol Scand ; 92(6): 679-85, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23181774

RESUMO

OBJECTIVE: Various reasons may guide the decision of men to become a sperm donor. Our aim was to identify a comprehensive set of possible reasons for and against sperm donation. DESIGN: Concept mapping. SETTING: Assisted reproduction clinics. SAMPLE: Nine sperm donors and seven non-sperm donors. METHODS: Interviews to obtain statements for and against sperm donation, card-sorting tasks to categorize these statements according to similarity, and hierarchical cluster analysis to structure these categorizations. MAIN OUTCOME MEASURES: Hierarchical structure with reasons for and against sperm donation. RESULTS: The hierarchical structure with 91 reasons comprised selfishness (including narcissism and procreation), psychosocial drives (including altruism, detached procreation, and sexual/financial satisfaction), and psychosocial barriers (including normative and moral barriers related to oneself, one's spouse, the donor child, and society). CONCLUSIONS: The identified hierarchical overview of reasons for and against sperm donation may help potential sperm donors when considering becoming a sperm donor, enable more systematic counseling of potential sperm donors, and guide further research on reasons for and against sperm donation.


Assuntos
Motivação , Espermatozoides , Doadores de Tecidos/psicologia , Adulto , Altruísmo , Análise por Conglomerados , Tomada de Decisões , Humanos , Renda , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Princípios Morais , Narcisismo , Países Baixos , Reprodução , Adulto Jovem
9.
Clin Chem Lab Med ; 50(12): 2141-8, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22745019

RESUMO

BACKGROUND: To manage the costs and performance of diagnostic services involving laboratory testing permanent evaluation is required. Among these, the ever increasing use of stat ordering, involving labour intensive phlebotomy,warrants explanation, especially for a phlebotomy service organised by the laboratory, not by those responsible for and/or carrying out the requests, such as doctors and nurses. METHODS: To explore the possibilities to reduce the number of stat phlebotomy requests, we conducted a survey among nurses and doctors of their motives in requesting 109 randomly selected stat orders. RESULTS: Fifty-fi ve percent of all stat phlebotomy orders were requested for immediate decision-making with respect to urgently required diagnosis and patient care, defined by us as medical reasons. The other 45 % of the stat orders were made for logistical reasons relating to the patient care or the hospital organisation. In total, 19 phlebotomy requests(17 % ) were unnecessary and could have been avoided.For most of the stat phlebotomy orders alternatives were not possible, as only 2 % of the requests could have been replaced by analysis in material that had been withdrawn earlier. CONCLUSIONS: The majority of the stat orders for phlebotomy were requested for good reasons, about equally distributed among the medical and logistical needs. This sets limits to the measures being feasible to further improve stat phlebotomy ordering efficiency, taking into account the way of functioning of modern hospital care.


Assuntos
Flebotomia , Revisão da Utilização de Recursos de Saúde , Tomada de Decisões , Estudos de Viabilidade , Humanos , Países Baixos
10.
Int J Androl ; 32(6): 656-65, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18798764

RESUMO

Present-day quality consciousness, as reflected in the newest European Directives and guidelines, demands from laboratories working with human gametes and embryos that attention be paid to risk analysis and management. Using these Directives and guidelines as reference, while also aiming at accreditation, we have worked out an approach for risk analysis in the fertility laboratory and semen bank for the processing of semen to be used for intrauterine insemination and for the preservation of semen in the semen bank, based on the general principles of failure mode and effect analysis. In this overview, we describe how risk analyses and various aspects of risk management in the fertility laboratory and semen bank can be carried out.


Assuntos
Fertilidade/fisiologia , Laboratórios/normas , Sêmen/fisiologia , Técnicas de Laboratório Clínico , Fertilização in vitro/métodos , Humanos , Masculino
12.
BMJ Open ; 9(7): e026065, 2019 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-31340957

RESUMO

INTRODUCTION: At present, studies comparing intrauterine insemination in the natural cycle versus intracervical insemination in the natural cycle in women undergoing artificial insemination with donor sperm are scarce. METHODS AND ANALYSIS: We perform a randomised controlled non-inferiority trial among five secondary and tertiary fertility clinics in the Netherlands and one tertiary fertility clinic in Belgium. Women eligible for artificial insemination with donor sperm are included. We perform six cycles of artificial insemination with donor sperm within a time horizon of 8 months comparing intrauterine insemination in the natural cycle with intracervical insemination in the natural cycle. The primary outcome is ongoing pregnancy leading to live birth conceived within eight months after randomisation. Secondary outcomes are clinical pregnancy rate, miscarriage rate, multiple pregnancy rate, pregnancy complications (preterm birth, birth weight <2500 g, pregnancy induced hypertension, (pre-) eclampsia, Hemolysis Elevated Liver enzymes Low Platelets (HELLP)), time to ongoing pregnancy, direct and indirect costs. To demonstrate the non-inferiority of intracervical insemination with a margin of 12%, we need 208 women per arm. ETHICS AND DISSEMINATION: The study has been approved by the Medical Ethical Committee of the Academic Medical Centre and from the Dutch Central Committee on research involving human subjects (47330-018-13). The boards of the participating hospitals approved the study. Results will be disseminated through peer-reviewed publications and presentations at international scientific meetings. TRIAL REGISTRATION NUMBER: NTR4462.


Assuntos
Inseminação Artificial/métodos , Colo do Útero , Feminino , Humanos , Ciclo Menstrual , Ensaios Clínicos Controlados Aleatórios como Assunto , Útero
14.
Clin Chim Acta ; 471: 6-11, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28495388

RESUMO

Clinical laboratories are regularly requested to inspect uncommon body fluids obtained from patients because clinicians are uncertain as to the origin of the collected material. They may need this information for the actual diagnosis, to confirm a supposition, or for guiding treatment and invasive operations like draining and puncturing. Often there is also a need to know more precisely what is going on in the cavity that gave rise to the fluid, for instance a local infection or metastasis, or whether the cavity is connected to organs or fluid compartments nearby etcetera. The results of the laboratory investigations often have () direct consequences. As the investigation of uncommon body fluids is distinct from routine laboratory analyses it requires special attention. This paper presents an overview of the characteristics of uncommon human body fluids, constituents useful as markers for recognizing and differentiating fluids and considerations that have to be taken into account when interpreting the results of analyses. In addition a number of practical recommendations for approaching the task of identifying uncommon body fluids are given.


Assuntos
Líquidos Corporais/química , Testes de Química Clínica/métodos , Humanos
15.
Clin Chim Acta ; 371(1-2): 176-82, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16674934

RESUMO

BACKGROUND: At least 20 inborn errors of metabolism may cause hydrops fetalis. Most of these are lysosomal storage diseases. The study proposes a diagnostic flowchart for prenatal diagnosis of non-immune hydrops fetalis. METHODS: This study contains a series of 75 non-immune hydrops fetalis pregnancies. Mucopolysaccharides, oligosaccharides, neuraminic acid and 21 lysosomal enzymes were measured in amniotic fluid and cultured amniotic cells. RESULTS: The study gives reference values for mucopolysaccharides and neuraminic acid at various stages of gestation. Four definite and two probable lysosomal diagnoses were found among the 75 investigated cases (=5.3-8%). Fetal death was found to cause false positive values for mucopolysaccharides in amniotic fluid. In the galactosialidosis case, two novel mutations were found in the cathepsin A gene. CONCLUSIONS: Reference values for mucopolysaccharides and neuraminic acid depend on gestational age. In a relatively high percentage of the hydrops foetalis pregnancies, a lysosomal aetiology is found. This study provides a strategy to diagnose lysosomal diseases in hydrops fetalis pregnancies. Awareness of lysosomal storage diseases causing hydrops fetalis is useful as it gives an opportunity for risk evaluation, genetic counseling to parents and targeted prenatal diagnostics for ensuing pregnancies.


Assuntos
Idade Gestacional , Hidropisia Fetal/diagnóstico , Doenças por Armazenamento dos Lisossomos/diagnóstico , Diagnóstico Pré-Natal/métodos , Líquido Amniótico/química , Catepsina A/genética , Células Cultivadas , Feminino , Glicosaminoglicanos/análise , Humanos , Hidropisia Fetal/genética , Hidropisia Fetal/mortalidade , Hidropisia Fetal/fisiopatologia , Doenças por Armazenamento dos Lisossomos/etiologia , Doenças por Armazenamento dos Lisossomos/genética , Doenças por Armazenamento dos Lisossomos/mortalidade , Lisossomos/enzimologia , Mutação , Ácido N-Acetilneuramínico/análise , Oligossacarídeos/análise , Gravidez , Valores de Referência , Fatores de Risco , Sialoglicoproteínas/genética , Sialoglicoproteínas/metabolismo
17.
Diagnosis (Berl) ; 2(4): 235-243, 2015 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-29540040

RESUMO

BACKGROUND: Prospective risk analysis (PRA) is a valuable instrument in quality assurance. The practical application of PRA in clinical laboratories according to the method we have described elsewhere leaves room for a number of adaptations to make it more applicable to and consistent with actual laboratory processes. METHODS: We distinguished between more and less critical tests and products in the laboratory processes and scored the consequences of failures at different steps in line with the previously described failure type and effect analysis (FMEA) method. PRA was carried out for two typical laboratory processes: standard clinical laboratory testing and the cryopreservation of semen. RESULTS: Tests in standard clinical laboratory in processes were labeled critical, semi-critical or non-critical. Consequence scoring (C) and assessed risk (R) were significantly higher for processes containing tests considered to be critical (C=6.6±1.5, R=19.3±13.5) as compared to processes containing tests considered semi- or non-critical (C=3.0±1.4, R=8.2±5.3 and C=3.2±1.8, R=8.6±5.9, respectively). There were no differences in the C and R scores for processes with tests considered semi- or non-critical. In the semen cryopreservation process, a distinction between the processes involving private semen and generally accessible semen was made. The C scores for these were significantly different (C=5.9±2.2 and 5.0±2.0, respectively), the R scores did not differ. CONCLUSIONS: Introduction of a test criticality classification for the purpose of consequence scoring led to an improved PRA methodology, better reflecting the reality of clinical laboratory practice. We found that two levels of criticality, critical and less critical, were sufficient to achieve this improvement.

18.
Ann Clin Biochem ; 51(Pt 6): 695-704, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24553437

RESUMO

BACKGROUND: Prospective risk analysis (PRA) is an essential element in quality assurance for clinical laboratories. Practical approaches to conducting PRA in laboratories, however, are scarce. METHODS: On the basis of the classical Failure Mode and Effect Analysis method, an approach to PRA was developed for application to key laboratory processes. First, the separate, major steps of the process under investigation are identified. Scores are then given for the Probability (P) and Consequence (C) of predefined types of failures and the chances of Detecting (D) these failures. Based on the P and C scores (on a 10-point scale), an overall Risk score (R) is calculated. The scores for each process were recorded in a matrix table. Based on predetermined criteria for R and D, it was determined whether a more detailed analysis was required for potential failures and, ultimately, where risk-reducing measures were necessary, if any. RESULTS: As an illustration, this paper presents the results of the application of PRA to our pre-analytical and analytical activities. The highest R scores were obtained in the stat processes, the most common failure type in the collective process steps was 'delayed processing or analysis', the failure type with the highest mean R score was 'inappropriate analysis' and the failure type most frequently rated as suboptimal was 'identification error'. CONCLUSIONS: The PRA designed is a useful semi-objective tool to identify process steps with potential failures rated as risky. Its systematic design and convenient output in matrix tables makes it easy to perform, practical and transparent.


Assuntos
Laboratórios/organização & administração , Controle de Qualidade , Medição de Risco/métodos , Química Clínica/organização & administração , Química Clínica/normas , Laboratórios/estatística & dados numéricos , Erros Médicos , Países Baixos , Gestão de Riscos
19.
Ned Tijdschr Geneeskd ; 158: A7232, 2014.
Artigo em Holandês | MEDLINE | ID: mdl-25004782

RESUMO

In recent years much has changed in care for artificial insemination with donor sperm (AID). Since new laws and regulations were implemented, a large number of sperm banks have closed and the total number of sperm donors and their availability have decreased. Long waiting times and the use of sperm donors recruited by foreign commercial sperm banks can indicate a shortage of sperm donors. The fact that the internet offers women the possibility of ordering donor sperm and starting treatment without the intervention of a sperm bank means that future donor-conceived children may be prevented from obtaining the identity of their sperm donor as stipulated in the Dutch law on donor information in the context of artificial insemination. In order to comply with this law, an active recruitment policy is needed for Dutch sperm donors, to prevent waiting lists and treatments outside Dutch sperm banks. Only then can current AID care be guaranteed in the Netherlands in the future.


Assuntos
Inseminação Artificial Heteróloga/legislação & jurisprudência , Inseminação Artificial Heteróloga/tendências , Inseminação Artificial , Bancos de Esperma/tendências , Doadores de Tecidos/legislação & jurisprudência , Humanos , Masculino , Países Baixos , Bancos de Esperma/provisão & distribuição , Listas de Espera
20.
Hum Fertil (Camb) ; 17(1): 21-7, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24575758

RESUMO

The shortage of sperm donors in formal settings (i.e., assisted reproduction clinics) and the availability of sperm donors in informal settings (such as through contacts on the internet) motivated us to investigate why men may prefer either a formal or an informal setting for sperm donation. Interviews with ten sperm donors and non-sperm donors yielded 55 reasons for sperm donation in the two settings. These reasons were categorized according to similarity by 14 sperm donors and non-sperm donors. These categorizations were then structured by means of hierarchical cluster analysis. Reasons favouring formal settings included being legally and physically protected, evading paternal feelings or social consequences, and having a simple, standardized procedure in terms of effort and finances. Reasons favouring informal settings related to engagement, the possibility to choose a recipient, lack of rules and regulations, having contact with the donor child, and having an (intimate) bond with the recipient. The overview of reasons identified may help potential sperm donors decide on whether to donate in a formal or informal setting, and may fuel discussions by professionals about the most appropriate conditions and legislation for sperm donation in formal settings.


Assuntos
Motivação , Espermatozoides , Doadores de Tecidos/psicologia , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA