Factors for adoption of artificial insemination technology in pig: evidence from small-scale pig production system.

The average treatment estimation framework was used to estimate the actual and potential adoption rates of artificial insemination technology in pig and their determinants using responses of 390 randomly selected pig farmers. The sample adoption rate of artificial insemination technology in pig is estimated to be 16% while the potential adoption rate is estimated at 47%. Incomplete diffusion or exposure of the technology in the population has lead to significant adoption gap of 31%. Result of the average treatment estimation probit model for determinants of adoption revealed the existence of significant difference in the coefficients and magnitude of marginal effects compared to the classic adoption model. Results showed that variables such as age of household head, piggery farming experience, maximum number of pigs reared in a year during the last 5 years, number of breeding sows, distance to artificial insemination provider centre, access to extension services and participation in training and demonstration programmes on pig were the significant determinants for adoption of artificial insemination technology in small-scale pig production system.

Cost-benefit Analysis of IUI and IVF based on willingness to pay approach; case study: Iran.

Assisted reproductive technologies (ARTs) are often considered luxury services by policy-makers and the general population, which are always susceptible of removal from public funding of health care. The analysis of the economic aspects of this scope seems essential due to the high prevalence of infertility in Iran and the high costs of infertility treatments. This study aimed to investigate the value put on IUI and IVF treatments by communities in Iran and the affordability of services based on community preferences. A cost-benefit analysis (CBA) was performed based on the WTP approach, and the contingent valuation method (CVM) was used to estimate WTP for IUI and IVF using a researcher-made survey in two cities of Kerman and Isfahan, Iran, in 2016-17. The sample size was 604, and the study sample frame to estimate WTP included two groups of couples who were/were not aware of their fertility statuses. The costs of one cycle of IUI and IVF were calculated according to the treatment protocols, tariffs of 2016-17, and medical information records of patients. The mean direct and indirect medical costs of one cycle of IUI and IVF were equivalent to 19561140 and 60897610 IRR, respectively. Also, the mean WTP for IUI and IVF treatments were obtained of 15941061 and 28870833 IRR, respectively. The demand for IUI and IVF treatments was elastic and the community was sensitive to price changes of these treatment methods. IUI and IVF treatments brought no positive net benefits, and economic variables had the highest impact on the WTP and community preferences, indicating the significant role of financial constraints in the community's valuation for advanced infertility treatments in Iran.

That Which Was "Not": Some Thoughts Regarding Oedipus's Modern Conflicts.

Historically, psychoanalysis has positioned the Oedipus complex as its focal point, based on a parental configuration of two-parent families consisting of a (male) father and a (female) mother. The modern era allows, albeit highly ambivalently, for the diversity of marital and parental configurations, reflecting cultural change as well as advances in the medical-technology of in vitro fertilization and of sperm and egg donations. The author discusses the analyses of two lesbian women who have chosen to mother a baby via an anonymous sperm donation. The author then takes up the question of whether unconscious oedipal conflicts influenced the decisions these patients made. She also questions whether the father in contemporary analytic thinking needs be a (male) "father" who is the "third," the "other." The work of Freud, Loewald, Searles, Poland, Ogden, and others will be brought to bear on these questions.

Using the EngagedMD multimedia platform to improve informed consent for ovulation induction, intrauterine insemination, and in vitro fertilization.

OBJECTIVE: To study patient and provider feedback on how a multimedia platform (EngagedMD) helps patients to understand the risks and consequences of in vitro fertilization (IVF), ovulation induction (OI), and intrauterine insemination (IUI) treatments and the impact of the informed consent process. DESIGN: Prospective survey study. SETTING: IVF units in the United States. PATIENT(S): Six-thousand three-hundred and thirty-three patients who viewed the multimedia platform before IVF or OI-IUI treatment at 13 U.S. IVF centers and 128 providers. INTERVENTION(S): Quantitative survey with 17 questions. MAIN OUTCOME MEASURE(S): Assessment of the impact of a multimedia platform on patient anxiety, comprehension, and satisfaction and provider/nurse feedback related to the informed consent process. RESULT(S): The survey was completed by 3,097 respondents (66% IVF treatment; 34% OI-IUI treatment) and 44 providers. Overall, 93% felt the media platform was intuitive, and 90% and 95% felt it had appropriate duration and detail, respectively. Most agreed/strongly agreed it better prepared them to consent (88%), increased their comfort in pursuing treatment (77%) and increased their satisfaction with their care (83%). Compared with the OI-IUI group, statistically significantly more participants who viewed the IVF media platform strongly agreed that the comprehension questions reinforced key concepts (47% vs. 40%), educated them about treatment risks (55% vs. 44%), helped them ask providers informed questions (45% vs. 36%), and better prepared them to sign consent forms (46% vs. 37%). Overall, 63% of providers felt that the media platform improved patient learning, made patients more accountable, and standardized information dissemination. CONCLUSION(S): The EngagedMD media platform improves patient knowledge, satisfaction, and control over medical decision making and better prepares patients to give informed consent. Furthermore, it is well-liked by providers and is easily implemented.

[Surrogacy in Maternity. A Depersonalising Human Relationship Phenomenology]. / La Subrogación en la Maternidad. Fenomenología de una Interacción Humana Despersonalizadora.

Ethical and bioethical problems, which are typical of the practice of surrogate motherhood, refer to its protagonists: the couple that orders it, due to its demand to satisfy the desire of paternity and maternity and the promptness of having a female body to fulfill its aspirations; the expectant mother, and the physical and psychic repercussions coming from the role performed in the surrogacy contract, as well as the risks of manipulation and exploitation, related to her position; the baby and his right to grow counting on the certainty of his parental relationships and on the preservation of his emotional balance. The human and anthropological importance of these issues, along with the growing development of this practice in the world, has questioned our moral conscience. In this context, the expectant mother, the weakest and the most affected part among the parts involved in the surrogacy contract, demands a particular attention. In this sense, the aim of this work is to lead a phenomenological analysis of the different steps of the practice of surrogacy, from the first stage of collection and classification of the information referring to the candidates, to the stage of the insemination and of its consequences about to the private life of the expectant. On the other hand, this work tries to justify the existence of a parallelism, as for the exploitation of the female body, between the practice of surrogate motherhood and prostitution. Finally, the issue relating to the effective social emancipation of the surrogate women in poor countries, the real autonomy and the freedom of their decision, as well as the typical features of the desire of paternity of the ordering couple are dealt with. The carried out study has allowed to conclude that this practice always implies a degree of physical, psychic and moral exploitation of the expectant mother, which suggests its prohibition at global level.

Absence or presence? Complexities in the donor narratives of single mothers using sperm donation.

STUDY QUESTION: How do single mothers who have conceived a child via anonymous or identity-release sperm donation represent the donor? SUMMARY ANSWER: While the majority of mothers described their anonymous and identity-release donors as symbolically significant to their families, others were more likely to emphasize that their lack of information limited their thoughts about him. WHAT IS KNOWN ALREADY: There is limited understanding of the factors that impact upon how single mothers represent the donor, and whether or not they are determined by specific donor programmes (anonymous or identity-release). STUDY DESIGN, SIZE, DURATION: Qualitative interviews were conducted with 46 women who had treatment at a UK licensed fertility clinic during the years 2003-2009. Twenty mothers (43%) had used an anonymous donor, and 26 (57%) had used an identity-release donor. PARTICIPANTS/MATERIALS, SETTING, METHODS: Among the 46 mothers interviewed, all had at least one child conceived via donor insemination who was between the ages of 4 and 9 years. Mothers were heterosexual and were currently without a live-in and/or long-term partner. Interview data were analysed qualitatively according to the principles of thematic analysis. MAIN RESULTS AND THE ROLE OF CHANCE: Findings indicated marked diversity in single mothers' representations of the donor. Most (n = 27) mothers talked about the donor as symbolically significant to family life and were likely to describe the donor as (i) a gift-giver, (ii) a gene-giver and (iii) a potential partner. Others (n = 16) talked about the donor as (i) unknown, (ii) part of a process and (iii) out of sight and out of mind. There were mothers with anonymous and identity-release donors in each group. Several mothers explained that their feelings about the donor had changed over time. LIMITATIONS, REASONS FOR CAUTION: All mothers conceived at a licensed fertility clinic in the UK. Findings are limited to individuals willing and able to take part in research on donor conception. WIDER IMPLICATIONS OF THE FINDINGS: The study offers greater insight into the factors influencing the donor narratives produced in single-mother families. It has implications for the counselling and treatment of single women seeking fertility treatment with donor gametes in both anonymous and identity-release programmes. Given that the number of clinics offering identity-release programmes worldwide seems to be increasing, the finding that single women may have varying preferences with regard to donor type, and varying interest levels with regard to donor information, is important. It is recommended that clinicians and other fertility clinic staff guard against making assumptions about such preferences and any thoughts and feelings about the donor or donor information on the basis of marital status. STUDY FUNDING/COMPETING INTERESTS: This study was funded by the Wellcome Trust [097857/Z/11/Z]. The authors have no conflicts of interest to declare.

Famílias homopaeentais e maternidade biológica / Familias homoparentales y maternidad biológica / Homparental famiilies and biological moteerhood

O presente estudo teve por objetivo analisar os desafios e percalços vivenciados por casais de mulheres para a concretização da maternidade biológica, com o auxílio das novas tecnologias reprodutivas. Foram discutidas as motivações para a utilização de sêmen de doadores anônimos, assim como as razões pela opção por certas características dos referidos doadores. Foram entrevistadas nove mulheres, que vivem em coabitação com outras mulheres e que planejaram a maternidade conjuntamente. A concretização da maternidade por meio de laços biológicos apareceu como prioridade para as mulheres entrevistadas, reproduzindo, de certa forma, um modelo idealizado e tradicional de família. Contudo, a maternidade realizada ao lado de outra mulher originou uma configuração familiar controversa e perturbadora, uma vez que a homoparentalidade, de qualquer tipo, subverte noções prontas de parentesco e, quando atravessada pelas novas tecnologias de reprodução, constituiu-se, necessariamente, como algo inovador...

El presente trabajo tuvo como objetivo analizar los desafíos y percances vividos por parejas de mujeres para la concretización de la maternidad biológica, con el auxilio de las nuevas tecnologías reproductivas. Fueron discutidas las motivaciones para la utilización del semen de donadores anónimos, así como las razones por la opción por ciertas características de los referidos donadores. Fueron entrevistadas nueve mujeres, que viven en cohabitación con otras mujeres y que planearon la maternidad conjuntamente. La concretización de la maternidad a través de lazos biológicos apareció como prioridad para las mujeres entrevistadas, reproduciendo, de cierta forma, un modelo idealizado y tradicional de la familia. Sin embargo, la maternidad realizada al lado de otra mujer originó una configuración familiar controvertida y perturbadora, una vez que la homoparentalidad, de cualquier tipo, subvierte nociones preconcebidas de parentesco y, cuando atravesada por las nuevas tecnologías de reproducción, se constituye, necesariamente, como algo innovador...

The present study aimed at analyzing the challenges and difficulties experienced by female couples to materialize biological motherhood, with the support of new reproductive technologies. The motivations to use semen from anonymous donors, as well as the reasons to choose for certain characteristics in the referred donors were discussed. Nine women who live with other women and who had jointly planned motherhood were interviewed. The concretion of motherhood through biological bonds appeared as a priority to interviewed women, reproducing, in some ways, an idealized model of family. However, motherhood performed alongside other woman resulted in a controversial and disturbing family configuration, once homoparenthood of any kind subverts consolidated notions of kinship. When homoparenthood is consolidated through new reproductive technologies it necessarily constitutes something innovative...

Cross-border reproductive care for law evasion: a qualitative study into the experiences and moral perspectives of French women who go to Belgium for treatment with donor sperm.

One consequence of the legal diversity in Europe is that legal restrictions on treatments can be evaded by going abroad. Many French lesbian couples and single women are crossing the border to Belgium because they are denied access to treatments with donor sperm at home. This is the first qualitative research study into the experiences and moral perspectives of these women. Between June 2012 and May 2013, 11 lesbian couples and 2 single women were recruited at the department of reproductive medicine at Ghent University Hospital. The data from the semi-structured interviews was analysed using inductive thematic analysis. The results show that these women face several additional challenges to the already difficult process of cross-border treatment. Before they can start the treatment, they can only obtain information from the internet or from stories of friends who also went abroad for treatment with donor sperm. During the treatment, they need to find local clinics or physicians to monitor their cycle. Several women managed to game the French system to ensure partial reimbursement for their treatment when they were successful in finding a physician who was willing to prescribe drugs and perform tests. Most women had difficulties justifying their absence from work. In general these women felt that they were discriminated against and that their rights were not protected because of who they are. In that regard, the lack of legal recognition of the genetically unrelated partner in their country was particularly hard to cope with for the lesbian couples. These women have to develop many different strategies to deal with the difficulties they face during cross-border reproductive care. It is concluded that it is very important that they find a physician who is willing to support them in their 'baby project'.

Effect of lifestyle on quality of life of couples receiving infertility treatment.

This study investigated the effect of lifestyle on the quality of life among couples undergoing infertility treatment. The research universe consisted of 200 couples undergoing infertility treatment in Akdeniz University's Center of Reproductive Endocrinology and Assisted Reproductive Techniques. The data collection tools the authors used were a personal information form requesting sociodemographic characteristics and history of infertility, the SF-36 Quality of Life Scale, and the Healthy Lifestyle Behaviors Scale. This study revealed that the quality of life of the women in the study was lower than that of the men. The authors also found that the couples' quality of life was reduced by variables such as advanced age, low education level, unemployment status, lower income, long duration of infertility, high body mass index, history of andrological surgery, and previous experience of assisted reproduction techniques three or more times. Last, it was determined that the couples' quality of life improved as their healthy lifestyle behaviors increased. Demonstrating positive health behavior is likely to improve the quality of life of couples undergoing infertility treatment.

Psychological distress in women who have experienced intrauterine insemination.

BACKGROUND: Despite evidence that psychological distress manifests itself in underreported and atypical ways, few studies have assessed these symptoms in women who have experienced intrauterine insemination (IUI). PURPOSE: The aim of this study was to examine the prevalence of psychological distress and explore the relationships among psychological distress, various demographic characteristics, and somatic symptoms in women who had received IUI treatment in Taiwan. METHODS: A cross-sectional study design was used in this study. The 117 participants were recruited from a teaching hospital in northern Taiwan. The brief symptom rating scale (BSRS-5) was used as the measurement instrument, and scores of more than 5 on the BSRS-5 were used to mark the boundary between milder and more severe psychological distress. Demographic characteristics and somatic symptoms of IUI that contributed most significantly to psychological distress were identified from the data. RESULTS: Thirty-eight (32.5%) participants experienced psychological distress. Psychological distress was most common in participants (a) with husbands who were an only son, (b) who had taken medication during the previous week, (c) with an education level below college or university, and (d) who reported feeling faint. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The factors studied are important to understand psychological distress in women who have undergone IUI treatment.

Parenthood motives, well-being and disclosure among men from couples ready to start treatment with intrauterine insemination using their own sperm or donor sperm.

BACKGROUND: As pregnancy and childbirth have long been considered women's issues and male infertility has long been surrounded by taboo, limited research has focused on the experience of infertile men. The purpose of this study was to compare male motives for parenthood, male well-being and disclosure patterns concerning the method of conception among men from couples starting treatment with IUI using their own sperm (autologous sperm recipient, ASR) or donor sperm (donor sperm recipient, DSR). METHODS: This prospective study included 46 DSR- and 151 ASR-couples. Self-report questionnaires assessing parenthood motives, well-being and disclosure patterns concerning the method of conception were administered to both men and women prior to treatment. Unpaired T-tests and Fisher's exact tests were used to test for significant differences. RESULTS: When compared with ASR-men, DSR-men expect more positive effects from parenthood on relationships and feelings of fulfilment, and report less negative effects of infertility on sexuality, but a lower self-image and more guilt. DSR-men plan to disclose the method of conception less frequently and have so far disclosed to a lesser degree than ASR-men. CONCLUSIONS: DSR-men feel differently about parenthood and infertility compared with ASR-men, and their higher expectations combined with lower self-esteem need (more) attention during counselling.

A child of "hers": older single mothers and their children conceived through IVF with both egg and sperm donation.

OBJECTIVE: To study the decision to have a child alone, the experience of gamete donation, the issue of disclosure of the donor link to the child, conception-related health and sociodemographic characteristics of the mothers, children's socioemotional development, and mother-child relationships. DESIGN: Qualitative study. SETTING: Prior clients of a sperm bank. PARTICIPANT(S): Eleven single women in their late forties who gave birth to children aided by IVF involving both egg and sperm donation, i.e., the children are not genetically related to the mothers. RESULT(S): Not only were there differences among the participants, but they also differed from the only previous study focusing on single women becoming mothers by choice and using advanced reproductive technologies. CONCLUSION(S): Similarly to previous studies, we generally found that the impact of assisted conception on parenting and child development gives no undue cause for concern while the children are still young. However, the young age of the children in our sample prevented us from answering many questions about the children's socioemotional development and about disclosure of donor conception to children born to older single women using double gamete donation and IVF.

Psychological trait and state characteristics, social support and attitudes to the surrogate pregnancy and baby.

BACKGROUND: Personality differences between surrogate mothers (SMs) who gestate and relinquish and intended mothers (IMs) who commission a genetically related or unrelated baby have been unexplored in the UK. Furthermore, the psychological effects of the arrangement have not been determined in a prospective longitudinal study, making this the first quantitative report of psychological functioning in SMs and IMs. METHODS: SMs and IMs (n = 81: 61 surrogate, 20 intended) undergoing genetic or gestational surrogacy (4 groups) were assessed by postal questionnaire during the first, second and third trimesters of pregnancy. Those with a positive outcome were assessed again in the first week, at 6 weeks and 6 months post-delivery of the surrogate baby. RESULTS: There were no significant differences between or within SM and IM groups on personality characteristics. Social support, marital harmony and state anxiety differed significantly (to P < 0.01) between SMs and IMs at different stages of the arrangement. Differences in attitudes towards the pregnancy and the baby were also observed between groups during pregnancy (to P < 0.001), but there was no evidence of post-natal depression amongst the groups studied. CONCLUSIONS: These results are important because they demonstrate psychological effects of the surrogate arrangement are notable and occur over an extended period of time. It also shows that psychological screening and support prior to, during and following surrogacy is indicated.

Parental coping with sudden infant death after donor insemination: case report.

We report the case of an artificial donor insemination couple experiencing sudden infant death of their 8-month-old child. Six months after the incident, the couple were investigated by means of an extensive interview, a repertory grid investigation and the Family Assessment Measure, as well as at 6 years after the incident by an extensive interview. The results show the importance of the diagnosis of male infertility and the preceding fertility treatment for coping with the death of their child. Six months after the incident, acute feelings associated with bereavement are mixed with feelings of anger and shame, apparently due to the experience of infertility. However, secrecy and shame associated with male infertility and donor insemination make it impossible for the couple to communicate their feelings to each other or to friends and relatives; furthermore, they decline psychological counselling. Repertory grid investigation and the Family Assessment Measure point to significant problems within the partnership. Six years after the incident, the couple's relationship is destabilized and both partners plan to divorce. We suggest a possible link between donor insemination secrecy and difficulties with coping. We discuss implications for couple counselling and emphasize the necessity for an improved legal framework for donor insemination in Germany.

Why do children want to know more about the donor? The experience of youngsters raised in lesbian families.

In this study, we focus on the donor origin of youngster who are raised in lesbian donor insemination (DI) families. The aim was to explore why some of these DI children like to know more about the donor while others do not, these data were gathered by means of a semi-structured interview. Secondly, we investigated, by means of several questionnaires, whether psychological variables such as global self-esteem, emotional and behavioral adjustment and children's perception of the quality of the parent-child relationship were in some way linked to whether or not they wanted to know more about the donor. In our study the majority of the children who preferred to have no information about the donor expressed their loyalty towards the social mother. For the majority of the children who opted for donor information, curiosity was the most salient motive. No differences were found with regard to the psychological variables between the two groups considered. In conclusion, the wish to know more about the donor or the absence of such a need is not reflected in the child's well-being and is not linked to the quality of the parent-child interaction.

Family functioning in lesbian families created by donor insemination.

The quantitative and qualitative data of this study on family functioning in lesbian donor insemination families reveal that according to both parents and children, the quality of children's relationship with the social mother is comparable to that with the biological mother. Unlike fathers in heterosexual families, the lesbian social mother is as much involved in child activities as is the biological mother. Furthermore, the lesbian social mother has as much authority as does the father in heterosexual families.