Surrogacy

Surrogacy is a promising treatment for infertility. It can potentially solve many intolerable difficulties that the infertile couples and their families face. Although initially frowned upon, evidence shows that the surrogacy arrangements are more acceptable now than when it was first introduced. Therefore, changes in the attitude in decision making about surrogacy can also be seen in some countries, but there are still indications of the degree of divergence between discourse and the actual practice of different forms of surrogacy around the world. Social, ethical and legal problems are subject to major debates and disagreements in natural or partial surrogacy or genetically unrelated full surrogacy. Genetic gestation surrogacy may largely free from social, legal and moral complications. It is a great choice of infertility treatment if the couple want their own genetic baby, but it still requires more thoughts and discussion. This chapter attempts to discuss the different notions related to surrogacy worldwide

Assisted reproduction and Middle East kinship: a regional and religious comparison

This article compares the use of assisted reproductive technology (ART) and resultant kinship formations in four Middle Eastern settings: the Sunni Muslim Arab world, the Sunni Muslim but officially 'secular' country of Turkey, Shia Muslim Iran and Jewish Israel. This four-way comparison reveals considerable similarities, as well as stark differences, in matters of Middle Eastern kinship and assisted reproduction. The permissions and restrictions on ART, often determined by religious decrees, may lead to counter-intuitive outcomes, many of which defy prevailing stereotypes about which parts of the Middle East are more 'progressive' or 'conservative'. Local considerations – be they social, cultural, economic, religious or political – have shaped the ways in which ART treatments are offered to, and received by, infertile couples in different parts of the Middle East. Yet, across the region, clerics, in dialogue with clinicians and patients, have paved the way for ART practices that have had significant implications for Middle Eastern kinship and family life

Knowledge, perceptions and myths regarding infertility among selected adult population in Pakistan: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>The reported prevalence of infertility in Pakistan is approximately 22% with 4% primary and 18% secondary infertility. Infertility is not only a medical but also a social problem in our society as cultural customs and perceived religious dictums may equate infertility with failure on a personal, interpersonal, or social level. It is imperative that people have adequate knowledge about infertility so couples can seek timely medical care and misconceptions can be rectified.</p> <p>We aim to assess the knowledge, perception and myths regarding infertility and suggest ways to improve it.</p> <p>Methods</p> <p>A cross-sectional survey was carried out by interviewing a sample of 447 adults who were accompanying the patients at two tertiary care hospitals in Karachi, Pakistan. They were interviewed one-on-one with the help of a pretested questionnaire drafted by the team after a thorough literature review and in consultation with infertility specialists.</p> <p>Results</p> <p>The correct knowledge of infertility was found to be limited amongst the participants. Only 25% correctly identified when infertility is pathological and only 46% knew about the fertile period in women's cycle. People are misinformed that use of IUCD (53%) and OCPs (61%) may cause infertility. Beliefs in evil forces and supernatural powers as a cause of infertility are still prevalent especially amongst people with lower level of education. Seeking alternative treatment for infertility remains a popular option for 28% of the participant as a primary preference and 75% as a secondary preference. IVF remains an unfamiliar (78%) and an unacceptable option (55%).</p> <p>Conclusions</p> <p>Knowledge about infertility is limited in the population and a lot of misconceptions and myths are prevalent in the society. Alternative medicine is a popular option for seeking infertility treatment. The cultural and religious perspective about assisted reproductive technologies is unclear, which has resulted in its reduced acceptability.</p

Recent cadmium exposure among male partners may affect oocyte fertilization during in vitro fertilization (IVF)

We recently reported evidence suggesting associations between urine cadmium concentrations, reflecting long-term exposure, measured in 25 female patients (relative risk = 1.41, P = 0.412) and 15 of their male partners (relative risk = 0.19, P = 0.097) and oocyte fertilization in vitro. Blood cadmium concentrations reflect more recent exposure. We here incorporate those measures into our prior data set and employ multivariable log-binomial regression models to generate hypotheses concerning the relative effects of long-term and recent cadmium exposure on oocyte fertilization in vitro. No association is indicated for blood cadmium from women and oocyte fertilization, adjusted for urine cadmium and creatinine, blood lead and mercury, age, race/ethnicity and cigarette smoking (relative risk = 0.88, P = 0.828). However, we suggest an inverse adjusted association between blood cadmium from men and oocyte fertilization (relative risk = 0.66, P = 0.143). These results suggest that consideration of long-term and recent exposures are both important for assessing the effect of partner cadmium levels on oocyte fertilization in vitro

Reproductive morbidity among Iranian women; issues often inappropriately addressed in health seeking behaviors

<p>Abstract</p> <p>Background</p> <p>Reproductive morbidity has a huge impact on the health and quality of life of women. We aimed to determine the prevalence of reproductive morbidities and the health seeking behavior of a nationally representative sample of Iranian urban women.</p> <p>Methods</p> <p>A sample of 1252 women, aged 18-45 years, was selected using the multi stage, stratified probability sampling procedure. Data were collected through interviews and physical, gynecological and ultrasonographic examinations.</p> <p>Results</p> <p>Reproductive tract infection (RTIs), pelvic organ prolapse (POP) and menstrual dysfunction were the three main groups of morbidities with a prevalence of 37.6%, 41.4% and 30.1%., respectively. Our study demonstrated that 35.1, 34.5 and 9.6 percent of women experienced one, two or these reproductive organ disorders mentioned, respectively, while 20.6 percent of participants had none of these disorders. Findings also showed that the majority of women who suffered from reproductive morbidities (on average two out of three) had not sought appropriate care for these except for infertility.</p> <p>Conclusions</p> <p>Reproductive health morbidities impose a large burden among Iranian women and have negative impact on their reproductive health and wellbeing.</p

Psychological distress as predictor of quality of life in men experiencing infertility: a cross-sectional survey

<p>Abstract</p> <p>Background</p> <p>Infertility is associated with impairment in human life. The quality of life (QOL) construct allows measuring the impact of health conditions in a broader way. The study aimed to explore the impact of the psychological distress on QOL's dimensions in men experiencing infertility.</p> <p>Methods</p> <p>162 men were completed a socio-demographic form, SF-36, WHOQOL-BREF, Beck Anxiety Inventory and Beck Depression Inventory. Hierarchical regressions included demographic and clinic variables, and subsequently depression and anxiety were added.</p> <p>Results and Discussion</p> <p>Model 1 was not accurate in predicting QOL. R²values ranged from 0.029 (Social Functioning) to 0.149 (Mental Health). Eight domains were not associated with any of the predictors. In the second model, a R²increase was observed in all domains. R²of QOL scores ranged from .209 (Role Physical) to .406 (Social Functioning). The intensity of the depression was a significant predictor for all outcomes. The load of depression was higher than the ones of the socio-demographic and clinical variables. Anxiety levels have also presented the same effect, but with less intensity.</p> <p>Conclusion</p> <p>Subthreshold depression and anxiety were major predictors of QOL in men experiencing infertility. Health professionals need to include assessment of psychological symptomatology to plan more efficient interventions to infertile patients.</p

Settler state apologies and the elusiveness of forgiveness : The purification ritual that does not purify

Peer reviewedPostprin