The changing profile of surrogacy in the UK – implications for national and international policy and practice

Since 2007, the numbers of UK Parental Orders granted following surrogacy have markedly increased. More recently, eligibility criteria have been extended to unmarried heterosexual couples and same-sex couples rather than only married couples. Numbers seeking fertility treatments, including through surrogates, outside their country of residence have also increased. This paper presents the limited data currently available – from UK General Register Offices, Child and Family Court Advisory and Support Service for England and the UK surrogacy agencies: COTS, Surrogacy UK, British Surrogacy Centre – to consider potential reasons for the increase and to consider policy and practice implications. It charts the apparent decline in involvement of surrogacy agencies and suggests the potential for exploitation where scrutiny of arrangements and follow up are limited. It recommends improvements to data collection and argues the need for a more integrated approach to review of surrogacy arrangements both nationally and internationally

The Application of the Geiger-Müller Ion Counter to the Study of the Space Distribution of X-ray Photoelectrons

The photographic plate in the apparatus for the magnetic analysis of x-ray photoelectrons has been replaced by a Geiger-Müller ion counter and the magnetic spectrum of the photoelectrons ejected from a thin film of gold by primary x-ray from molybdenum has been studied. Very great resolving power is obtained and considerable precision in determining the exact position of the lines (i.e. the energies of the photoelectrons). The numbers of LIII electrons of gold ejected by the Kα1 x-ray of molybdenum have been plotted as a function of the angle of ejection and compared with the theoretical longitudinal distribution predicted by Schur

Fetal thrombocytopenia : preventive strategies.

Intracranial haemorrhage (ICH) among term neonates is associated with neonatal death or lifelong disability. Between all the proposed aetiological mechanisms, including impairments in coagulation, hypoxic-ischemic injury and birth related trauma, thrombocytopenia seems to be the most important predictor of ICH among term neonates and is also associated with the most severe forms of haemorrhage. Neonatal thrombocytopenia is defined as a platelet count < 150 x109/L. The incidence of thrombocytopenia (< 150 x 109/L) in all newborns is 1-4%. However, due to absence of clinical signs, mild or moderate thrombocytopenia is often not noted. Symptoms that might occur are petechiae, haematomas, gastro-intestinal bleedings and intracranial haemorrhages. Especially neonates with severe thrombocytopenia (<50 x109/L) are at risk for bleeding problems. Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is the most common cause of thrombocytopenia, especially in otherwise healthy term newborns. The aim of the studies described in this thesis was to contribute to improve the outcome of pregnancies complicated by fetal thrombocytopenia, caused by alloimmune thrombocytopenia, red cell alloimmunisation (Rhesus D and Kell) and Parvovirus B19 infection.UBL - phd migration 201

Searching for ‘relations’ using a DNA linking register by adults conceived following sperm donation

This paper considers how sperm donor-conceived adults registered with a voluntary DNA linking register, UK DonorLink, constructed identity and relatedness by examining two areas: how their identity was affected by becoming aware that they were donor-conceived; and the process of searching for their donor and donor-conceived siblings. The views and experiences of donor-conceived adults has, until recently, been a neglected area. This study is the first to consider the experiences of those searching through a DNA-based register, and contributes to the growing literature on searching. This paper presents qualitative data from a questionnaire-based study with 65 adults conceived following sperm donation. It examines emerging linkages by investigating how ideas of relatedness, kinship and identity were enacted and how narrative certainties were moved and removed by opening up new conceptions of what it means to be ‘related’. Their knowledge of being donor-conceived was both a powerful disrupter and a consolidator of family relationships. No single story of being donor-conceived emerged – with competing narratives about the effects and implications for respondents’ kinship relationships and sense of identity. This study sheds light on how kinship relationships are negotiated and managed in adulthood by those conceived following sperm donation and how this can change over the life-course

Expectations and experiences of gamete donors and donor-conceived adults searching for genetics relatives using DNA linking through a voluntary register

STUDY QUESTION: What are the experiences of donor-conceived adults and donors who are searching for a genetic link through the use of a DNA-based voluntary register service? SUMMARY ANSWER: Donor-conceived adults and donors held positive beliefs about their search and although some concerns in relation to finding a genetically linked relative were reported, these were not a barrier to searching. WHAT IS KNOWN ALREADY: Research with donor-conceived people has consistently identified their interest in learning about-and in some cases making contact with-their donor and other genetic relatives. However, donor-conceived individuals or donors rarely have the opportunity to act on these desires. STUDY DESIGN, SIZE, AND DURATION: A questionnaire was administered for online completion using Bristol Online Surveys. The survey was live for 3 months and responses were collected anonymously. PARTICIPANTS/MATERIALS, SETTING, AND METHODS: The survey was completed by 65 donor-conceived adults, 21 sperm donors and 5 oocyte donors who had registered with a DNA-based voluntary contact register in the UK. The questionnaire included socio-demographic questions, questions specifically developed for the purposes of this study and the standardized Aspects of Identity Questionnaire (AIQ). MAIN RESULTS AND THE ROLE OF CHANCE: Motivations for searching for genetic relatives were varied, with the most common reasons being curiosity and passing on information. Overall, participants who were already linked and those awaiting a link were positive about being linked and valued access to a DNA-based register. Collective identity (reflecting self-defining feelings of continuity and uniqueness), as assessed by the AIQ, was significantly lower for donor-conceived adults when compared with the donor groups (P 0.05) for donor-conceived adults. LIMITATIONS, REASONS FOR CAUTION: Participants were members of a UK DNA-based registry which is unique. It was therefore not possible to determine how representative participants were of those who did not register for the service, those in other countries or of those who do not seek information exchange or contact. WIDER IMPLICATIONS OF THE FINDINGS: This is the first survey exploring the experiences of donor-conceived adults and donors using a DNA-based voluntary register to seek information about and contact with genetic relatives and the first to measure aspects of identity using standardized measures. Findings provide valuable information about patterns of expectations and experiences of searching through DNA linking, identity and of having contact in the context of donor conception that will inform future research, practice and policy development

Gamete donors’ reasons for, and expectations and experiences of, registration with a voluntary donor linking register

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

Voluntary DNA-based information exchange and contact services following donor conception: an analysis of service users’ needs

Medical science has enabled the creation of families through the use of donor conception but some lifelong policy and practice implications are only recently being recognized. Research and practice have shown that donor conception can, for some, carry substantial long-term consequences. In this paper we present findings from a questionnaire-based study that sought to shed light on donor-conceived adults’ and gamete donors’ views on service and support needs when searching for genetic relatives with the aid of DNA testing. The findings demonstrate the complexity and sensitivity of providing services in this newly emerging area of need. Such provision requires collaboration between very different disciplines and agencies (scientific and psychosocial), introduces the potential for blurring of lines of accountability and responsibility, and highlights the challenges of identifying appropriate funding streams. In addition, the findings demonstrate the opportunities and limitations afforded by the use of DNA in identifying unknown genetic relatives

‘This neo- natal ménage à trois’: British media framing of transnational surrogacy

Background: Media framing can influence people’s perceptions of social changes in family building, and has the potential to influence their future actions. Objectives: to analyse the type of framing and construction used in British news print of transnational commercial surrogacy. Methods: UK newspapers were searched using the search engine Lexis-Nexis. One hundred ninety seven articles were analysed. Content analysis was undertaken to identify the use of gain, loss, neutral, alarm and vulnerability frames, as well as type of construction (i.e. ethical, social, legal, financial and medical). Four researchers independently analysed articles using a coding strategy. Results: Differences between serious (mainly legal, financial), middle market (legal) and tabloid (social, financial) newspapers were found. There were three main foci; buying babies - affordable only to those wealthy enough to pay for it; the legal complications of transnational surrogacy - reporting a sense of the legal system lagging behind this practice; and gay families - repeatedly questioning their suitability as parents - demonstrating a prevailing heterosexual stereotype about reproduction and parenting. Conclusions: Stereotyping was prevalent and the welfare of children and medical aspects of transnational surrogacy were minimally addressed, indicating the media selectively influences its readership

Secrets and disclosure in donor conception

This paper considers the disclosure, sharing and exchange of information on being donor conceived within families, drawing on data from a study undertaken with donor-conceived adults registered with UK Donor Link (a voluntary DNA-linking register). It considers the narratives of how respondents found out they were donor-conceived and what events triggered disclosure of this information. It goes on to examine the role secrecy played in their family life and uses the concept of ‘display’ to explore how it affected their relationships with their immediate and extended family. Secrets are notoriously ‘leaky’ and we found complex patterns of knowing and uncertainty about whom in the family knew that the person was donor-conceived. We argue that what is kept secret and from whom provides insights into the multifaceted web of social relationships that can be created by donor-conception, and how knowledge can be managed and controlled in attempts to display and maintain family narratives of biogenetic connection

The Direction of Ejection of X-Ray Electrons

No conclusive evidence that the direction in which photo-electrons are ejected by X-rays depends in any way upon the nature of the atom from which the ejection takes place has as yet been brought forward. Auger, using the C. T. R. Wilson cloud expansion-chamber method, showed that the most probable direction of ejection in a gas is a function of the frequency of the incident X-rays, but the variations which he found in this most probable direction with the nature of the gas used (oxygen or nitrogen, argon, krypton, xenon) were probably less than the experimental error, particularly as heterogeneous X-rays were used and the frequency of the X-rays which were most effective in ejecting electrons may have varied from gas to gas. Loughridge concluded that the most probable direction of ejection was the same for water-vapor, air and argon, but the absorption energies of even the K-shells of all these atoms is so small that at best only a small effect would be expected in these cases. Bothe using the point-discharge ion-counter made observations on air and on gases the molecules of which contained I, Br and Cl atoms. His results show small variations with the nature of the gas, but again as heterogeneous X-rays were used and his maxima were not sharp the variations were probably less than the experimental accuracy