Infertility is a condition that affects a significant number of couples around the world and Assisted Reproductive Technology (ART), which offers a range of possible treatments, is the most effective means to treat infertility. One of the key features of ART is conception by egg donation in which the child has no genetic link with the mother.
The aim of the present thesis is to examine how the Iranian (Eastern) and British (Western) public, as well as mothers (both Iranian and British) who have conceived a child by egg donation, differ in their perceptions of the consequences of children born by egg donation from psychological, social and medical perspectives (study1).
Furthermore, it aims to examine how Iranian pregnant women who have conceived by egg donation differ in their maternal bonding and health practices from those who conceived naturally (study 2).
The sample group in study 1 consisted of 121 participants, 63 Iranian (Male = 26, Female = 37, Mean Age = 42.91, SD = 13.58) and 58 British (Male = 19, Female = 39, Mean Age = 32.36, SD = 14.02), in which 8 participants (4 Iranian and 4 British) were mothers with a donor egg child of primary school age. A 12-item questionnaire/statements was presented to the participants based on key reported literature on various scientific research findings on psychological, medical and social issues related to children born through ART. The participants were requested to respond to each statement by choosing one of the Likert scale options ranging from 1 to 4, Strongly agree, Agree, and Disagree to Strongly disagree. There was also an opportunity for the participants to write down additional comments in response to each of the statements about the reasons for their choice on each of the options. The process of data collection took 5 months to complete from January to May 2015.
Study 1 results were subjected to quantitative analyses for the Iranian and the British public and for the Iranian and British mothers who have children born as a result of egg donation. Furthermore, all written comments were subjected to content analysis.
The results showed that Iranian mothers with a donor egg child agreed more than their British counterparts (8 participants) that conception via egg donation might have psychological, social and medical problems for the resulting children due to a) lack of genetic link b) being unhappier than naturally born and c) might experience overt prejudice from the society.
Overall, study 1 found that men more than women and the Iranians more than the British were in agreement with scientific research that children conceived via egg donation have more medical, psychological and social problems than naturally born children due to lack of genetic link, being unhappier and experience more prejudice from their society.
Study 2 conducted in a hospital in Tehran aimed to explore maternal bonding between mother and fetus, and health practices in Iranian pregnant women via egg donation and naturally through the Maternal-Fetal Attachment (MFA), Fetal Health Locus of Control (FHLC) and Maternal Health Practices (MHP). The target group consisted of 21 Iranian women pregnant via egg donation (Mean Age = 32.42, SD = 4.48). For comparison, a sample of 50 women pregnant by natural conception (Mean Age = 28.06, SD = 5.45) was also recruited. The process of data collection initiated in January 2018 and concluded in May 2018.
The results showed women who conceived via donor egg, compared to women who conceived naturally, scored lower on the 4 subscales of MFA namely: Attributing characteristics to the fetus, Giving of self, Differentiation of self from the fetus and Interaction with the fetus. On the FHLC scale, women who conceived via donor egg, compared to women who conceived naturally, considered both Chance and Professionals/Powerful Others (External factors) as being more responsible for the health of their baby rather than Internal factors (or themselves). Finally, women who conceived via donor egg, compared to women who conceived naturally, scored lower on MHP indicating they paid significantly less attention to their health activities during pregnancy.
Overall, the results of the two studies are argued to make an original contribution to public perceptions of donor egg children and maternal bonding, and health practices of pregnant women who conceived by egg donation, in particular, in a culture such as Iran. It is hoped that practitioners and those involved in infertility treatment benefit from the results of the present study in giving the best advice to their patients. The limitations of the thesis, as well as recommendations and future directions, are discussed
