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The Role of Biomedical Technology
Published in Kant Patel, Mark Rushefsky, Healthcare Politics and Policy in America, 2019
The second category of ARTs involves third-party assistance. When couples fail to achieve pregnancy from infertility treatments or traditional ARTs, couples often opt to use a third-party to assist in achieving pregnancy. Third-party reproduction can take a variety of forms (American Society for Reproductive Medicine 2018).
Overview of Infertility
Published in Steven R. Bayer, Michael M. Alper, Alan S. Penzias, The Boston IVF Handbook of Infertility, 2017
There are ongoing ethical concerns about third-party reproduction arrangements, the most common of which is egg donation. The majority of egg donation arrangements are with anonymous donors. While there may be an element of altruism, the main reason why women donate eggs is financial. Egg donors need to be paid for their services, but how much is too much? Advertisements have appeared in college newspapers recruiting prospective donors with a certain level of intelligence, physical characteristics, and athletic ability—with price tags up to $50,000–$100,000. These high prices devalue the whole process and likens egg donation to the trading of a commodity. Most in the field regard these practices as unacceptable. Furthermore, the financial enticement significantly weakens the informed consent process of the egg donor. In addition, it may affect the donor in being forthright in providing important aspects of her medical and family history that could disqualify her. When two professional societies weighed in with guidance to clinicians on what they felt were reasonable fees that could be paid to egg donors without crossing the murky border of trading eggs as a commodity, they were subject to a class action lawsuit. The suit, settled in 2016, caused the societies to remove guidance on compensation to donors from their published guidelines.
Therapist Anger, Despair, Cynicism
Published in Allison Rosen, Jay Rosen, Frozen Dreams, 2015
The team in a reproductive medical practice generally consists of physicians, nurses, embryologists, lab technicians, support staff such as office workers and clinical assistants, and a mental health professional. In this context, the psychologist or social worker is generally not called on to do long-term psychotherapy or necessarily to help the patient with ingrained, unresolved conflicts. More often, the patient is looking for emotional support, strategies for making treatment decisions, relief from the depression and anxiety that come with the territory, stress reduction, assistance with couple issues that arise, and education about third-party reproduction. Generally, the standard of care in the industry would make counseling available but not mandatory for all patients except for those participating in third party reproduction, who are required to attend one counseling session. Third-party reproduction counseling includes recipients of donor gametes, egg donors, both known or anonymous, known sperm donors, surrogates or gestational carriers, and the intended parents. Anonymous sperm donors fall under the domain of a sperm bank. In actuality, programs vary widely in their treatment of the psychological component of infertility; some have no affiliated mental health professional and no mandatory counseling at all; others require all IVF patients to consult with a counselor.
Human oocyte cryopreservation: revised evidence for practice
Published in Human Fertility, 2023
Virginia N. Bolton, Catherine Hayden, Michele Robinson, Dima Abdo, Angela Pericleous-Smith
The issues confronting patients contemplating fertility preservation include: (i) pre-existing psychological distress in patients undergoing treatment for an index condition such as newly diagnosed malignancy; (ii) choice of fertility preservation strategy in the face of an uncertain relationship future (oocytes versus embryos); (iii) decision-making regarding the use of third-party reproduction (e.g. sperm/oocyte donation, gestational surrogacy); (iv) treatment expectations regarding pregnancy and miscarriage; (v) ethical issues related to treatment including the creation, cryopreservation, and disposal of oocytes/embryos; and (vi) ‘decision regret’ in patients who may decline treatment (Lawson et al., 2015). There will also be specific issues for patients considering oocyte preservation prior to transitioning, such as the long-term implications including possible irreversible impairment to reproductive function, the desire for physical transition, and the risk of prioritising short- versus long-term outcomes which may lead to regret later. The importance of fertility counselling for transgender people has been highlighted as ‘ethical, interdisciplinary practice’ and the World Professional Association of Transgender Health (Hudson et al., 2018), and the Endocrine Society recommend fertility counselling prior to hormone treatment (Coleman et al., 2012; Hembree et al., 2017).
Step-by-step decision-making process in third party assisted reproduction: a qualitative study
Published in Human Fertility, 2022
Zohreh Behjati Ardakani, Mehrdad Navabakhsh, Fahimeh Ranjbar, Mohammad Mehdi Akhondi, Alireza Mohseni Tabrizi
Biological motives for survival are unconscious and compulsory. The human beings’ inclination towards reproduction and child-rearing is an example of this instinct. People, knowing that they are mortal, try every means to maintain self-preservation and continue their existence, which is only possible through reproduction (Werner, 2001). The introduction of new assisted reproductive techniques has provided the ground for couples that cannot have children to overcome infertility. When a couple experiences a lack or defect in the uterus, gametes, or embryos, they can become parents only through third-party reproduction (Akhondi et al., 2007). The American Society for Reproductive Medicine defines third-party reproduction as the use of oocytes, sperm, or embryos that have been donated by a third person (donor) to enable an infertile individual or couple (intended recipient) to become parents. This also includes using a surrogate for fertility (Carsten, 2000; Tremayne, 2012).
Preserving fertility in female patients with hematological malignancies: the key points
Published in Expert Review of Hematology, 2019
Mahmoud Salama, Antoinette Anazodo, Teresa K. Woodruff
If fertility preservation options are rejected, contraindicated, infeasible, unavailable, or unsuccessful, adoption and third-party reproduction (egg donation, embryo donation, and surrogacy) can be offered as family building alternatives [23–25].