Assisted Reproduction: What factors interfere in the professional's decisions? Are single women an issue?

Abstract

BackgroundWith the development of medical technology, many countries around the world have been implementing ethical guidelines and laws regarding Medically Assisted Reproduction (MAR). A physician's reproductive decisions are not solely based on technical criteria but are also influenced by society values. Therefore, the aim of this study was to analyze the factors prioritized by MAR professionals when deciding on whether to accept to perform assisted reproduction and to show any existing cultural differences.MethodsCross-sectional study involving 224 healthcare professionals working with assisted reproduction in Brazil, Italy, Germany and Greece. Instrument used for data collection: a questionnaire, followed by the description of four special MAR cases (a single woman, a lesbian couple, an HIV discordant couple and gender selection) which included case-specific questions regarding the professionals' decision on whether to perform the requested procedure as well as the following factors: socio-demographic variables, moral and legal values as well as the technical aspects which influence decision-making.ResultsOnly the case involving a single woman who wishes to have a child (without the intention of having a partner in the future) demonstrated significant differences. Therefore, the study was driven towards the results of this case specifically. The analyses we performed demonstrated that professionals holding a Master's Degree, those younger in age, female professionals, those having worked for less time in reproduction, those in private clinics and Brazilian health professionals all had a greater tendency to perform the procedure in that case. A multivariate analysis demonstrated that the reasons for the professional's decision to perform the procedure were the woman's right to gestate and the duty of MAR professionals to help her. The professionals who decided not to perform the procedure identified the woman's marital status and the child's right to a father as the reason to withhold treatment.ConclusionThe study indicates differences among countries in the evaluation of the single woman case. It also discloses the undervaluation of bioethics committees and the need for a greater participation of healthcare professionals in debates on assisted reproduction laws.

La maternidad en parejas de mujeres: reformulando el parentesco heteronormativo y biologicista

“…These results are in agreement with those obtained in similar studies (e.g. Bergmann, 2012;Donoso, 2013;Herrera, 2009;Tasker, 2013;Záchia et al, 2011). Considering this panorama, it is necessary for professionals, particularly those in the sphere of social work, to receive specific training so that their actions are not pervaded by the biases described.…”

“…Estos modelos familiares ponen en entredicho la propia organización y funcionamiento de la sociedad y, en particular, la hegemonía de la heterosexualidad (e.g. Grau, 2010;Yanagisako y Collier, 1999) y su vinculación con una sexualidad reproductora (Cadoret, 2013;Rivas, 2008;Rubin, 1986). Los cambios legislativos introducidos en materia de adopción y las posibilidades ofertadas por las técnicas de reproducción asistida han permitido rebatir ese binomio que vincula heterosexualidad y reproducción (Stone, 2008;Thompson, 2001).…”

Ethical Attitudes of German Specialists in Reproductive Medicine and Legal Regulation of Preimplantation Sex Selection in Germany

“…Between July 2003 and July 2005, a cross-sectional study [35] was carried out with a sample of health care professionals working in assisted reproductive medicine in Brazil, Germany, Greece and Italy. 224 persons participated in the study, of these 50 Germans (39 with medical profession).…”

Correspondence Between Legislation and Public Opinion in Bulgaria about Accessto Assisted Reproductive Technologies (ART)

“…A survey in Australia explored the attitudes to access to ART for single women and for lesbians; 38% of respondents approved of access for single women and 31% of respondents approved of access for lesbians (14). The study of Brazilian authors shows that female and young male professionals working with ART are more tolerant and inclined to perform insemination of single women with donor semen (15). In a survey among health practitioners that was carried out in Denmark, the approval of access to ART was 42% for single women and 37.4% for lesbians (16).…”