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Attitudes towards embryo donation to infertile couples of fertility patients, specialists in the field and community
Even though relaxation massage was a welcome intervention for our subjects, there is no evidence that this could improve semen quality or enhance pregnancy rates. Supported by: The Charlotte-Mecklenburg Health Services Foundation, Inc.
P-202 ATTITUDES TOWARD WOMEN AND EMOTIONAL WELL-BEING IN WOMEN WITH SPONTAEOUS 46,XX PRIMARY OVARIAN INSUFFICIENCY (HYPERGONADOTROPIC HYPOGONADISM). S. N. Covington, M. Davis, J. Ventura, V. Vanderhoof, J. F. Troendle, L. M. Nelson. Integrative Reproductive Medicine Unit, NICHD/National Institutes of Health, Bethesda, MD; Department of Psychology, Arizona State University, Tempe, AZ; Biometry and Mathematical Statistics Branch, DESPR, NICHD, National Institutes of Health, Bethesda, MD. OBJECTIVE: Women with spontaneous 46,XX primary ovarian insufficiency (sPOI), previously referred to as premature ovarian failure (POF), score adversely compared to control women on measures assessing symptoms of depression and anxiety. In this study, we assess the association between affective measures and attitudes towards the rights and roles of women in contemporary society. DESIGN: Cross-sectional. MATERIALS AND METHODS: We recruited women with sPOI (n¼100) and control women (n¼60) between 18 and 42 years of age. Measures included a subset of 5 items from the Attitudes Towards Women Scale (ATW, Spence et al. 1973) assessing women’s roles in the family, Center of Epidemiologic Studies Depression Scale (CES-D), and the state anxiety subscale of the State-Trait Anxiety Inventory (STAI). The ATW includes statements such as ‘‘Women should worry less about their rights and more about becoming good wives and mothers.’’ (1 - agree strongly, 2 - agree mildly, 3 - disagree mildly, 4 - disagree strongly). Statistical tests: Wilcoxon rank-sum tests and Spearman rank correlation. RESULTS: Patients and controls did not differ significantly with regard to age, race/ethnicity, marital status, or education. Women with sPOI had a significantly lower median (interquartile range) score on the ATW scale [17 (4) vs. 19 (3), p<0.03], indicating that as a group they had a more traditional view towards the rights and family roles of women in contemporary society. The ATW score in patients was negatively correlated with both depressive symptoms (r ¼ -0.25, p < 0.02) and anxiety symptoms (r ¼ -0.23, p <0.025). Among control women ATW was positively associated with level of education (r ¼ 0.44, p <0.001) yet this was not true among women with sPOI (r ¼ 0.14, p ¼ 0.17). ATW scores did not associate with marital status, income, race, or age either in patients or controls or with age at diagnosis or time since diagnosis in women with sPOI. CONCLUSIONS: Women with sPOI have more conservative views toward the family role of women in contemporary society than controls. Further, the more conservative view a woman with sPOI has toward the role of women, the more symptoms of anxiety and depression. Broadening perspectives on the family roles of women may reduce affective disturbance related to infertility and should be examined as a potential target of intervention to promote emotional resilience among women with sPOI. Supported by: The Intramural Research Program, NICHD/NIH; United States Public Health Service.
P-203 ATTITUDES TOWARDS EMBRYO DONATION TO INFERTILE COUPLES OF FERTILITY PATIENTS, SPECIALISTS IN THE FIELD AND COMMUNITY. L. Urdapilleta. Psychology, Cegyr (Center of Studies in Gynaecology and Reproduction), Buenos Aires, Argentina. OBJECTIVE: As a part of a larger study, the attitudes of three groups of subjects – fertility patients, professionals working in the field and general population - towards embryo donation to infertile couples, concerning destiny of their spare embryos, personal redefinitions of ‘‘embryo,’’ ‘‘parents,’’ and ‘‘child,’’ known vs. anonymous donation, identificatory information, disclosure and contact, will be described.
S176
Abstracts
DESIGN: Exploratory (ad hoc attitude scale), descriptive. MATERIALS AND METHODS: Four hundred and seven men and women (160 fertility patients recruited from three reproductive clinics, 97 experts in the area and 150 individuals of general population) were administrated a protocol with an attitudinal scale. Each of them had to hypothetically situate themselves in three different scenarios: being an embryo donor, being an embryo recipient and being a person born through donated embryos, assessing the same topics from these alternative perspectives (frequencies and percentages). RESULTS: More than half of the subjects in the three groups chose to donate their embryos to infertile couples. Correspondingly, they also believe an embryo is not a child but a group of cells with the potential of becoming a person. Over 90% of them considered ‘‘parents’’ to those who rear a child and with similar percentages, that the individual born through embryo donation would consider his parents those who gestated and brought him up despite those who donated the embryo. Although most of the theoretical donors and recipients preferred anonymous donation over known one, positive attitudes towards the rights to reveal the origins to the child were shown in 70.3% of the recipients and 71.5% of the ones born trough embryo donation. Likewise, 43.5% of the donors would leave identificatory information for the offspring and 45.9% would accept contacting him in the future. Fifty nine percent of the recipients agreed that the child has the right to access to identificatory registries. The offspring (68.8%) would like to know that he was born trough embryo donation. CONCLUSIONS: Even though the positive attitudes showed towards different topics surrounding embryo donation of the subjects of this study could differ from those of real or prospective donors/recipients since they were in a hypothetical situation, these findings can also be suggesting a new trend towards supporting families built up in a non traditional way. Supported by: None.
P-204 SHAME IN RECEIVING IVF TREATMENT AFFECTS THE DECISION MAKING PROCESS OF THE FATE OF CRYOPRESERVED EMBRYOS IN JAPANESE INFERTILITY PATIENTS. S. Takahashi, T. Fujiwara, A. Fujimoto, A. Akabayashi, O. Tsutsumi, Y. Taketani. Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, Japan; Center for Biomedical Ethics and Law, The University of Tokyo, Tokyo, Japan. OBJECTIVE: To ascertain how Japanese infertility patients approach making a decision to donate their embryos to research and how they view their embryos in comparison to patients of other options. DESIGN: Qualitative interview study. MATERIALS AND METHODS: Twelve women who donated their embryos to research, 10 who continued storage and 3 who discarded were interviewed using a narrative structure at a university hospital. Tape recorded interviews were then transcribed and analyzed using qualitative methods with particular attention to patients who donated to research and the differences between the other two groups. RESULTS: Patients, who donated to research, though they still considered having children, would rather donate than continue storage for they did not desire to receive treatment again. Many felt shame over initially receiving IVF treatment since it was ‘‘not normal’’ and ‘‘unnatural.’’ Some considered their decision egotistical. Donating the embryos to research relieved them of this shame and all patients were appreciative of having this option. Patients discussed only with their partners about their embryos and many have not disclosed about receiving treatment to relatives. Patients, therefore, expressed the need for counseling not at the time of decision making but rather during and at commencement of IVF. All patients in the donation and storage groups felt the embryos as being ‘‘Mottainai,’’ a Japanese word meaning that it is so wasteful that things are not made full use of their respectful value. The effort and the experience of IVF treatment were considered ‘‘Mottainai’’ to the donation patients, whereas the chance of another pregnancy was ‘‘Mottainai’’ to the storage patients. All patients considered the status of the embryo as a ‘‘virtual’’ child or a ‘‘seed to life.’’ Donation patients viewed their embryos as having lived by acting as a sacrifice for other infertile individuals or their own children.
Vol. 90, Suppl 1, September 2008
P-202 ATTITUDES TOWARD WOMEN AND EMOTIONAL WELL-BEING IN WOMEN WITH SPONTAEOUS 46,XX PRIMARY OVARIAN INSUFFICIENCY (HYPERGONADOTROPIC HYPOGONADISM). S. N. Covington, M. Davis, J. Ventura, V. Vanderhoof, J. F. Troendle, L. M. Nelson. Integrative Reproductive Medicine Unit, NICHD/National Institutes of Health, Bethesda, MD; Department of Psychology, Arizona State University, Tempe, AZ; Biometry and Mathematical Statistics Branch, DESPR, NICHD, National Institutes of Health, Bethesda, MD. OBJECTIVE: Women with spontaneous 46,XX primary ovarian insufficiency (sPOI), previously referred to as premature ovarian failure (POF), score adversely compared to control women on measures assessing symptoms of depression and anxiety. In this study, we assess the association between affective measures and attitudes towards the rights and roles of women in contemporary society. DESIGN: Cross-sectional. MATERIALS AND METHODS: We recruited women with sPOI (n¼100) and control women (n¼60) between 18 and 42 years of age. Measures included a subset of 5 items from the Attitudes Towards Women Scale (ATW, Spence et al. 1973) assessing women’s roles in the family, Center of Epidemiologic Studies Depression Scale (CES-D), and the state anxiety subscale of the State-Trait Anxiety Inventory (STAI). The ATW includes statements such as ‘‘Women should worry less about their rights and more about becoming good wives and mothers.’’ (1 - agree strongly, 2 - agree mildly, 3 - disagree mildly, 4 - disagree strongly). Statistical tests: Wilcoxon rank-sum tests and Spearman rank correlation. RESULTS: Patients and controls did not differ significantly with regard to age, race/ethnicity, marital status, or education. Women with sPOI had a significantly lower median (interquartile range) score on the ATW scale [17 (4) vs. 19 (3), p<0.03], indicating that as a group they had a more traditional view towards the rights and family roles of women in contemporary society. The ATW score in patients was negatively correlated with both depressive symptoms (r ¼ -0.25, p < 0.02) and anxiety symptoms (r ¼ -0.23, p <0.025). Among control women ATW was positively associated with level of education (r ¼ 0.44, p <0.001) yet this was not true among women with sPOI (r ¼ 0.14, p ¼ 0.17). ATW scores did not associate with marital status, income, race, or age either in patients or controls or with age at diagnosis or time since diagnosis in women with sPOI. CONCLUSIONS: Women with sPOI have more conservative views toward the family role of women in contemporary society than controls. Further, the more conservative view a woman with sPOI has toward the role of women, the more symptoms of anxiety and depression. Broadening perspectives on the family roles of women may reduce affective disturbance related to infertility and should be examined as a potential target of intervention to promote emotional resilience among women with sPOI. Supported by: The Intramural Research Program, NICHD/NIH; United States Public Health Service.
P-203 ATTITUDES TOWARDS EMBRYO DONATION TO INFERTILE COUPLES OF FERTILITY PATIENTS, SPECIALISTS IN THE FIELD AND COMMUNITY. L. Urdapilleta. Psychology, Cegyr (Center of Studies in Gynaecology and Reproduction), Buenos Aires, Argentina. OBJECTIVE: As a part of a larger study, the attitudes of three groups of subjects – fertility patients, professionals working in the field and general population - towards embryo donation to infertile couples, concerning destiny of their spare embryos, personal redefinitions of ‘‘embryo,’’ ‘‘parents,’’ and ‘‘child,’’ known vs. anonymous donation, identificatory information, disclosure and contact, will be described.
S176
Abstracts
DESIGN: Exploratory (ad hoc attitude scale), descriptive. MATERIALS AND METHODS: Four hundred and seven men and women (160 fertility patients recruited from three reproductive clinics, 97 experts in the area and 150 individuals of general population) were administrated a protocol with an attitudinal scale. Each of them had to hypothetically situate themselves in three different scenarios: being an embryo donor, being an embryo recipient and being a person born through donated embryos, assessing the same topics from these alternative perspectives (frequencies and percentages). RESULTS: More than half of the subjects in the three groups chose to donate their embryos to infertile couples. Correspondingly, they also believe an embryo is not a child but a group of cells with the potential of becoming a person. Over 90% of them considered ‘‘parents’’ to those who rear a child and with similar percentages, that the individual born through embryo donation would consider his parents those who gestated and brought him up despite those who donated the embryo. Although most of the theoretical donors and recipients preferred anonymous donation over known one, positive attitudes towards the rights to reveal the origins to the child were shown in 70.3% of the recipients and 71.5% of the ones born trough embryo donation. Likewise, 43.5% of the donors would leave identificatory information for the offspring and 45.9% would accept contacting him in the future. Fifty nine percent of the recipients agreed that the child has the right to access to identificatory registries. The offspring (68.8%) would like to know that he was born trough embryo donation. CONCLUSIONS: Even though the positive attitudes showed towards different topics surrounding embryo donation of the subjects of this study could differ from those of real or prospective donors/recipients since they were in a hypothetical situation, these findings can also be suggesting a new trend towards supporting families built up in a non traditional way. Supported by: None.
P-204 SHAME IN RECEIVING IVF TREATMENT AFFECTS THE DECISION MAKING PROCESS OF THE FATE OF CRYOPRESERVED EMBRYOS IN JAPANESE INFERTILITY PATIENTS. S. Takahashi, T. Fujiwara, A. Fujimoto, A. Akabayashi, O. Tsutsumi, Y. Taketani. Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, Japan; Center for Biomedical Ethics and Law, The University of Tokyo, Tokyo, Japan. OBJECTIVE: To ascertain how Japanese infertility patients approach making a decision to donate their embryos to research and how they view their embryos in comparison to patients of other options. DESIGN: Qualitative interview study. MATERIALS AND METHODS: Twelve women who donated their embryos to research, 10 who continued storage and 3 who discarded were interviewed using a narrative structure at a university hospital. Tape recorded interviews were then transcribed and analyzed using qualitative methods with particular attention to patients who donated to research and the differences between the other two groups. RESULTS: Patients, who donated to research, though they still considered having children, would rather donate than continue storage for they did not desire to receive treatment again. Many felt shame over initially receiving IVF treatment since it was ‘‘not normal’’ and ‘‘unnatural.’’ Some considered their decision egotistical. Donating the embryos to research relieved them of this shame and all patients were appreciative of having this option. Patients discussed only with their partners about their embryos and many have not disclosed about receiving treatment to relatives. Patients, therefore, expressed the need for counseling not at the time of decision making but rather during and at commencement of IVF. All patients in the donation and storage groups felt the embryos as being ‘‘Mottainai,’’ a Japanese word meaning that it is so wasteful that things are not made full use of their respectful value. The effort and the experience of IVF treatment were considered ‘‘Mottainai’’ to the donation patients, whereas the chance of another pregnancy was ‘‘Mottainai’’ to the storage patients. All patients considered the status of the embryo as a ‘‘virtual’’ child or a ‘‘seed to life.’’ Donation patients viewed their embryos as having lived by acting as a sacrifice for other infertile individuals or their own children.
Vol. 90, Suppl 1, September 2008