March 13th 2012 the Swedish social Committee brings up a proposal that assisted reproduction should be legalize for single women in Sweden. The suggestion was quickly forwarded to the parliament for a decision making. Although majority of the Swedish parties (the alliances) are positive about this proposal, there are also a few who are strongly against the proposal, for example the Christian Democratic Party. The purpose of this study has been to investigate how the two Swedish newspapers Dagens Nyheter and Svenska Dagbladet has written about the issue on legalizing assisted reproduction for single women in Sweden. To help me come to my results and conclusion on this study I decided to use the quantitative content analysis and the qualitative text analysis method. I have specifically chosen to concentrate on how these two newspapers have chosen to present this issue and what angles do Dagens Nyheter and Svenska Dagbladet uses to present this issue to their readers. After my qualitative text analysis, I came to the conclusion that this issue didn’t get the attention that it deserves from both of the newspapers. Since the issue is about babies, women and their bodies, I expected the newspapers to write about this issue as a gender issue, but that was not the case. Instead it was twisted around by the press and made into a political fight between the Christian Democrat party that is against the proposal and the alliances that is positive to the proposal. In all the articles I had chosen to analyze, I as a reader was met by the voices of different politicians that had strong opinions about legalizing assisted reproduction for single women. The opinion of ordinary people didn’t seem to matter to any of the journalist and neither was the opinion of women, because I realized that neither of these groups were found in the articles. Even more interesting was the fact that the voices of the politicians were all dominated by men. In conclusion looking at the issue on legalizing assisted reproduction for single women, one would supposed that the issue is going to be based on subjects about babies, hospitals, women and their bodies. Instead the issue was made into a political fight and dominated by male voices and opinions.

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The use of assisted reproductive technologies (ART) in Canada has increased rapidly over the past decade, with a 235% increase in reported ART cycle starts and a 190% increase in resultant clinical pregnancies from 2008-2018, outpacing our understanding of potential adverse perinatal outcomes. This dissertation project recognizes that the use of ART will continue to increase in both scale and scope, and that it will continue to be a valued means of overcoming infertility and involuntary childlessness. The balance of risks and benefits of these rapid technological innovations for human health is uncertain. Therefore, this project seeks to produce evidence about both the risks associated with ART as well as component treatment factors amenable to modification to make its use safer. While available evidence indicates that medically assisted pregnancies are at greater risk of placental complications, data are scarce, and estimates of specific effects are varied and not reported in the context of service provision for Canada. Linking data from the Canadian Assisted Reproductive Technologies Register to the Better Outcomes Registry & Network Ontario data, this project commenced with a foundational retrospective cohort study to assess the relationship between ART (in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI)) and placental and placentally-mediated complications by comparing assisted conceptions from four years of ART cycle starts to non-assisted conceptions. Building on the findings from the foundational study, two additional studies were performed to investigate the contributions of two treatment factors, day or stage of embryo at transfer and cryopreservation, to the observed patterns of risk. Compared to non-assisted pregnancies, we find that assisted pregnancies are associated with an increased risk of placental and placentally-mediated complications. Within assisted pregnancies, risk profiles are best achieved by stratifying the analysis by both treatment type (IVF or ICSI) and embryo transfer type (fresh or frozen), in keeping with clinical practice. Although we did not find the day or stage of embryo at transfer to be a primary independent contributor to the observed increase in risk of these complication, patterns observed in the relationship between method of cryopreservation and these outcomes warrant further investigation. This thesis concludes by arguing for the pursuit of a hierarchy of risk approach to the use of ART, which is supported by the findings of this project, as it may be the most effective method to guide technological innovation and policy implementation to mitigate the risks associated with ART while not being overly restrictive of the options available to those seeking to build a family.

This study is based on how politicians’ standars were represented in the debate about assisted reproduction of single women and surrogacy in Sweden. And also which arguments the politicians performed on both issues. The study was based on the protocol 2011/12:91 from the parliamentary debate in Sweden. The aim of the study was to examine political standards is identified according to parenting and family in the assisted reproduction and surrogacy debate. The empirical material has been analyzed through social constructivism as a theory and standard critical perspective related to normality. Argument analysis was used as a method to identify pro et contra arguments on the issues. Two theses from the protocol 2011/12:91 was identified and analyzed. The first thesis was "Every child has a right to have both a mother and a father" and the second thesis was, "Every human should have an opportunity to have children". Pro arguments to the first thesis was that a child has a right to know its genetic origin and to be nursed by both its parents as far as possible. They meant that the traditional family constellation with a mother and a father is a good family to raise a child within. Contra arguments in this issue also meant that the child has a right to know its genetic origin, and therefore should get this right in Sweden to reduce the risk that mothers get infertility treatment abroad with a donor that is anonymous. Additional contra arguments in this thesis was that the most important thing for a child is to grow up in a family with love and care, regardless of family constellation. Pro arguments to the last thesis, "Every human should have an opportunity to have children" was that it is a biological instinct to reproduce and politicians should therefore not stand in the way by prohibiting single women to get assisted reproduction. Contra argument to this thesis was that parenting is an impossible question to fairness. They meant that if you do not have the physical ability to have children, society should not help you with this matter. They also meant that if we legislate surrogacy in Sweden it is a big risk that women become a commodity in the matter. And this risk outweigh parents’ desire to have children.

Objective To investigate symptoms of anxiety and depression in lesbian couples undergoing assisted reproductive treatment (ART), and to study the relationship of demographic data, pregnancy outcome and future reproductive plans with symptoms of anxiety and depression. Design Descriptive, a part of the prospective longitudinal ‘Swedish study on gamete donation’. Setting All university clinics in Sweden performing gamete donation. Population A consecutive sample of 214 lesbian couples requesting assisted reproduction, 165 of whom participated. Methods Participants individually completed three study-specific questionnaires and the Hospital Anxiety and Depression Scale (HADS): time point 1 (T1), at commencement of ART; time point 2 (T2), approximately 2 months after treatment; and time point 3 (T3), 2–5 years after first treatment. Main outcome measures Anxiety and depression (HADS), pregnancy outcome and future reproductive plans. Results The vast majority of lesbian women undergoing assisted reproduction reported no symptoms of anxiety and depression at the three assessment points. A higher percentage of the treated women, compared with the partners, reported symptoms of anxiety at T2 (14% versus 5%, P = 0.011) and T3 (10% versus 4%, P = 0.018), as well as symptoms of depression at T2 (4% versus 0%, P = 0.03) and T3 (3% versus 0%, P = 0.035). The overall pregnancy outcome was high; almost three-quarters of lesbian couples gave birth 2–5 years after sperm donation treatments. Open-ended comments illustrated joy and satisfaction about family building. Conclusion Lesbian women in Sweden reported good psychological health before and after treatment with donated sperm. / <p>Funding Agencies|Merck Serono||Uppsala/Orebro Regional Research Council||Medical Research Council of Southeast Sweden||Marianne and Marcus Wallenberg Foundation||</p>

Posthumous assisted reproduction (PAR), or conception after death, is of significant ethical debate. This thesis seeks to explore and evaluate the major ethical considerations concerning PAR. Autonomy, considered the most important ethical principle, holds a majority of the weight in this evaluation; it is not the sole topic on deciding whether to permit a request for PAR. In addition to the autonomy of the deceased, the discussion focuses on stakeholders, justice, and welfare of the child in regard to PAR. Application of these ethical principles allows for a holistic review of a PAR request, and ensures the best possible outcome for each request. / Urban Bioethics

This work deals with infertility and the ethical aspects of assisted reproduction. Theoretic part is devoted to male and female infertility, its causes, the methods and issues of assisted reproduction, which are ethically unacceptable as shledávány, where some are tolerated under certain conditions. The practical part of this thesis are examined attitudes of infertile couples and the public on the ethical aspects of assisted reproduction.

The purpose of this thesis is to analyze the legal pre-conditions for parenthood. These are objectively understood as a set of provisions, which give us the answer, who are the legal parents of a child. These provisions are motivated by an effort to harmonize legal parenthood with biological. They are a source of important statutory rights of an individual, which to some extent determine his/her legal status from the very birth. With statutory rights are subsequently firmly bound public legal consequences. These are mainly a relationship between the individual and the state, in particular the obligation to register a child in the state-led civil registration, and also the acquisition of the citizenship. The relationship of parent and child can be considered as basic and most important personal relationship ever. As a result, various rights and duties arise of this relationship, and therefore the need to regulate such relations by the law has appeared with the evolution of human society, so they were build on a solid basis without being disputed. Every state should thus have the obligation to implement such provisions into its legal order. This thesis is drafted in accordance with the division of the legal pre-conditions for parenthood to motherhood and fatherhood. A short introductory part deals...

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Introdução: A avaliação da reserva ovariana em reprodução assistida (RA) busca identificar mulheres em que a exaustão folicular determine as dificuldades reprodutivas. Além da idade, a presença de causas outras de subfertilidade, como a endometriose (EDT), implica interferências negativas potenciais sobre a resposta ovariana. Objetivo: Avaliar a reserva folicular ovariana de mulheres subférteis portadoras de endometriose e determinar o melhor preditor de má resposta em RA. Métodos: Foram analisados 87 ciclos de RA em mulheres com idade inferior a 40 anos, ciclos menstruais regulares, sem patologias endócrinas e com ambos os ovários, sendo 30 ciclos em portadoras de EDT (casos) e 57 ciclos em mulheres subférteis por fator masculino exclusivo (controles). A reserva ovariana foi inferida pelas dosagens basais dos hormônios anti-mülleriano (AMH) e folículo estimulante (FSH), a contagem de folículos antrais pequenos (CFA) e a medida do volume ovariano médio (VOM). Curvas Receiver Operating Characteristic (ROC AUC) foram traçadas para avaliação da capacidade discriminatória de cada teste em identificar má resposta. Resultados: Pacientes com EDT apresentaram FSH basal significativamente maior em relação aos controles (9,13 ± 5,09 mUI/mL vs. 6,28 ± 2,45 mUI/mL; p < 0,05), sem diferenças para AMH, CFA e VOM. O número total de oócitos aspirados foi menor na EDT em relação aos controles (5,33 ± 3,43 vs. 8,28 ± 5,8; p < 0,05) e correlacionou-se significativamente com o AMH em ambos os grupos (EDT: r = 0,61; Controles: r = 0,58; p<0,0001). O FSH basal apresentou correlação significativa com o total de oócitos aspirados apenas na EDT (r = -0,48; p<0,01); também na EDT, o AMH basal foi o marcador individual com melhor potencial discriminatório para má resposta (AUC = 0,875), seguido de FSH basal (AUC = 0,682) e VOM (AUC = 0,665), enquanto no grupo controle, o AMH foi o melhor marcador (AUC = 0,8372), seguido do VOM (AUC = 0,709) e da CFA (AUC = 0,686). Conclusões: O FSH basal está significativamente maior nas pacientes subférteis com EDT e correlaciona-se com a resposta em RA apenas nas portadoras da doença. Já o AMH basal, é o marcador com o melhor potencial discriminatório de má resposta, independentemente da presença da endometriose. CFA e VOM não se apresentaram como bons preditores de má resposta. Sendo assim, a associação entre endometriose e subfertilidade deve estar vinculada a alterações do crescimento/desenvolvimento do folículo ovariano e não a prejuízos sobre a reserva folicular gonadal propriamente dita. / Introduction: Ovarian reserve evaluation in assisted reproduction (AR) aims to identify women in whom follicular exhaustion determines reproductive difficulties. More than age, the presence of other subfertility factors, such as endometriosis (EDT), implies potential negative interference on ovarian response. Objective: To evaluate follicular ovarian reserve in subfertile patients with endometriosis and determine the best predictor of poor response in AR. Methods: We evaluated 87 AR cycles of women presenting with less than 40 years of age, regular menses, no endocrine diseases and with both ovaries, divided in 30 EDT cycles (cases) and 57 cycles in women with subfertility associated to male factor (controls). Ovarian reserve was determined based on basal levels of anti-müllerian hormone (AMH) and follicle- stimulating hormone (FSH), small antral follicle count (AFC) and medium ovarian volume (MOV). Receiver Operating Characteristic curves (ROC AUC) were obtained for evaluation of discriminatory capacity of each test in identifying poor response. Results: EDT patients presented significantly higher basal FSH levels when compared to controls (9,13 ± 5,09 mUI/mL vs. 6,28 ± 2,45 mUI/mL; p < 0,05) and there were no differences in AMH, AFC and MOV between groups. The total number of oocytes retrieved was lower in endometriosis when compared to controls (5,33 ± 3,43 vs. 8,28 ± 5,8; p < 0,05) and significantly correlated with AMH in both groups (EDT: r = 0,61; Control: r = 0,58; p<0,0001). Basal FSH presented significant correlation with the number of oocytes retrieved only among EDT patients (r = - 0,48; p<0,01); in EDT patients, either, basal AMH was the individual marker with the best discriminatory potential for poor responders identification (AUC = 0,875), followed by basal FSH (AUC = 0,682) and MOV (AUC = 0,665), whereas among controls, AMH was the best marker (AUC = 0,8372), followed by MOV (AUC = 0,709) and AFC (AUC = 0,686). Conclusions: Basal FSH is significantly higher in subfertile patients with endometriosis and correlates with ovarian response in AR among these patients. Basal AMH, by the way, is the individual marker with the best discriminatory potential in determining poor response, which is not dependent on endometriosis presence. AFC and MOV did not presented as good predictors of poor response. The association between endometriosis and subfertility, therefore, may be linked to prejudice to growth/development of the ovarian follicle, but not to damage to the real ovarian follicular reserve.