A Infertilidade é, hoje, um problema real na vida de homens e mulheres. Pelo menos, 20% da população mundial está descobrindo que o filho nem sempre chega no momento planejado. Habitualmente, um casal infértil é definido como aquele que não obteve gravidez após um ano tendo relações sexuais regulares sem o uso de qualquer método contraceptivo, apesar de alguns autores estenderem esse período para dois anos. As principais causas da Infertilidade feminina estão relacionadas com a idade da paciente, com os fatores ovulatório, cervical, tubário, peritoneal e o endometrial. A Síndrome dos Ovários Policísticos não determina, necessariamente, a Infertilidade da mulher, porém é considerada como uma de suas etiologias, dado ao desequilíbrio hormonal que a acompanha. Obrigatoriamente, o tratamento de um casal infértil deverá ser realizado após uma investigação detalhada das possíveis causas da Infertilidade. As técnicas empregadas para o tratamento da Infertilidade são conhecidas como \'Reprodução Assistida\'. Apesar de existir certo reconhecimento dos fatores emocionais presentes nessa condição, as pesquisas sobre a Infertilidade que consideram os aspectos psicológicos e psicodinâmicos ainda são incipientes, principalmente no Brasil. Diante disso, a realização da presente pesquisa teve como objetivo conhecer os psicodinamismos de mulheres inférteis portadoras da Síndrome dos Ovários Policísticos, sendo operacionalizada por meio de avaliação psicológica, a qual incluiu entrevistas, técnicas objetivas e projetivas de avaliação da personalidade, a saber: Inventário de Sintomas de Stress de Lipp (ISSL) e Teste de Apercepção Temática (TAT). As entrevistas psicológicas foram analisadas por meio do método da livre inspeção do material; o ISSL, a partir das diretrizes expostas no manual; o TAT, pelo sistema interpretativo de Morval, acrescentando uma avaliação dinâmica das estórias. A amostra foi composta com quatro mulheres que apresentaram o referido quadro, sem suspeita de fator masculino envolvido na Infertilidade. A investigação sustenta-se numa abordagem qualitativa de cunho biopsicossocial, analisando os elementos conscientes e inconscientes presentes nas mulheres inférteis, bem como o seu nível de stress. A estratégia metodológica eleita foi a do estudo de caso coletivo e os resultados mostraram que as participantes vivem em ambientes familiares conflitivos, permeados pela deficiência de holding, com presença de rivalidade fraterna, dificuldades na introjeção da figura materna, sentimentos de desvalorização, rejeição, solidão, baixa autoestima, ambivalência frente à maternidade, enfrentando a Infertilidade vivida por elas como uma doença. Com isso, essas mulheres apresentaram dificuldades em seu desenvolvimento emocional, especialmente no que se refere à integração da sexualidade na personalidade e na identificação com a figura feminina, necessária para posterior estabelecimento de sua identidade sexual. / Nowadays, infertility is a real problem in women and men\'s life. At least 20% of people around the world are realizing that a child is not always born in the planned moment. Ordinary couples, that usually have active sexual life, have 25% chances of conceiving every month. After a year, 85% of the couples obtain a pregnancy. An infertile couple is defined as the one who is not able to obtain a pregnancy after trying one year without the use of any contraception - despite the fact that some authors consider a two-year period. The treatment of an infertile couple must be performed after a detailed research of the infertility reasons. Nevertheless, many general factors such as age, habits, environment and psychological factors may also have influence in the success of the infertility treatment. The techniques are known as \"Assisted Reproduction\" and have the objective of helping the nature, obtaining a good oocyte and spermatozoa quality, that should result in a healthy pregnancy and embryo. The present study aims to make a medical, psychoanalytic, psychological and social literature, investigating unconscious aspects and the psychodynamics of women with infertility caused by Polycystic Ovary Syndrome. The inquiry is supported by a qualitative boarding of biopsych- social matrix type, and regards the understanding of the desire for maternity - however it emphasazes unconscious elements found in the infertile women, as well as their level of stress. The methodological strategy was the study of a 4 infertile women collective case, with the instruments: the TAT - Thematic Apperception Test, the ISSL - Inventory of Stress Symptoms for adults with Lipp and the psychological interview. The analysis of the data was made through the interpretation of the interview, the Thematic Apperception Test and the interpretation of the ISSL.

66 Abstract Legal issues of gametes in relation to assisted reproduction The thesis deals with the issue of assisted reproduction with a specific focus on gametes and some issues that are associated with them. In order to better understand contradictory opinions and views on a particular issue, the Czech legislation is compared with the British legislation. Then, in each individual case, it is assessed which country has dealt with the problem better, using a comparative method. The introduction of the thesis deals with assisted reproduction in general, especially from the point of view of definition of the concepts and historical development of this issue. Subsequently, the basic legal framework for assisted reproduction is defined both in the Czech Republic and the United Kingdom. Briefly, there are also summarized the most basic requirements for gametes donors in both countries. In terms of specific problems related to gametes, much of the work focuses on the anonymity of sperm donors, in particular summarizing the most important arguments of its opponents and subsequently refuting these arguments. The conclusion of this chapter submits why, in my view, the anonymity of sperm donors should be maintained. The next part is devoted to financial rewards for donation of gametes, their admissibility and amount....

Made available in DSpace on 2015-03-05T19:36:36Z (GMT). No. of bitstreams: 0 Previous issue date: 21 / Nenhuma / O presente estudo teve como objetivo identificar as expectativas, os sentimentos, medos e desejos de mulheres em relação à maternidade, às Técnicas de Reprodução Humana Assistida e à infertilidade. Para tanto, foram analisados três blogs que versavam sobre o tema da infertilidade. Cada blog foi considerado como caso de análise, caracterizando um estudo de casos múltiplos, de abordagem qualitativa. As autoras tinham entre 26 e 29 anos de idade e estavam casadas há mais de um ano. Os achados foram discutidos a partir de dois eixos temáticos: desejo de gravidez e maternidade e sentimentos em relação à infertilidade e formas para lidar com essa condição e com o tratamento. Evidenciou-se o desejo de maternidade entre as participantes, a partir da necessidade de engravidar a qualquer custo físico e psíquico, na busca de uma completude narcísica. Foi possível perceber ainda que o tratamento com técnicas de reprodução humana assistida muitas vezes exacerbou os seus sentimentos de frustração e desvalia. Sugere-se que / This study aimed to identify women’s expectations, feelings, fears and desires on motherhood, human assisted reproduction technologies and infertility as well. Three blogs about infertility were analyzed. Each blog was considered as a case, characterizing a qualitative multiple cases study desing. The blogs’ authors were women (26 to 29 years old) that were married for more than a year. The findings were analyzed according two thematic axes: 1. the pregnancy and motherhood desire, and 2. feelings related to infertility and manners of handling with this condition and its treatment. The motherhood desire was manifested by participants, because the need to getting pregnant at any physical and psychic effort, in search of a narcissistic fulfillment. It was possible to note that human assisted reproduction treatment has increased their frustration and depreciation feelings. New studies could broaden the investigation about this theme, considering aspects such as the eventual repercussions of infertility experience

Given the rapidly changing nature of third party reproduction, there is an increasing need for pastoral guidance about the use of these technologies and the relationships that develop from them. This dissertation explores theological bases upon which Episcopalians can ground their practice of third party reproduction, with implications for the wider Church. Beginning with a study of Episcopal clergy and their present practices, this dissertation engages Episcopal, womanist, and feminist theological resources to forge a practical theological response. It highlights layered practices, including the development of relationships between third parties and intended parents, the abuse of third parties, and disclosure to children that call for theological reinterpretations of family, the ministerial vision of Jesus, and the doctrine of God. The thesis of this dissertation is that third party procedures offer an opportunity for Christians to enrich their relationships with one another and with God in unique and--literally--life-giving ways. The argument unfolds with qualitative research findings from Episcopal clergy interviews and it documents how the writings of F.D. Maurice and David H. Smith provide additional context for an Episcopal practical theology. It then turns to the work of Delores Williams for the purpose of arguing that, while contemporary third party reproduction potentially casts third parties as scapegoats, it does not necessarily do so. In response, it develops a six-fold application of William's ministerial vision to prevent abuse. This model in turn provides resources for Episcopal clergy to use in pastoral conversations. The next chapter discusses Sallie McFague's metaphorical theology to argue that American culture upholds the biological family as a model much as Christians have upheld patriarchal language as a model. It advocates for new language to express the God-human relationship that might in turn support the construction of broader metaphors for family relationships. Finally, this dissertation incorporates these findings into practical theological themes and questions that Episcopal priests can utilize in their work. It advocates for applying discernment when navigating loyalty claims, for thinking about reproduction as a calling, for broader constructions of family, for building awareness of how autonomy can facilitate idolatry, for encouraging disclosure and healthy boundaries, and for composing liturgies for those participating in third party procedures.

Introdução: No Brasil, para cada 100 nascidos vivos existiam 7 mulheres em tratamento para a infertilidade em 2013. O Acre é o estado brasileiro com a maior taxa de fecundidade (2,95 filhos por mulher e idade fértil) e a terceira maior taxa de natalidade (23,9 nascidos vivos/mil habitantes). Objetivo: Analisar a implantação da Política Nacional de Atenção Integral em Reprodução Humana Assistida (PNAIRHA) no Acre. Métodos: Pesquisa documental em cartilhas, manuais, protocolos, planos, leis, portarias e regulamentos na área, entre outros. Para descrever a situação da PNAIRHA no Acre foram realizadas entrevistas com gestores de saúde do Acre e um coletivo de mulheres em situação de infertilidade. Resultado: Segundo os gestores entrevistados, a política não foi implantada, a desconhecem e não é discutida no âmbito da gestão de saúde do Acre, sendo prioridade a implantação de outras políticas e programas voltados a problemas de maior impacto (ex.: redução da taxa de gravidez na adolescência). As mulheres entrevistadas referiram desconhecer a política e, assim, não buscam seus direitos junto ao Sistema Único de Saúde (SUS). Conclusão: Mesmo com a existência da Política, a integralidade, a universalidade e a equidade do direito reprodutivo não foram alcançados, sendo que as mulheres inférteis entrevistadas não se percebem amparadas na mesma. / Introduction: In Brazil, for every 100 live births, there were seven women undergoing treatment for infertility in 2013. Acre is the Brazilian state with the highest fertility rate (2.95 children per woman in fertile age) and the third highest birth rate (23.9 live births per thousand inhabitants). Objective: To analyze the implementation of the National Policy of Integral Attention in Human Reproduction Assisted (PNAIRHA) in Acre. Methods: Documentary research in booklets, manuals, protocols, plans, laws, ordinances and regulations in the area, among others. In order to describe the situation of PNAIRHA in Acre, interviews were conducted with health managers from Acre and a group of women in situations of infertility. Result: According to the managers interviewed, the policy was not implemented, people are unaware of this and it is not discussed within the scope of Acre's health management. The priority is the implementation of other policies and programs focused on problems of greater impact (example: reduction of the teenage pregnancy rate). The women interviewed mentioned that they did not know the policy and, therefore, did not seek their rights with the Unified Health System (SUS). Conclusion: Even with the existence of the Policy at the federal level, the comprehensiveness, universality and equity of the reproductive right has not been achieved, and the infertile women interviewed do not perceive themselves supported in it.

O tornar-se pai e mãe e constituir uma família são fenômenos importantes para o estabelecimento de uma identidade social adulta, contribuindo para a realização pessoal do indivíduo. Quando esse projeto parental não pode ser realizado em decorrência de infertilidade no casal, é possível recorrer às técnicas de reprodução assistida, como uma tentativa de concretização desse projeto. Entretanto, o desgaste físico e emocional decorrente desses procedimentos pode conferir à gestação e à parentalidade um caráter específico, com repercussões ainda pouco conhecidas. Por meio deste estudo longitudinal, com três casais que engravidaram por técnicas de reprodução assistida, buscou-se conhecer o processo de tornar-se pai e mãe no contexto da reprodução assistida, com medidas coletadas no terceiro trimestre de gestação e aos três meses do bebê. Os resultados apontaram que a vivência da gestação nesse contexto caracteriza-se pelo constante medo de perder o bebê, mesmo no último trimestre gestacional, sendo que as gestantes deste estudo apresentaram sentimentos de incapacidade de levar a gestação a termo. A prematuridade tornou real a possibilidade de perda do bebê, tornando a vivência dessa etapa um desafio. Superado esse período, o medo da perda do bebê diminuiu, dando espaço para o estabelecimento da crença de que esses casais são capazes de garantir a sobrevivência de seus bebês. / Becoming a father or a mother and building a family are important phenomena that contribute for the establishment of an adult identity as well as for a personal accomplishment. When the dream of building a family can not be fulfilled couples may be helped by assisted reproduction techniques, although the physical and psychological stress produced by these techniques is not well-known yet. This longitudinal and qualitative research aims at knowing how transition to parenthood occurs in the context of assisted reproduction techniques. Three couples who got pregnant through assisted reproduction techniques were interviewed in two moments: during the last trimester of pregnancy and when the baby is three months old. The results show that the participants of this research lived pregnancy freightened by the possibility of loosing their baby. When the baby was born these feelings turned into a possibility due to they were pre-term babies. Afterwards, these feelings decreased while the belief of being capable of keeping the baby alive emerged.

This study examines the problems which are created by assisted reproductive techniques on the individuals and their decisions about the reproduction. In the study, the data of a field study which was conducted in 2010 is used in order to make the examination deeper and to give a qualitative and quantitative dimension to the theoretical framework. Through the sociological analysis of both controversial issues occurred by pre-natal reproductive technologies such as sex selection, abortion, PGD, IVF babies, disability, etc. and personal decisions which are impossible to be given independent from the social environment, providing a contribution to the development of sociology of reproduction is desired. In this study it is claimed that assisted reproductive techniques are power which will possibly get ahead of natural reproduction and reduce and even erase the biodiversity and coincidental characteristics of human reproduction, and increase the inequalities in the society. Thus this power may courage the reproduction of &lsquo / desirables&rsquo / and prevent &lsquo / undesirable&rsquo / ones from living and even insemination anymore. Another argumentation which is under discussion is the illusion of all these activities and problems were taking their sources from the own decisions of prospective parents. Reproductive biotechnology commerce hopes to people through its economy, cuts across all boundaries through the bounties of its technical abilities and by doing so it does not see a drawback in making people &lsquo / victims&rsquo / of their choices that regarded as &lsquo / rational and free&rsquo / which in fact mere &lsquo / irrational&rsquo / preferences. Thus in this thesis, the theoretical foundations and social results of this technology which extending up to the pre-natal processes are discussed to contribute a more democratic policies

This thesis aims to discuss the concept of Assisted Reproduction Technology and its social and affective impacts. Women will be at the center of this research as it has been thought that emotional stressors are mostly effective on them. In the present work, an investigation will be carried out among women who have used assisted reproduction technology methods and women who are able to reproduce and conceive &ldquo / naturally&rdquo / . The comparison of these two groups will illuminate problematical aspects of assisted reproduction technology. The research will be based on two sets of questionnaires designed for each group of women. In this study, both qualitative and quantitative data were used. These analyses will not only lead us to compare infertile and fertile women&rsquo / s responses and evaluate the consequences of emergent assisted reproduction technology but also to assess its social and emotional impacts.

O tornar-se pai e mãe e constituir uma família são fenômenos importantes para o estabelecimento de uma identidade social adulta, contribuindo para a realização pessoal do indivíduo. Quando esse projeto parental não pode ser realizado em decorrência de infertilidade no casal, é possível recorrer às técnicas de reprodução assistida, como uma tentativa de concretização desse projeto. Entretanto, o desgaste físico e emocional decorrente desses procedimentos pode conferir à gestação e à parentalidade um caráter específico, com repercussões ainda pouco conhecidas. Por meio deste estudo longitudinal, com três casais que engravidaram por técnicas de reprodução assistida, buscou-se conhecer o processo de tornar-se pai e mãe no contexto da reprodução assistida, com medidas coletadas no terceiro trimestre de gestação e aos três meses do bebê. Os resultados apontaram que a vivência da gestação nesse contexto caracteriza-se pelo constante medo de perder o bebê, mesmo no último trimestre gestacional, sendo que as gestantes deste estudo apresentaram sentimentos de incapacidade de levar a gestação a termo. A prematuridade tornou real a possibilidade de perda do bebê, tornando a vivência dessa etapa um desafio. Superado esse período, o medo da perda do bebê diminuiu, dando espaço para o estabelecimento da crença de que esses casais são capazes de garantir a sobrevivência de seus bebês. / Becoming a father or a mother and building a family are important phenomena that contribute for the establishment of an adult identity as well as for a personal accomplishment. When the dream of building a family can not be fulfilled couples may be helped by assisted reproduction techniques, although the physical and psychological stress produced by these techniques is not well-known yet. This longitudinal and qualitative research aims at knowing how transition to parenthood occurs in the context of assisted reproduction techniques. Three couples who got pregnant through assisted reproduction techniques were interviewed in two moments: during the last trimester of pregnancy and when the baby is three months old. The results show that the participants of this research lived pregnancy freightened by the possibility of loosing their baby. When the baby was born these feelings turned into a possibility due to they were pre-term babies. Afterwards, these feelings decreased while the belief of being capable of keeping the baby alive emerged.

Este estudo investigou a relação conjugal durante a gravidez, em casais que engravidaram com o auxílio das técnicas de reprodução assistida (TRA). Realizou-se um estudo de caso coletivo, do qual participaram três casais no terceiro trimestre de gestação. Os dados foram obtidos em entrevistas individuais semi-estruturadas e, posteriormente, submetidos a uma análise de conteúdo qualitativa. As categorias de análise foram a história do casal, a decisão de ter um filho e o tratamento, a relação do casal com a família ampliada e a relação conjugal, que englobou três dimensões (coesão, afetividade/sexualidade e comunicação). Observaram-se mudanças nas três dimensões em função das TRA e da gravidez. As TRA mostraram-se fonte potencial de algumas dificuldades para a comunicação, a sexualidade e até mesmo para a coesão, mas sua superação pareceu ter sido favorecida pelo apoio existente entre os cônjuges. Durante a gravidez, algumas dificuldades permaneceram, especialmente na sexualidade em função do medo de perder o bebê, ainda que a coesão tendesse a aumentar, estimulada pela presença do bebê. Constatou-se que a família ampliada pode servir como um recurso para o casal ou como um estressor adicional. Destaca-se a importância de considerar as vivências prévias do casal, através da uma investigação da sua história. / This study investigated marital relationship during pregnancy in couples who were submitted to assisted reproduction. A collective-case study was carried out in which three couples, in the last trimester of pregnancy, took part. The data were collected from semistructured interviews and later submitted to content analysis. The categories of analysis were the marital history, the decision to have a child and the infertility treatment, the couple's relationship with the extended family, and, finally, the marital relationship, comprising three dimensions (cohesion, affectivity/sexuality and communication). Changes were identified in all three dimensions of marital relationship as a function of treatment and the pregnancy. The assisted reproduction techniques can be seen as a potential source of difficulties for communication, sexuality and even for cohesion, which can be overcome by marital support. During pregnancy, some difficulties can still remain, especially in sexuality, for fear of losing the baby, even though cohesion tends to increase, triggered by the baby's presence. The extended family may serve either as a resource for the couple or as an additional stressor. The importance of considering the couple's previous experiences is highlighted, through an investigation of the marital history.