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<p>We live in a society that continually reinforces the connection between femininity and maternity and for the majority of women, attempts to experience motherhood are successful. However, for others the world of motherhood is not so easy to enter. To date, research regarding the needs and life satisfaction of women who are unsuccessful in becoming mothers, is fairly limited. The purpose of this study was to explore the transitional phase women endure from potential motherhood to non-motherhood and to highlight some of the complexities underpinning infertility and its impact on the lives of women in South Africa. The main objective was to gain deeper insight into how women incorporated this experience into their lives and relationships and how they began to create a future life without their own biological children. A secondary aim of this study was to investigate whether the women viewed aspects such as age and finances as having had an effect on their decision to discontinue treatment for infertility. Feminist standpoint theory served as a theoretical framework for the study that recognized that each individual voice be heard. This study was a qualitative exploration, utilizing a short demographic questionnaire and an in-depth semi-structured interview. Five interviews were conducted with women from diverse backgrounds. These interviews were recorded / transcribed verbatim and thematic analysis of the data was conducted.</p>

BACKGROUND: Current estimates indicate approximately 6.7% of women in the US are infertile. Infertility can arise from many different conditions and can be both attributed to male and female factors. In women, measures of ovarian reserve such as AMH level or FSH level on day three of the menstrual cycle can be used to predict reproductive success. In conjunction with additional tests and lifestyle screening, these values help to guide the course of treatment, with some patients moving eventually to in vitro fertilization. In vitro fertilization therapy is cost-prohibitive if the patient does not have insurance coverage, an issue for the majority of patients across the United States. AIMS: To evaluate the correlation between cycle number, age, and AMH level with achieving a successful live birth through a statistical analysis of over 50,000 cycles of in vitro fertilization. Methods: Data was obtained from Practice Highway, a company that owns the electronic medical record (EMR) program eIVF, used by over 140 reproductive endocrinology practices across the country. The database provided a total of 88 variables and 138,526 IVF cycle observations ranging from 01/01/2005 to 09/09/2015. A thorough review of available literature was performed to determine the need for the correlations analyzed in this paper. Utilizing this information in conjunction with the scope of this paper, the number of variables was reduced to four. Linear regression and multivariate regression was performed on the four main study variables to identify possible correlations. Results: The results of our study indicate that there is not a strong correlational relationship between the variables analyzed. There was not a significant correlation between age and whether a live birth was achieved. As expected, the strongest relationship identified through our study is the decrease in AMH as age increases. Conclusions: Our study results indicate that there is no correlation between AMH and live birth, suggesting that this biomarker alone is insufficient to be used by physicians as a means of advising patients on IVF success. Additionally, measures such as number of cycles completed and age at cycle start can be useful when counseling patients on their probability of success with assisted reproductive technologies.

Infertility is a serious public health issue. Infertile couples may perceive infertility differently based on their own cultural background. There is a paucity of literature about how infertility is perceived among Arab women living in the United States. The purpose of this study was to be able to understand how Arab women who live in Dearborn, Michigan feel about infertility and to understand their concerns and worries about their health status. The primary research questions asked Arab women how they perceive infertility and how infertility may impact their future. This qualitative case study was guided by the social support theory and the choice theory. The social support theory is mainly used in health promotion to describe unmet social, emotional, and informational needs for a certain community or population. The choice theory helped understand the way women perceive their health issue and the way to overcome it. The case study approach was used to interview 10 participants who self-identified as Arab American women with infertility problems. The qualitative data gathered were analyzed for thematic content, using open, axial, and selective coding. Results showed that for these participants, cultural beliefs regarding infertility had affected their well-being, causing feelings of shame and incompleteness. In addition, the study's findings indicated a need for more extensive psychological services and medical resources to be available for infertile couples. Positive social change may be seen in understanding the specific issues faced by Arab American women struggling with infertility and through translating this knowledge into public health programs.

As women who are sub-fertile, infertile or whose children have died, kanyalengs play a special role at public gatherings and celebrations as performers in The Gambia. The collective activities of kanyalengs speak to the hardships that are associated with the inability to meet cultural expectations for a sufficiently large family They traditionally take the form of bold song and dance performances which enable kanyalengs to shame themselves before Allah in hopes that their outrageous behavior will convince divine will to take pity and make them fertile or allow their children to survive. Drawing on data from interviews, participant observation and archival research conducted in Gambia over an eight month period in 2004, this dissertation considers the reproductive concerns of kanyalengs in the context of marriage and kinship as well as their micro political-economic interests in creating and maintaining an appropriately large family. It investigates Gambian women's explanations of and responses to reproductive disruptions including various healing modalities as well as kanyaleng membership. Kanyaleng performances often reveal gender disparities in various aspects of Gambian life as well as the burden of successful reproduction that lies squarely on women's shoulders. However, this dissertation argues that the goal of kanyaleng yaa ("being a kanyaleng") is not to permanently transform reproductive expectations, but to ultimately fulfill them. Kanyaleng yaa operates both as an individual identity and as an expression of group solidarity, with members working together to attain their personal and collective goals, reproductive and otherwise, through ritual and work. Increasingly, the lines between these two categories of action have become blurred with kanyalengs' entrée into development work as "traditional communicators." This dissertation examines how kanyalengs' concerns correspond to or conflict with the reproductive health agendas that national and international agents have set for Gambian women and asserts that new opportunities for kanyalengs in development present chances to parlay their liminal status into social and economic advantages. Further, it explores the unique way in which kanyalengs are engaged with the dissemination of messages as development educators that may ultimately be at odds with what they perceive to be their best reproductive interests.

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published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

In the first part of study, our objective was to determine the effect of CoQ10 supplementation of culture media on preimplantation mouse and human embryo development. CoQ10 supplementation of culture media did not improve mouse or human embryo development in vitro. Since the results appeared to be negative, we decided to move on to research the effect of age on female infertility. In the second part, we investigated the effect of female age and ovarian stimulation protocols on IUI outcome in 411 infertile women. We found that the ongoing/live birth rate per cycle in women ≤ 37 years was significantly higher than in older patients. In the third section, we determined if very young age (≤25 yrs) has an impact on pregnancy outcome in women undergoing IVF-ET. Our results demonstrating lower pregnancy rates in very young patients and egg donors compared to the patients in their early thirties were surprising.

Approximately 1% of women will experience menopause before the age of 40, a condition known as premature ovarian failure (POF). The goal of this thesis was to identify genetic causes of POF by examining a number of candidate factors in POF patients and control women. Carriers of FMR1 premutations (55-200 CGG repeats) are known to be at increased risk of POF. A higher prevalence of alleles between 35-54 repeats was found among POF patients (p=0.01), suggesting that risk for POF may extend outside the classic premutation range. There was no evidence for any difference in FMRI promoter methylation or gene expression between cases and controls. Allele distributions of gene polymorphisms in the androgen receptor (AR), estrogen receptor (ß, sex hormone binding globulin, and FSH receptor genes did not differ between POF patients and controls. However, haplotype at the estrogen receptor a gene, ESRI, was found to be associated with POF in a simple dominant manner (RR=9.7; 95% CI=2.6-35.6). Although the functional effect of this haplotype could not be confirmed, it may confer a more active promoter that influences risk by increasing the rate of follicular atresia. X-chromosome inactivation (XCI) skewing can indicate an abnormal X chromosome and may therefore be increased in POF patients. There was no increase in skewed XCI >90% in patients with secondary amenorrhea, however, there was a significant increase in 4 POF patients with primary amenorrhea (p=0.001). No X-chromosome abnormalities were detectable by high resolution DNA microarray, and skewed XCI may be explained by a trisomic rescue event causing reduced follicular pool. Age-related chromosome factors were assessed to determine if POF patients demonstrate an increased rate of cellular aging. With age, XCI skewing and AR methylation increase and telomere length decreases. There was no difference in skewing or methylation between patients and controls. Surprisingly telomere length was increased in POF patients (p=0.04), a finding that may be explained by abnormal estrogen exposure. Genotype at the longevity-associated APOE gene was not associated with POF. In conclusion, these findings have illuminated several new areas of research in this field and provide background for future research into POF pathogenesis.