Made available in DSpace on 2014-06-11T19:29:15Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-02-28Bitstream added on 2014-06-13T19:26:54Z : No. of bitstreams: 1 carreira_jt_me_jabo.pdf: 1115702 bytes, checksum: f2dddb9edf2109b5192f0e4f605b5b97 (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / O objetivo deste trabalho foi avaliar os efeitos da gota citoplasmática proximal (GCP) no sêmen de bovinos quanto à integridade do DNA, das membranas citoplasmática, acrossomal, no potencial mitocondrial e verificar a taxa de produção de embriões in vitro. Três amostras descongeladas de cinco (Controle: espermiograma normal), e oito touros Bos indicus (Gota: GCP ≥15%) foram avaliadas. Foram realizados os seguintes testes: motilidade e vigor pós-descongelação, concentração, morfologia espermática, teste de termo-resistência lento (TTL), integridade da membrana acrossomal, plasmática e potencial mitocondrial utilizando sondas fluorescentes (PI, FITC-PSA e JC-1) e integridade da cromatina pelo método de coloração com laranja de acridina. Dois touros com índices elevados de GCP e três animais controle foram selecionados para fertilização in vitro (FIV). As análises estatísticas foram efetuadas empregando-se o programa Statistical Analysis System. O nível de significância foi de 5%. Os resultados obtidos demonstraram que altos índices de GCP não afetaram a motilidade e o vigor, antes e após o TTL, assim como não interferiram na porcentagem de acrossomas intactos. Os resultados destas avaliações mostraram que a alta incidência de GCP afetou a integridade da membrana acrossomal e plasmática bem como a presença de potencial mitocondrial. No entanto, a alta incidência de GCP não promoveu aumento na porcentagem de injúrias à cromatina após descongelação, mas os resultados sugerem que podem ser mais sensíveis à desnaturação quando incubados por três horas. No experimento II, os índices de produção de embriões in vitro podem ter sido afetados pela interação da alteração morfológica e o efeito individual do touro. / The objective of this study was to evaluate the effects of the proximal cytoplasmic droplets (PCD) in bovine semen, on the integrity of DNA, cytoplasmic membrane, acrossome, mitochondrial function and the rate of in vitro embryo production. Three batches of five (control group G1: normal sperm parameters) and eight Bos indicus bulls (G2: PCD ≥15%) were analysed. The following tests were carried out: post thaw motility and, vigor, concentration, sperm morphology, slow thermo-resistance (TRT), membrane integrity, acrossome status, mitochondrial function through fluorescent probes (FITC-PSA, PI and JC-1) and integrity of chromatin was accessed by acridine orange stain. Two bulls with high rates of PCD and three animals (control group) were selected for in vitro fertilization (IVF). Statistical analyses were performed using the Statistical Analysis System. The significance level was 5%. The results showed that high rates of PCD did not affect motility and vigor, before and after the TRT, and did not affect the percentage of intact acrossome. The results showed that the high incidence of PCD affected membrane integrity, acrossome status and mitochondrial function when compared to the G1 group due. However, the high incidence of PCD did not affect the percentage of chromatin injury after thawing, but results suggest that spermatozoa may be more susceptible to damage when incubated for three hours. In experiment II the embryo production rate may have been affected by the interaction of the morphology traits and the bull effect.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / Preimplantation genetic diagnosis (PGD) is becoming a current issue in animal reproduction biotechnology due to economical reasons. Predetermining the sex of offspring is one example of PGD. This study aimed to determine the percentage of male and female bovine embryos in vitro produced after oocyte fertilization with Percoll density gradient centrifugation or with self-migration (swim-up) selected semen. In experiment 1, sperm selection was performed by 90%-45% discontinuous Percoll density gradient centrifugation (T1) and swim-up (T2). In experiment 2, along side the discontinuous gradient, a 67.5% continuous density gradient, and centrifugation time of 5 and 10 minutes were used. A total of 4 treatment groups was defined (TI = continuous, 5 minutes, TII = discontinuous, 5 minutes, TIII = continuous, 10 minutes and TIV = discontinuous, 10 minutes). Polymerase chain reaction (PCR) was used to determine the sex of the embryos. T1 (n=185) resulted in 48.65% (n=90) male embryos and 51.35% (n=95) female embryos and T2 (n=142) in 58.45% (n=83) male and 41.55% (n=59) female embryos. In experiment 2, the percentages of male and female embryos obtained in TI (n=93), TII (n=70), TIII (n=82) and TIV (n=82) were 49.46% (n=46) and 50.54% (n=47), 57.14% (n=40) and 42.86% (n=30), 36.59% (n=30) and 63.41% (n=52) and 48.78% (n=40) and 51.22% (n=42), respectively. There was no difference on the percentage of males and females in all treatment groups from experiments 1 and 2 when these were individually compared to the expected percentage of 50% of each sex. There was also no difference in male and female embryo percentage between treatment groups in experiments 1 and 2. / O diagnóstico genético pré-implantação (DGP) vem se destacando na área da biotecnologia da reprodução animal por motivos econômicos. Um exemplo de DGP é a predeterminação do sexo da prole. Neste estudo foi verificada a percentagem de embriões bovinos machos e fêmeas produzidos in vitro após a fertilização de oócitos com sêmen selecionado por centrifugação em gradiente de densidade de Percoll ou por migração ascendente (swim-up). No experimento 1 a seleção espermática foi realizada usando o gradiente descontínuo de Percoll de 90% e 45% (T1) e o swimup (T2). No experimento 2 foi utilizado, além do gradiente descontínuo, um gradiente contínuo de densidade de Percoll de 67,5%, e tempos de centrifugação de 5 e 10 minutos, totalizando 4 tratamentos (TI = contínuo 5 minutos, TII = descontínuo 5 minutos, TIII = contínuo 10 minutos e TIV = descontínuo 10 minutos). A sexagem dos embriões foi realizada através da técnica da reação em cadeia da polimerase (PCR). No T1 (n=185) foram obtidos 48,65% (n=90) de embriões masculinos e 51,35% (n=95) de femininos e no T2 (n=142) 58,45% (n=83) foram machos e 41,55% (n=59) fêmeas. No experimento 2, a percentagem de embriões masculinos e femininos no TI (n=93), TII (n=70), TIII (n=82) e TIV (n=82) foi de 49,46% (n=46) e 50,54% (n=47), 57,14% (n=40) e 42,86% (n=30), 36,59% (n=30) e 63,41% (n=52), e 48,78% (n=40) e 51,22% (n=42), respectivamente. Não houve alteração na percentagem de machos e fêmeas nos tratamentos dos experimentos 1 e 2 quando estes tratamentos foram comparados individualmente com a percentagem teoricamente esperada de 50% de cada sexo. Também não houve alteração na percentagem de machos e fêmeas na comparação entre os dois tratamentos do experimento 1 e entre os quatro tratamentos do experimento 2.

Gamete donors are actively searched by companies dedicated to assisted reproduction in the Spanish State, and advertising is not only legal but rather common. This thesis provides an overview of the main themes that arise from the analysis of mostly visual materials used to promote ovum donation in public spaces in Barcelona, and critically links them to current debates in intersectional feminist cultural studies of technoscience, bodily theory and visual studies. Conceptual and affective tensions between characterisations of women’s bodies, reproductive function and desires are identified and brought forward in terms that imply tropes of sacralisation, reification of cells/organs/tissues, and fragmentation of the bodily reality. It is argued that egg donation advertisements use an imagery that deeply connects with practices well rooted in Western biomedical traditions when it comes to female bodies, physiology and reproductive function, and that such practices are to be understood against the backdrop of neoliberalism. The analysis supports the idea that the publicity discourse of the assisted reproduction industry in Spain actively engages in a legitimation of the desire of biological parenthood as a right, in ways that value lives conceived in different circumstances and geopolitical contexts in radically different ways, and that can be interpreted as paving the way to prosurrogacy and/or eugenic positions. Future research is encouraged and directed towards exploring issues of agency, particularly in vulnerable groups such as migrant, poor, uneducated or racialised women. Further research is needed in order to build the foundations of a feminist ethical reflection on reproductive technologies and particularly of ovum donation.

Factors currently at the forefront of human in vitro fertilization (IVF) that collectively influence treatment success in the form of blastocysts development were investigated during early mammalian embryology with concentration on infertile patients presenting with diminished ovarian reserve or preliminary ovarian failure. A novel experimental technique, Graft Transplant-Embryonic Stem Cells (GT-ESC) was introduced in the mouse model, as the first inclusive approach for embryo selection in IVF treatments resulting in successful graft integration of sibling cells, stage-dependent (day 4) blastocysts. E-Cadherin-catenin bonds play an integral role in trophectoderm cell viability and calcium removal, inducing disruption of cell-to-cell bonds at the blastocyst stage was detrimental to continued blastocyst development. One of the leading methods for embryo selection for uterine transfer in human IVF is application of pre-implantation genetic screening (PGS) methods such as next generation sequencing (NGS). Female patients <35 y do not benefit from this treatment when outcome is measured by presence of fetal heart beats at 10 weeks of gestation. Patients 35-37 y benefit from PGS with no significant difference of outcome based on form of PGS method utilized. Therefore, small nucleotide polymorphism array (snp-array) or targeted-NGS should be selected for this age range to lessen the financial burden of the patient. Embryos from women >40 y have a higher rate of mosaic cell lines which can be detected by NGS. Therefore NGS is most beneficial for women >40 y. Additionally, ovarian stimulation of the patient during human IVF can notably influence outcome. Anti-Müllerian hormone (AMH) is a more conducive indicator of blastocysts development per treatment compared to basal follicle stimulating hormone (FSH). Actionable variables included in a decision tree analysis determined a negative influence (0% success, n=11) of high dose gonadotropin use (>3325 IUs) in good prognosis patients (>12 mature follicles at trigger, AMH >3.15 ng/mL). A positive relationship exists (80% success, n=11) between poor responders (AMH <1.78 ng/mL, <12 mature follicles at trigger) and high dose gonadotropin use (>3025 IUs). Utilizing the decision tree during IVF treatment can be beneficial to treatment success. Moreover, a parallel relationship of the fundamental principles of culture medium pH, pCO2 and pO2 was found with respect to blastocyst development. Human infertility patients' gametes predisposed to primary stressors (i.e., age, genetics and etiology) are negatively impacted (~30% success, n=7) for cleavage stage (day 3) embryo development when primary culture medium has pCO2 <30mmHg given age >31 y and <14 oocytes retrieved. When day 3 embryo development is measured at >65% good quality embryos per treatment (based on SART grading criteria), blastocysts development success is highest when secondary culture medium pO2 is 69-88 mmHg (~90% success, n=12). Thus, IVF treatment outcome can be optimized with utilization of predictive model analyses in the form of decision trees providing greater success for the IVF laboratories, ultimately decreasing the emotional and financial burden to infertility patients.

This master's thesis focuses on the retrospective biographical interviews with three now fertile women who as narrators retrospectively create their identities during the experience with the diagnosis and treatment of infertility. I also explored how the medical and social institution could lead to a change of identity of female infertility. This master's thesis is based on theory of Erving Goffman about patients in total institution: this theory supports the idea that total (medical) institution destroys the patient's original identity and then constructs new identity. The major result of this master's thesis found four different changes in woman's identity during the experience of infertility: identity of implicitly fertile woman and potential mother, denial of identity and the process of accepting a new identity, identity of infertile woman and patient's identity, and mother's identity. The changes of woman's identity are based on diagnostic phase. Therefore I decided to separate them into four various period in this research: pre-diagnostic, diagnostic, post-diagnostic and contra-diagnostic. I also found a difference between Goffman's theory and my results: Based on my research I concluded that the construction of identity of infertile women in the diagnostics and treatment of infertility is...

Within many communities and religions, including the LDS community, there is some controversy surrounding the use of stem cells – particularly embryonic stem cells (ESC). Much of this controversy arises from confusion and misconceptions about what stem cells actually are, where they come from , and when life begins. The theology of the Church of Jesus Christ of Latter-day Saints has interesting implications for the last of these considerations, and it becomes less a question of “when does life begin” and more an exploration of “when does personhood begin” or “when does the spirit enter the body.” With no official Church stance, statements from Church leaders vary on this topic, and this first section of the thesis explores the philosophical and practical meaning of personhood with a biological background intended for those not familiar with the origin or uses of stem cells.The second portion of the thesis explores possible cloning technologies. Recent events and advances address the possibility of cloning endangered and extinct species. The ethics of these types of cloning have considerations uniquely different from the type of cloning commonly practiced. Cloning of cheetahs (and other endangered or vulnerable species) may be ethically appropriate, given certain constraints. However, the ethics of cloning extinct species varies; for example, cloning mammoths and Neanderthals is more ethically problematic than conservation cloning, and requires more attention. Cloning Neanderthals in particular is likely unethical and such a project should not be undertaken. It is important to discuss and plan for the constraints necessary to mitigate the harms of conservation and extinct cloning, and it is imperative that scientific and public discourse enlighten and guide actions in the sphere of cloning.

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Des facteurs masculins sont identifiés dans près de la moitié des cas d’infertilité. À ce jour, les tests évaluant la fertilité masculine demeurent peu prédictifs de la survenue d’une grossesse. Dans le but de pallier cette lacune, nous avons mis au point deux nouveaux tests mesurant l’intégrité de l’ADN et le temps de survie des spermatozoïdes. Nous avons effectué une étude prospective portant sur 42 couples infertiles suivis en fécondation in vitro (FIV). Le spermogramme a été effectué selon les critères de l’Organisation Mondiale de la Santé (OMS) et le temps de survie des spermatozoïdes exposés à un détergent cationique a été mesuré en observant la mobilité sous microscope. L’intégrité de l’ADN des spermatozoïdes a été vérifiée par la nouvelle méthode de marquage radioenzymatique et par analyse de la structure de la chromatine (SCSA). Tous les tests ont été réalisés sur la partie des échantillons de sperme non utilisée par la clinique de fertilité. Le projet a été approuvé par le comité d’éthique du Centre Hospitalier Universitaire de Montréal (CHUM) et les patients ont préalablement signé un formulaire de consentement éclairé. L’analyse des paramètres du spermogramme et de l’intégrité de l’ADN n’a montré aucune différence statistiquement significative entre les données chez les couples avec ou sans grossesse. Cependant, le taux de grossesse biochimique était statistiquement plus élevé chez les couples dont le temps de survie des spermatozoïdes était long (>250 s) comparativement à ceux dont ce temps était court (≤250 s): 66% vs 27% respectivement (p<0,05). Les taux de grossesse clinique et d’implantation étaient aussi plus élevés, mais les différences n’atteignaient pas le seuil de signification statistique. Nos résultats confirment que le spermogramme et la mesure de la fragmentation de l’ADN des spermatozoïdes ne sont pas de bons facteurs prédictifs des résultats de la FIV. Par contre, le test de survie des spermatozoïdes serait un meilleur indicateur de la possibilité d’une grossesse en FIV. L’amélioration de sa spécificité et un plus grand nombre de sujets sont nécessaires avant de proposer son application en clinique de fertilité. / Male factors are known to be involved in almost half of the couples consulting for infertility. To date, the tests for evaluating male fertility are poor predictors of pregnancy. We developed two new tests to evaluate sperm function: a sperm survival test and a new method to measure sperm DNA integrity. This prospective study was conducted on 42 infertile couples undergoing in vitro fertilization (IVF). Assessment of sperm parameters was done according to the World Health Organization (WHO) criteria, and sperm survival upon exposure to a cationic detergent was measured by observing motility under the microscope. Sperm DNA integrity was verified by our new radioenzymatic method as well as by the sperm chromatin structure analysis (SCSA) method. All testing was performed on a remainder aliquot of the semen samples. The study was approved by the ethics committee of the Centre Hospitalier Universitaire de Montréal (CHUM), and informed consent was obtained before inclusion. Neither conventional semen analysis, nor sperm DNA fragmentation showed statistically significant difference between conception and non-conception cycles. However, the biochemical pregnancy rate was statistically higher in couples where the sperm survival time was long (>250 s) compared to short (≤250 s): 66% vs. 27% respectively, (p < 0.05). The clinical pregnancy rate and implantation rate were also higher but the differences did not reach statistical significance. Our study confirms that conventional semen analysis and the assay for sperm DNA integrity are not reliable indicators of IVF outcome. In contrast, our new sperm survival test seems to be a better predictor of the pregnancy rate after IVF. Improvement of its specificity and a larger cohort of patients are necessary before proposing its regular application in IVF clinics.

Justificativa: Falhas recorrentes de implantação (FRI) são uma fonte de grande frustração para pacientes e especialistas que, frequentemente buscam intervenções com o objetivo de atingir resultados favoráveis. A prevalência exata dessa condição é de difícil estimativa, uma vez que existem diversas definições para caracterizá-la. Diversas intervenções que visam a melhora dos resultados reprodutivos dessas pacientes já foram propostas. Entretanto, nenhuma revisão sistematizada abordou, simultaneamente, todas as potenciais estratégias para esse grupo de mulheres. Dessa forma, a eficácia e a segurança dessas intervenções não são bem definidas. Devido ao alto número de intervenções descritas para esse fim, julgamos que uma metanálise que as contemple de forma abrangente é importante para casais, especialistas e pesquisadores do assunto. Objetivos: Avaliar a eficácia e segurança das intervenções que visam a melhora do resultado reprodutivo das pacientes com FRI submetidas a um novo tratamento de reprodução assistida. Métodos de busca: As buscas por estudos randomizados e controlados, publicados e em andamento, foram realizadas nas principais bases de dados eletrônicas. Adicionalmente, as listas de referências de estudos incluídos e revisões semelhantes foram avaliadas pelos autores. A última busca eletrônica foi realizada em fevereiro de 2018. Critérios de Elegibilidade: Foram considerados elegíveis apenas os estudos verdadeiramente randomizados que comparassem quaisquer intervenções destinadas a esse grupo depacientes. No presente estudo, consideramos como FRI a história de duas ou mais falhas prévias. Extração e análise de dados: Dois autores realizaram, individualmente, a seleção de estudos, extração de dados e análise do risco de viés. Discordâncias foram resolvidas em consulta a um terceiro autor. Os pesquisadores de estudos potencialmente elegíveis foram contatados sempre que necessário para obtenção de informações adicionais. Resultados: Foram identificados 2794 registros; desses, 62 estudos foram incluídos, representando uma população de 9308 pacientes, submetidas a 26 intervenções diferentes. Informações sobre 24 intervenções e 8461 pacientes foram submetidas à análise quantitativa. Não há evidências de alta ou moderada qualidade de que alguma dessas intervenções seja realmente eficaz para a melhora dos resultados reprodutivos de pacientes com FRI. As seguintes intervenções se mostraram benéficas: assisted hatching, injúria endometrial, histeroscopia, uso de FSH urinário + recombinante para estimulação endometrial e administração intrauterina de hCG. Porém as evidências são de baixa qualidade, o que nos traz incerteza em relação aos seus reais efeitos. Todas as outras intervenções identificadas não permitiram nenhuma outra conclusão adicional, uma vez que as evidências foram avaliadas como de muito baixa qualidade ou não foram encontrados estudos randomizados que as tivessem avaliado. Conclusões: Evidências de ensaios clínicos randomizados não sustentam o uso de nenhuma intervenção para a melhora dos resultados reprodutivos de pacientes com FRI. Todos os achados foram julgados como de baixa ou muito baixa qualidade, o que nos traz incerteza quanto aos seus reais efeitos na prática clínica. Deve-se estar ciente de que o emprego de tais intervenções impõe despesas e riscos adicionais para as pacientes. Além disso, a falta de critérios universalmente aceitos para odiagnóstico de falha recorrente de implantação é uma importante limitação para o avanço do conhecimento sobre essa condição / Background: Recurrent implantation failure (RIF) is a source of deep frustration to couples and clinicians, who often look for interventions to improve the reproductive outcomes. Its exact prevalence is difficult to determine because there are several definitions used to describe the condition. Several interventions aiming to improve reproductive outcomes for such patients have been studied. However, there are no systematic reviews that focus on all potential interventions for improving reproductive outcomes in women with RIF undergoing assisted reproduction techniques. The efficacy and safety of these interventions are not clear. Because of the large number of potential interventions for this condition, it would be very difficult to be aware of the current evidence for all of them. We believe this systematic review is important for subfertile couples, clinicians and researchers. Objectives: To assess the efficacy and safety of interventions designed to improve reproductive outcomes in women with RIF undergoing ART. Search methods: We searched for randomised controlled trials (RCT) in electronic databases (Cochrane Gynaecology and Fertility Group (CGF), The Cochrane Central Register of Controlled Trials, MEDLINE Ovid, EMBASE Ovid, PsycINFO, PsycINFO Ovid, CINAHL, LILACS), trials registers (ClinicalTrials.gov, ISRCTN registry, The WHO International Clinical Trials Registry Platform, World Health Organization International Clinical Trials Registry Platform) and grey literature (OpenGrey); in addition, we handsearched the reference lists of included studies and similar reviews. We performed the last electronic search on 22 Feb 2018.Selection criteria: We considered eligible only truly randomised controlled trials comparing any intervention designed to improve outcomes in women with repeat implantation failure (RIF) compared to other intervention, placebo or no treatment. For study selection, we defined RIF as two or more previous failures Data collection and analysis: Two authors independently performed study selection, data extraction, and assessment of the risk of bias. Any disagreements were solved by consulting a third review author. Study\'s authors were contacted whenever needed to solve any queries. Results: the search retrieved 2794 records; from those, sixty-two studies were included, comprising 9308 participants, submitted to 26 different interventions. Data from 24 interventions and 8461 participants were pooled for quantitative analysis. We found no high or even moderate quality evidence that any of the tested interventions are really effective to improve reproductive outcomes of women with RIF undergoing a new IVF treatment. We observed low-quality evidence of benefit for women with RIF with the following interventions: assisted hatching, endometrial Injury, hysteroscopy, the use of human + recombinant FSH for ovarian stimulation and intrauterine hCG administration. All the other listed interventions did not allow any further conclusion: either very low-quality evidence or no evidence from RCTs. Conclusions: Evidence from RCTs does not support the use of any specific intervention for improving reproductive outcomes in women with RIF. All evidences were deemed of low to very low quality, which makes us uncertain of their real effectiveness on clinical practice. One should be aware that the employment of such interventions imposes additional expenses and risks. Additionally, the lack of universally accepted criteria for recurrent implantation failure is an important limitation for the advance of knowledge regarding this condition.More studies are needed to evaluate their real effect. Maybe even more importantly is to create universally accepted criteria for defining implantation failure; only them one will be able to test interventions for this specific group

Surrogacy arrangements have become an option for many involuntarily childless couples. Although surrogacy arrangements are not regulated in Sweden, there is an implied prohibition contained in the Genetic Integrity Act which makes it impossible to facilitate such arrangements under the Swedish health care system. However, many couples go abroad to fulfill their dream of having a child. The paper discusses whether surrogate arrangements can change the view of biological / genetic motherhood. The unwritten maternity presumption makes it difficult to determine the legal parenting of children born through surrogacy arrangements, which puts the child in a lawless position. Why have surrogate arrangements become controversial? The motherhood presumption has been used as a way to mark ethical resistance to surrogate arrangements. This is evident partly from preliminary work on the presumption and the presumption and it´s definition. Arguments that are weighted heavily for the legislation are that surrogate arrangements can be harmful to women and children and that it is considered a violation of the human dignity principle. The legislator believes that a woman's body is used in such cases as a means of achieving someone else's goals. The legislator also states that it can be difficult for the birth woman to give up the child during the exchange. There are different ways to implement a surrogate arrangement and one is considered better than the other. The debate that has been made in Sweden has been that; either both forms, altruistic and commercial surrogate arrangements should be banned, or that they should only allow altruistic surrogate arrangements. Altruistic for some is considered more accepted because this form of surrogate arrangement is about a woman carrying the child without agreeing on money in exchange. In commercial surrogate arrangements, the woman carries the child in exchange for compensation, which is not considered acceptable in society. One problem that is highlighted in the paper is that there are clear differences between commissioning father and commissioning father with genetic linkage to the child in surrogate arrangements. The differences arise when the parties are to be determined as legal parents. Based on practice it appears that men's genetics are recognized to a greater extent than women by the legislature. The genetic mother becomes powerless without the consent of the genetic father. As a result of our investigation, we believe that surrogacy arrangements need regulation in Sweden. What is considered most ethically justifiable is to legalize altruistic surrogacy. When egg donation was legalized in Sweden the same discussion took place as it is today with surrogacy arrangements, whether it is ethically justifiable or not. Today egg donation is not unusual when a woman´s eggs are unusable, and we believe the future will be the same for surrogacy arrangements. Surrogacy arrangements will be normalized in society and therefore the legislation should also keep up. The view of who the child´s mother is will be expanded, and more people will be involved, if surrogacy arrangements are legalized. The child will have the opportunity for a larger network of parents and in altruistic contexts, the woman who carries the child will have a close connection without being a legal parent and guardian. / Surrogatarrangemang har blivit ett alternativ för många ofrivilligt barnlösa par när de vill bilda familj. Det är inte reglerat i Sverige och det är heller inte lagligt att utföra sådana behandlingar inom den svenska hälso-sjukvården pga. ett implicit förbud enligt genlagen. Detta medför att många par åker utomlands för att uppfylla drömmen om ett barn. Det som diskuteras i uppsatsen är huruvida surrogatarrangemang bör legaliseras i Sverige och om surrogatarrangemang kan ändra synen på biologiskt/genetiskt moderskap. Den oskrivna moderskapspresumtionen gör det svårt att fastställa det rättsliga föräldraskapet till barn födda genom surrogatarrangemang vilket sätter barnet i en rättsosäker position. Varför har surrogatarrangemang blivit kontroversiellt? Moderskapspresumtionen har använts som ett sätt att markera etiskt motstånd mot surrogatarrangemang. Detta framgår dels av förarbeten till presumtionen och den utformning som den fick år 2003. Argument som vägt tungt för lagstiftningen är att surrogatarrangemang kan vara skadligt för kvinnor och barn samt att det anses vara en kränkning mot människovärdesprincipen. Lagstiftaren menar att en kvinnokropp används i sådana fall som medel för att åstadkomma någon annans mål. Lagstiftaren framför även att det kan vara svårt för den födande kvinnan att ge upp barnet efter födseln. Det finns olika vägar att genomföra ett surrogatarrangemang och det ena anses bättre än det andra. Debatten som framförts i Sverige har handlat om att antingen bör båda formerna, altruistiskt och kommersiellt surrogatarrangemang, förbjudas eller endast tillåta altruistiskt surrogatarrangemang. Altruistiskt anses för vissa mer accepterad eftersom denna form av surrogatarrangemang handlar om att en kvinna bär barnet utan att avtala om pengar i utbyte. I kommersiella surrogatarrangemang bär kvinnan barnet i utbyte mot ersättning vilket inte är lika accepterat av samhället.  Ett problem som belyses i uppsatsen är att det uppstår tydliga skillnader mellan beställande män och beställande kvinnor med genetisk koppling till barnet i surrogatarrangemang. Skillnaderna uppstår när parterna ska fastställas som rättsliga föräldrar. Med utgång i praxis framgår det att män genetiskt erkänns i större utsträckning än kvinnor av rättstillämparen. Den genetiska modern blir maktlös utan den genetiska faderns samtycke. Resultatet av denna undersökning blev att surrogatarrangemang är i behov av reglering i Sverige. Det som anses mest etiskt försvarbart är att legalisera altruistiska surrogatarrangemang. När äggdonationer legaliserades i Sverige pågick ungefär en likadan diskussion som det idag gör kring surrogatarrangemang, huruvida det är etiskt försvarbart eller inte. Idag är äggdonationer inget ovanligt när en kvinnas ägg är obrukbara och vi anser att framtiden kommer se likadan ut för surrogatarrangemang. Surrogatarrangemang kommer normaliseras i samhället och därför bör även lagstiftningen utvecklas i takt med samhället. Synen på vem som är barnets moder kommer att utvidgas och fler personer involveras, om surrogatarrangemang legaliseras. Barnet kommer få möjlighet till ett större nätverk av föräldrar och i altruistiska sammanhang kommer kvinnan som bär barnet ha en nära anknytning utan att vara rättslig förälder och vårdnadshavare.