The dissertation follows up metods of assisted reproduction and its ethical aspects that are described with their particular metods of assisted reproduction. It summarizes opinions of supporters, such as doctors, but also opinions of respondents such as ethicists or theologian. Dissertation is mostly focused on moral status of embryo and their superfluous creations. It warns us to be aware that assisted reproduction can leads to violation of human dignity but also let us learn ways of assisted reproduction which are considerate to embryos and which do not jeopardize human dignity. It describes problems of legislation in Czech Republic but also in Germany and Great Britain. One part is also dedicated to opinions of catholic Church. Last chapter describes involuntary childlessness.

Background: An increasing number of couples turn to treatment with oocyte or sperm donation, but there is limited knowledge regarding the consequences of these treatments in a program using identifiable donors. Aim: The overall aim was to study information-sharing among heterosexual couples following identity-release gamete donation. A further aim was to study donors’ attitudes towards future contact with donation offspring. Methods: The four studies were part of The Swedish Study on Gamete Donation; a prospective, longitudinal study of donors and recipients of donated oocytes and sperm. Study I and II had a quantitative approach with recipients of donated oocytes or sperm participating through questionnaires at start of treatment, two months after the first treatment and when their child was 1-4 years old. Study III was a qualitative interview study with 30 parents following sperm donation with school-aged children. Study IV had a quantitative approach with oocyte and sperm donors participating through questionnaires 5-8 years post-donation. Results: Study I revealed that the recipients of donated gametes in general were open about their treatment with the people around them and supported disclosure to offspring regarding his/her genetic origin. Study II reported that most of those who became parents following donor conception intended to share information about the donation with their offspring and some had already started the information-sharing process with their young child. Study III described information sharing with the offspring to be a process of several levels, revealing various amounts of information about the way of conception. The parent was seen to be the owner of the process and moving the process forward with different aspects and the reactions of the offspring serving as driving or impeding forces of the process. Study IV reported that a majority of the gamete donors seem to have a positive or neutral attitude towards a future meeting with a donation offspring. Conclusion: The present thesis suggests that there is a trend towards more openness among recipients of donated gametes in Sweden. It also points out that most recipients and donors within the Swedish gamete donation programme acknowledge the child’s right to his/her genetic origin and have the best interest of the child in mind.

Introduction: The desire to have children and form a family is for many people central for life fulfilment and the desire does not differ by sexual orientation. Due a series of societal changes during the last decade, today we see a lesbian baby boom. Planned lesbian families are a relatively new group of patients and parents in reproductive health care, yet little is known about psychological wellbeing during the transition to parenthood in these families. Aim: The overall aim of this thesis was to fill a gap of knowledge about the psychological aspects of undergoing treatment with donated sperm, at the time of pregnancy and during early parenthood that affect lesbian couples forming a family. Method: This is a multicentre study comprising all 7 university clinics that perform gamete donation. The study includes lesbian couples undergoing treatment with donated sperm and heterosexual couples undergoing IVF treatment with their own gametes. Participants were recruited consecutively during 2005 and 2008. 165 lesbian couples and 151 heterosexual couples participated in the study. Participants responded questionnaires at three time points (T); time point 1 (T1) at the commencement of treatment, (T2) after the first round of treatment, around 2 month after T1 and (T3) 12-18 months after first treatment when a presumptive child had reached 1 year. Data was analysed with statistical methodology. Results: Lesbian couples reported an all over high satisfaction with relationship quality, good psychological wellbeing and low parenting stress. Heterosexual couples also reported good satisfaction with relationship quality, however somewhat lower than the lesbian couples. Parenting stress in the heterosexual couples was similar to the lesbian couples. A strong association was found between high relationship satisfaction and low parenting stress. Conclusions: Lesbian couples forming a family through sperm donation treatment are satisfied with their relationships, they report a good psychological health and experiences of low parenting stress.

Introduction: The desire to have children and form a family is for many people central for life fulfilment and the desire does not differ by sexual orientation. Due a series of societal changes during the last decade, today we see a lesbian baby boom. Planned lesbian families are a relatively new group of patients and parents in reproductive health care, yet little is known about psychological wellbeing during the transition to parenthood in these families. Aim: The overall aim of this thesis was to fill a gap of knowledge about the psychological aspects of undergoing treatment with donated sperm, at the time of pregnancy and during early parenthood that affect lesbian couples forming a family. Method: This is a multicentre study comprising all 7 university clinics that perform gamete donation. The study includes lesbian couples undergoing treatment with donated sperm and heterosexual couples undergoing IVF treatment with their own gametes. Participants were recruited consecutively during 2005 and 2008. 165 lesbian couples and 151 heterosexual couples participated in the study. Participants responded questionnaires at three time points (T); time point 1 (T1) at the commencement of treatment, (T2) after the first round of treatment, around 2 month after T1 and (T3) 12-18 months after first treatment when a presumptive child had reached 1 year. Data was analysed with statistical methodology. Results: Lesbian couples reported an all over high satisfaction with relationship quality, good psychological wellbeing and low parenting stress. Heterosexual couples also reported good satisfaction with relationship quality, however somewhat lower than the lesbian couples. Parenting stress in the heterosexual couples was similar to the lesbian couples. A strong association was found between high relationship satisfaction and low parenting stress. Conclusions: Lesbian couples forming a family through sperm donation treatment are satisfied with their relationships, they report a good psychological health and experiences of low parenting stress. / <p>Name change: Paper 2, "Psychological health in lesbian and heterosexual couples undergoing assisted reproduction" in the list of papers has been changed to "Symptoms of anxiety and depression in lesbian couples treated with donated sperm: a descriptive study"</p>

Název diplomové práce v anglickém jazyce: Legal aspects of abortion, sterilization and assisted reproduction Summary: The thesis deals with the three topics from the field of medical law, particularly abortion, sterilization and assisted reproduction. The issue of giving birth is the key here. The new Special Medical Services Act regulating, inter alia, some aspects of sterilization and assisted reproduction came into effect in April 2012. The previous regulation of these matters was outdated and some legal issues were not tackled at all. The first part of the thesis focuses on legal regulation of abortion, which is contained in the act from 1986 and in the implementing legislation. Especially the conditions of intervention itself, payments and intervention on juveniles (under 18) and foreigners in the Czech Republic are tackled. The regulation of other countries is mentioned and compared as well. The second part of the thesis deals with the legal regulation of sterilization, conditions of sterilization and contraindication as well. The specific problem of illegal sterilizations of gypsy women in the second half of the twentieth century is pointed out. These disputes were present even before the European Court for Human Rights in Strasbourg. The methods of assisted reproduction, as a modern way of resolving...

The work follows the current legislation dealing with matters of parenthood. It is designed in accordance with the breakdown of motherhood and fatherhood. After an introduction, defining the purpose and need for legal regulation of family issues, follow the main chapters dealing with different issues. First, attention is paid to the determination of motherhood. This section is divided into three chapters, the first of which is further divided for clarity even in the following sections. The first chapter is devoted to the issue of child identity undetected. This chapter is further divided into parts and special sections devoted to the identity of unidentified child, called the found child, another sub-chapter describes the legislation and the possibility of using the birth mother's identity and privacy of anonymous births, and the last sub-sections deal with the problem of their baby boxes, and legal issues. In other chapters of the work deals with the erroneous entry in the matrix and the state where the child is born outside the medical facility. Then follow chapters on the determination and denial of paternity. The work follows a system of three statutory presumptions of paternity and the subsequent denial of the possibility of paternity. So the first presumption of paternity mother indicating...

The work follows the current legislation dealing with matters of parenthood. It is designed in accordance with the breakdown of motherhood and fatherhood. After an introduction, defining the purpose and need for legal regulation of family issues, follow the main chapters dealing with different issues. First, attention is paid to the determination of motherhood. This section is divided into three chapters, the first of which is further divided for clarity even in the following sections. The first chapter is devoted to the issue of child identity undetected. This chapter is further divided into parts and special sections devoted to the identity of unidentified child, called the found child, another sub-chapter describes the legislation and the possibility of using the birth mother's identity and privacy of anonymous births, and the last sub-sections deal with the problem of their baby boxes, and legal issues. In other chapters of the work deals with the erroneous entry in the matrix and the state where the child is born outside the medical facility. Then follow chapters on the determination and denial of paternity. The work follows a system of three statutory presumptions of paternity and the subsequent denial of the possibility of paternity. So the first presumption of paternity mother indicating...

The concept of assisted reproduction is widely discussed by both professional and lay public. New scientific discoveries in the fields of biology and medicine as well as the use of methods and procedures that enable the emergence of new life raise number of issues, not only the legal ones. The purpose of this thesis is to provide the comprehensive survey of criminal law relationships which may arise in the context of providing the assisted reproduction. The thesis examines whether the current legislation guarantees sufficient protection of relations, interests and values covered by the Criminal Code. Within the analysis of crimes the thesis deals with the need for criminal repression and gives proposals de lege ferenda. The thesis is composed of five chapters. The first chapter is subdivided into two parts. Part One defines the concept of assisted reproduction, describes the historical overview of the events that preceded the current interpretation of the concept and explicates basic medical terminology related to the chosen topic. Part Two presents the basic principles on which the Czech regulation is established and contains specification of the relevant sources of law. The second chapter briefly characterizes the criminal and medical law and clarifies their relationship. The third chapter deals with the...

Cette recherche de thèse porte sur le travail réalisé avec des sujets demandant une prise en charge en médecine procréative. Nous envisageons la question du travail collaboratif entre psychanalyse et médecine dans le champ de l’assistance médicale à la procréation, sur la base de deux approches. La première, historique, porte sur l’évolution de la représentation culturelle de l’infertilité, et la seconde, clinique, d’inspiration psychanalytique, a été construite sur la base de notre expérience au sein d'un centre d’assistance médicale à la procréation et dans un cabinet privé. Nos hypothèses visent à montrer comment les pré-conceptions médicales et psychologiques barrent le dialogue entre le sujet demandant une prise en charge et celui qui l’accueille. À cet effet, nous envisagerons le processus d’objectivation subi par le concept de désir d’enfant, de plus en plus assimilé à celui de projet d’enfant, et nous abordons aussi les difficultés que l’infertilité pose aux hommes dans une époque où elle commence à être conçue comme une maladie du couple et non pas comme une maladie des femmes. À partir d’une mise à jour de la notion d’infertilité, telle qu’elle est comprise par la médecine et par la loi, et de la reprise des théorisations freudiennes autour du symptôme et de la pratique clinique, nous chercherons à montrer la valeur d’une perspective qui n’assume pas d’emblée que toute demande de prise en charge en médecine procréative est une demande d’enfant à la médecine. / This research focuses on work with subjects requiring care in medically assisted procreation. Based on two approaches: an historical one, on the evolution of the cultural representation of infertility. The other clinical, from a psychoanalytic perspective, developed working in a center of assisted reproduction and in private practice. Our work addresses the question of collaborative work between psychoanalysis and medicine in the field of reproductive medicine. Our hypotheses are intended to show how medical and psychological preconceptions difficult the dialogue between the subject requiring care and those who receive him. To this end we will consider the process of objectification suffered in the concept of desire for a child, now assimilated to that of the project of a child. We also address the challenges that infertility imposes on men when it begins to be seen as a couple’s disease and not only as women’s disease. From an update of the notion of infertility, as it is comprised now by medicine and law, and the recovering of Freudian theories about the symptom and clinical practice, we intend to show the value of a perspective that does not automatically assume the demand for care in reproductive medicine as a demand of a child to medicine.

A ultra-sonografia é essencial para a condução de casos que irão ser submetidos aos tratamentos de reprodução assistida. Apesar de inúmeras pesquisas, não se mostrou capaz de predizer o sucesso do procedimento e apenas a medida da espessura endometrial tem algum valor prognóstico. Com a introdução da ultra-sonografia tridimensional, cresceu o interesse no assunto, na esperança que a possibilidade de uma avaliação espacial mais exata dos tecidos e da vascularização pudesse melhorar nossa habilidade de predizer a resposta à estimulação ovariana ou determinar a receptividade do meio endometrial. Objetivamos nesta revisão apresentar os resultados dos trabalhos envolvendo a ultra-sonografia tridimensional e a reprodução assistida, e suas possíveis aplicações nestes procedimentos. / Ultrasonography is essential to guide the cases that will be submitted to assisted reproduction. In spite of the great amount of researchs, it is not able to predict the sucess of the treatment and only the endometrial thicknesshas some prognostic value. With the introduction of three-dimensional ultrasound, therewas a new curiosity incoming, in the expectancy that the possibility of volume assessment of tissues and its vascularization could improve our ability to determine endometrial receptivity or to predict the patient response to ovarian stimulation. In this review we intend to present the results of researchs about three-dimensional ultrasound and assisted reproduction as well as its possible clinical aplications.