Over the past decade, a ‘gayby boom’ (Richman, 2002) has occurred in the Israeli male-gay community: hundreds of gay couples became fathers through cross-border commercial surrogacy. This rise was accompanied by political struggles over access to surrogacy for same-sex couples within Israel. This study explores first, the causes of this sudden rise in ‘gay surrogacy’; and second, the social implications, especially pertaining to the alteration of family norms in the 21st century. Drawing on Science and Technology Studies (STS), surrogacy is analysed as an 'assemblage', consisting of the interaction between socially shaped practices and desires, the medical and legal technologies involved, and the overarching state apparatuses. To draw out the complexity of the different components of this assemblage (individual, medical and legal, and state), 31 gay surrogacy fathers were interviewed, along with Israeli surrogacy industry representatives (n=6) and policy makers (n=13). Media coverage of ‘gay surrogacy’ and documentation from relevant court appeals and state committees on reproductive technologies were incorporated into the analysis to provide a contextual framework. Three themes were identified. First, surrogacy provides Israeli gay men a unique combination of novelty and sameness: surrogacy offers ‘biological’ fatherhood, similar to that enjoyed by heterosexual couples, but also facilitates the creation of a new family model, the ‘two-father-family’. The contradiction between the application of technology and the idea of ‘procreation’ disappeared through a discursive normalising and neutralising mechanism, in which surrogacy serves as a stand-in for ‘natural procreation’. Through this process, assisted reproduction facilitated the normalisation of the gay family. Second, despite the fact that surrogacy markets operate globally, the State emerged as a significant force in shaping the specific mechanisms of the surrogacy process, as well as the procreative desires of the Israeli surrogacy fathers – who were geared towards both genetic procreation and reproducing the nation. Gay fatherhood through surrogacy was found to be part of the new ‘gaystream’ (Duggan, 2002), expressing desires towards a new (homo)normativity and participating in homonationalist (Puar, 2007) struggles. Finally, cross-border surrogacy operates in a global market, based upon the commerce of gametes and reproductive services involving third-party women, often from impoverished parts of the world (Vora, 2015). This creates a moral dilemma for commissioning fathers, regarding the commodification of women and children in the market for reproductive services, and the related harm and exploitation within surrogacy markets. Surrogacy fathers negotiated these moral conflicts by forming ideas and ideals of reciprocity, intimacy and shared commitment towards and with the surrogate. However, the realisation of these values is heavily dependent upon the regulatory regimes in the surrogacy state and the outcomes of the medical and physical procedures – that is, the birth of a live healthy child. In conclusion, surrogacy offers a site for making families and remaking ‘the family’. It is based on already existing familial norms, but at the same time partially unsettles these; it is shaped by state regulations and national desires; and it is deeply implicated in unequal global markets, while explicitly harbouring ideals of intimacy and reciprocity. As surrogacy becomes the normative familial form for gay men in Israel, the need arises for collective critical reflexion on the impacts of surrogacy practices on global ‘others’, and on minorities within the Israeli queer community.

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

Les marqueurs épigénétiques, en particulier la méthylation de l’ADN des gènes soumis à empreinte parentale, sont sensibles aux changements environnementaux. Les techniques de l’aide médicalisée à la procréation (AMP) nécessitant la manipulation des gamètes et des embryons in vitro et dans la plupart des cas la stimulation hormonale de l’ovulation des patientes, peuvent interférer avec la reprogrammation et/ou le maintien de la méthylation des gènes soumis à empreinte. Afin d’évaluer ce risque nous avons analysé le profil de méthylation de KvDMR1, qui régule l’expression de KCNQ1OT1, dans des ovocytes humains mûris in vivo ou in vitro, provenant de patientes stimulées ou non. Nos résultats montrent que la mise en place de la méthylation au niveau de KvDMR1 se poursuit au cours de la maturation de l’ovocyte après reprise de la méiose, in vivo et in vitro et que la superovulation des patientes en AMP génère des ovocytes épigénétiquement immatures. Par ailleurs, l’étude de la méthylation de KvDMR1 et de H19 DMR (qui régule l’expression d’Igf2 et H19) dans des embryons issus d’ICSI, évolutifs ou présentant un défaut de développement, n’établit pas de lien entre les dérégulations de l’empreinte et l’arrêt du développement embryonnaire au stade blastocyste. / Epigenetic modifications, particularly DNA methylation of imprinted genes are sensible to environment. Techniques of assisted reproduction require in vitro manipulation of gamete and embryos and currently superovulation of patients. These technologies may interfere with eprogramming and maintenance of methylation at imprinted genes. To evaluate such a risk, we have determined the methylation profile of KvDMR1, the region that regulates KCNQ1OT1 imprinted gene, in human oocytes retrieved from stimulated or unstimulated cycles, at different phases of their maturation in vivo or in vitro. Our results show that the timing of establishment of the methylation profile of KvDMR1 covers the maturation phase of 199 oocyte growth, in vivo and in vitro, and that hyperstimulation likely recruits young follicles epigenetically immature. Analysis of the methylation profile of KvDMR1 and H19DMR (DMR of IGF2/H19) in ICSI embryos suggests that imprinting disorders are not responsible of embryo developmental failure prior the blastocyst stage

Problématique : L’infertilité – considérée par l’Organisation mondiale de la santé (OMS) comme une maladie du système reproducteur – affecte de plus en plus d’hommes et de femmes, soit un couple sur six en âge de procréer au Canada et au Québec. Elle a un impact sur le bien-être physique et mental des patient.e.s, souvent stigmatisé.e.s et isolé.e.s socialement parce que, pour plusieurs, l’infertilité demeure un sujet tabou. L’infertilité est traitée en procréation médicalement assistée (PMA) où les patient.e.s-familles sont accompagné.e.s par des infirmières dont la pratique est complexe et diversifiée, mais méconnue. But : L’étude avait pour but d’explorer la pratique infirmière en PMA dans un établissement de santé québécois. Méthode : Le devis retenu est une autoethnographie où l’étudiante-chercheuse a mis à profit son expérience comme patiente et comme infirmière en PMA. Des entretiens semi-dirigés, une observation participante et un journal de terrain ont été employés pour la collecte des données. Une analyse thématique a été réalisée. Résultats : L’expérience des patient.e.s-familles en infertilité est au cœur de la pratique infirmière et l’une des principales dimensions de cette pratique est le soin relationnel, peu importe les sphères d’activités auxquelles les infirmières sont affectées au sein de la clinique. Les autres dimensions rapportées sont le leadership/advocacy, l’apprentissage/enseignement, la collaboration et les interventions techniques. Ces résultats correspondent à l’expérience de l’étudiante-chercheuse, tant à titre de patiente que d’infirmière en PMA. Retombées : L’étudiante-chercheuse a documenté la pratique infirmière en PMA, mettant en valeur une méthode peu usitée en sciences infirmières : l’autoethnographie. / Problem: Infertility – classified by the World Health Organization (WHO) as a reproductive system disease – affects an ever-increasing number of women and men. Today, one couple out of six of reproductive age struggles with this condition in Canada and in Quebec. It has an impact on the patients’ physical and psychological well-being, often leaving both partners stigmatized and socially isolated as infertility remains a societal taboo for many. Infertility can be treated via Assisted Reproduction Technologies (ART) where the patients-families are cared for by fertility nurses, whose practice is both complex and diversified, but remains little-known. Purpose: This study explores the field of fertility nursing as it is practised in a Quebec healthcare institution. Method: The student-researcher chose to do an autoethnography in order to draw from her own experience as both a fertility nurse and a fertility patient. Semi-directed interviews, participant observation and field journal were used to collect data. A thematic analysis of data then followed. Results: The patients-families’ infertility experience is at the heart of the fertility nurse’s practice and relational care is the main dimension of that practice, regardless of which nursing activities are assigned to them in the clinic. These other dimensions were also reported : leadership/advocacy, learning/teaching, collaboration and technical interventions. These results coincide with the student-researcher’s experience, both as a fertility patient and as a fertility nurse. Impact: The student-researcher documented the practice of fertility nursing and showcased a method rarely used in nursing science: autoethnography.

Les techniques d’assistance médicale à la procréation particulièrement l’induction de l’ovulation, la maturation in vitro des ovocytes et la culture embryonnaire prolongée impliquent la manipulation des gamètes ainsi que les embryons à des moments critiques de leur maturation et développement qui sont également des étapes clé du remodelage épigénétique. Par conséquent, elles pourraient interférer avec la reprogrammation épigénétique, en particulier la mise en place de la méthylation des gènes soumis a empreinte au cours de l'ovogenèse, ou son maintien au cours du développement préimplantatoire. Afin d’évaluer ce risque nous avons analysé le profil de méthylation de KvDMR1, qui régule l’expression de KCNQ1OT1, dans des ovocytes humains mûris in vivo ou in vitro, provenant de patientes stimulées ou non. Nos résultats montrent que la mise en place de la méthylation au niveau de KvDMR1 se poursuit au cours de la maturation de l’ovocyte du stade VG au stade MII, in vivo et in vitro et que l’induction ovarienne des patientes génère des ovocytes épigénétiquement immatures. Par ailleurs, l’étude de la méthylation de H19 DMR qui régule l’expression d’Igf2 et H19 dans des embryons d’ICSI, atypiques bloqués en culture prolongée et dans les spermes correspondants met en évidence une hypométhylation de l'allèle paternel et une méthylation de l'allèle maternel dans certains embryons, sans que l'on puisse établir de lien entre les dérégulations de l’empreinte et l’arrêt du développement au stade blastocyste. / Assisted reproductive technologies particularly the induction of ovulation, oocytes in vitro maturation, and prolonged embryo culture require in vitro manipulation of gamete and embryos at critical times of their maturation and development. In consequence, they may interfere with epigenetic reprogramming and affect particularly demethylation and remethylation of imprinted genes. To evaluate such a risk, we have determined the methylation profile of KvDMR1, the region that regulates KCNQ1OT1 imprinted gene, in human oocytes retrieved from stimulated or unstimulated cycles, at different phases of their maturation in vivo or in vitro. Our results show that the timing of establishment of the methylation profile of KvDMR1 covers the maturation phase of oocyte growth, in vivo and in vitro, and that hyperstimulation likely recruits young follicles epigenetically immature. Analysis of the methylation profile of H19DMR (DMR of IGF2/H19) in atypical ICSI embryos and corresponding sperm suggests that imprinting disorders are not responsible of embryo developmental failure prior the blastocyst stage.

Ce mémoire porte sur le dualisme sujet/objet visible dans les représentations sociales du corps maternel véhiculées par les discours portant sur la gestation pour autrui. À travers une analyse des discours juridiques, gouvernementaux et de presse, nous montrerons de quelle manière une vision objectivante du corps maternel côtoie une vision subjectivante de celui-ci et comment ce double regard constitue une condition d’émergence de la pratique étudiée. Pour ceux qui s’opposent à la pratique, la subjectivité maternelle prend place dans le corps enceint et pour les tenants, elle se situe prioritairement dans l’intention, dans le projet parental. Le corps maternel ne peut être désigné comme tel seulement s’il accompagne l’intention, sinon, il n’est qu’enceint. La littérature en science sociale est abondante quant à la manière dont les acteurs directement concernés, comme les mères porteuses, les parents d’intention et les tiers reproducteurs et reproductrices conçoivent la pratique, mais peu de recherches s’intéressent aux représentations du corps maternel, et encore moins, à la place du dualisme sujet/objet en leur sein. Ainsi, suivant la conception du corps humain et du sujet moderne, le corps reproducteur féminin est appréhendé comme une entité séparée du sujet et de nature mécanique et pathologique que l’obstétrique moderne doit contrôlée afin de soigner plus facilement le nouveau patient, le fœtus. Toutefois, en parallèle se construit un discours psychologique concevant le corps maternel comme un lieu où la subjectivité de la future mère et du futur enfant se construisent. Le corps maternel pose problème à la figure hégémonique moderne d’un sujet masculin séparé du monde, de par ses potentialités reproductives et sa position face à l’altérité qui est vécue de manière interne et corporelle. Il est donc l’objet d’un recadrage technique et discursif vers cette hégémonie. Les techniques de reproduction assistée et la gestation pour autrui sont des exemples de ce recadrage et du double processus de subjectivation et d’objectivation. Ce mémoire démontrera comment les discours sociaux sur la pratique suggérant une vision de la subjectivité maternelle fluide (priorité à l’intention) se heurtent à une vision rigide (inscrite dans le corps maternel) de celle-ci. / This thesis focuses on the subject/object dualism visible in the social representations of the maternal body conveyed by the different speeches on surrogacy. Through an analysis of governmental, legal and media discourses, we will demonstrate how an objectivating conception of the maternal body stand alongside a subjectivating conception of it and how this double glance constitutes one of the emergence condition of the studied practice. For whom who disagree with surrogacy, the maternal subjectivity take place inside the pregnant body while for the upholder, it is located in priority in the intention, the parental project. The maternal body cannot be designated as such if it doesn’t come with the intention, if not, it is only pregnant. The social literature is abundant about the way the different actors, like surrogate mothers, intentional parents, and third parties perceive the practice but limited researches take a direct interest in the social representations of the maternal body, less again in the place of the subject/object dualism in them. In this way, following the modern conception of the human body and of the subject, the female reproductive body is seen as a entity separated of the subject and with a mechanical and pathological nature that the modern obstetrics should control so it can treat the real patient, the fetus. However, in parallel, a psychological discourse is being constructed in which the maternal body is seen like a place where subjectivity of the future mother and the future child are developing. The maternal body is problematic for the hegemonic modern figure of the masculine subject separated from the world, because of its reproductive potentialities and its position in front of the alterity whom is experience in an internal and a corporal way. It is then the object of a technical and a discursive reframing towards hegemony. The assisted reproduction technologies and surrogacy are examples of this reframing and of the double process of subjectification and objectification. This paper will show how the social discourses on surrogacy that suggest a vision of a flowing maternal subjectivity (intention is priority) collide with a inflexible vision of it, that is inscribed in the body.