The work focuses on the issues of the market solving the human organ shortage. The market solution faces the same criticism as the commercial surrogacy. The main purpose of the work is to evaluate the commercial surrogacy system efficiency. Within the solution of this question, the work focuses first on the analysis of the arguments against a market in human organs and consequently theise objections applies to the surrogate motherhood with emphasis on the problem of adverse selection, which from an economic point of view appears to be the most serious. In the applied part the paper tests the existence of the signs of the adverse selection in the countries where payment for the surrogacy is legal. The paper leads to the conclusions, despite some specifics of the market, this solution is efficient and the market itself creates sufficient mechanisms to prevent adverse selection

A Síndrome da Imunodeficiência Adquirida (AIDS) é doença causada pelo vírus da imunodeficiência humana. Apesar dos benefícios proporcionados pela terapia de supressão viral, algumas doenças como lipodistrofia, doenças cardiovasculares e infertilidade aumentaram a sua prevalência. No paciente com AIDS, considera-se a carga viral e o uso de terapia antirretroviral como possíveis agentes de genotoxicidade. Apesar do espermograma não poder detectar a causa precisa da infertilidade, o mesmo ainda é o exame mais realizado para averiguar a qualidade seminal. Por outro lado, a integridade do DNA do espermatozóide tem sido proposta como um parâmetro adicional de qualidade do sêmen. O ensaio cometa alcalino detecta a genotoxicidade de células germinativas humanas e pode ser usado para demonstrar a capacidade de uma substância interagir com o material genético das células gonadais. O presente estudo incluiu 50 pacientes com AIDS, atendidos no Ambulatório de Infectologia do Município de Caxias do Sul e no Ambulatório da Universidade de Caxias do Sul, sendo analisados dois grupos: usuário de terapia antirretroviral e naive. Realizou-se espermograma e o ensaio cometa alcalino, comparando com o número de linfócitos T CD4+, a carga viral, a idade, etc. Os dados demonstraram que o uso de antirretrovirais reduziu a genotoxicidade espermática, mas não se encontrou correlação com o espermograma. O presente trabalho demonstra que o ensaio cometa alcalino é um método eficiente para mensurar a genotoxicidade espermática dos pacientes portadores do vírus da imunodeficiência adquirida. / The Acquired Immune Deficiency Syndrome (AIDS) is a disease caused by the human immunodeficiency virus. Despite all the benefits provided by the viral suppression therapy, some diseases such as lipodystrophy, heart diseases and infertility increased their prevalence. In patients with AIDS, viral load and anti-retroviral therapy are possible agents for genotoxicity. The World Health Organization guidelines are reference for semen analysis and sperm DNA integrity has been proposed as an additionalparameter for semen quality and a potential predictor of fertility. The alkaline comet assay has the potential to detect genotoxic human germ cells and can be used to demonstrate the ability of a substance or metabolite to interact directly with the genetic material of gonadal cells. The study has included 50 patients with AIDS treated at the Outpatient Center for Infectious Diseases and at the University of Caxias do Sul Clinical Center, evaluated as two groups: one treated with anti-retroviral therapy and the other was a naive group. Semen and sperm genotoxicity were analysed by alkaline comet assay, comparing CD4 cell count, viral load, age and other factors of potential genotoxicity between the two groups. Data showed that the use of any anti-retroviral class has reduced sperm genotoxicity. This study shows that the alkaline comet assay is a eficcientmethod to measure sperm genotoxicity in patients infected with the human immunodeficiency virus.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-01-12T17:34:43Z No. of bitstreams: 1 nataliamachadobrito.pdf: 1118656 bytes, checksum: 57ac8f9e9647b471a806d0e2ac6b603f (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-25T17:23:39Z (GMT) No. of bitstreams: 1 nataliamachadobrito.pdf: 1118656 bytes, checksum: 57ac8f9e9647b471a806d0e2ac6b603f (MD5) / Made available in DSpace on 2016-01-25T17:23:39Z (GMT). No. of bitstreams: 1 nataliamachadobrito.pdf: 1118656 bytes, checksum: 57ac8f9e9647b471a806d0e2ac6b603f (MD5) Previous issue date: 2015-02-27 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A teoria do Medo (Angst) de Freud postula que o ego, ao perceber a ameaça de desejos inconscientes, desencadeia o afeto de medo, que por sua vez aciona o recalque, podendo, então, desencadear a formação de sintomas neuróticos, como também os somáticos. Aqui, o medo neurótico, da mesma forma que uma grave ameaça real, mantém o sistema fisiológico em funcionamento alterado caracterizando o processo de estresse crônico, que desencadeia as doenças psicossomáticas. A partir dessa premissa, suspeita-se a ISCA possa ser outro sintoma. Esta pesquisa qualitativa tem como objetivo pesquisar uma possível relação entre medo e ISCA, analisando possíveis vivências estressantes e às manifestações clínicas do medo em mulheres que fazem tratamento. A coleta de dados se deu por meio de entrevistas semiestruturada e de um diário de campo. Para análise dos dados adotou-se a Análise de Conteúdo, em específico a análise temática. A análise dos resultados evidenciou eventos estressores, anterior à decisão de engravidar e na fase do tratamento. Tais eventos foram acompanhados de sintomas somáticos e neuróticos. Pode-se inferir que a ISCA talvez possa ser uma consequência do processo de defesa psíquica, embora não seja possível desvendar este enigma, pois teríamos que entrar numa discussão de causalidade, que na verdade não diz nada quando estamos diante do inconsciente. / The Unexplained Infertility (UI) is a medical diagnosis given when there is no identified changes signals related to reproduction. But what escape of scientific knowledge when we cannot identify the infertility`s cause? This research bet that there is something of the order of fear and psychic defense that deserves more attention, since the point of view of the unconscious productions, UI might be another symptom. This qualitative research aims to investigate the relationship between fear and UI, analyzing possible stressful experiences and clinical manifestations of fear in women under treatment. The data collection was carried out through interviews semi-structured interviews and a diary. For data analysis we adopted the Content Analysis, specifically thematic analysis. The results showed stressful events preceding the decision to get pregnant and at the stage of treatment. These events were followed by somatic and neurotic symptoms. It can be inferred that the UI might be a consequence of psychic defense process, although it is not possible to unravel this puzzle, because we would have to enter into a discussion of causality, which actually says nothing when we face the unconscious.

L’infertilité masculine est actuellement considérée comme un problème majeur qui pose une situation alarmante sur la santé publique. L’oligozoospermie, l’asthénozoospermie et la tératozoospermie sont les trois anomalies les plus connues des spermatozoïdes. Elles affectent, respectivement, la densité, la motilité et la morphologie des spermatozoïdes. Un spermatozoïde anormal est très souvent corrélé à des altérations génétiques et épigénétiques qui peuvent affecter considérablement le transcriptome. Dans ce sens, le séquençage aléatoire du transcriptome entier des spermatozoïdes ou RNA-seq constitue un outil puissant pour caractériser ces maladies. Jusqu’à présent, il n’existe aucune étude exploitant des données RNA-seq chez des hommes présentant de telles anomalies spermatiques. L’objectif principal de notre étude fût d’identifier des profils distincts des modifications du transcriptome de chaque phénotype d’infertilité pour ainsi révéler des gènes-signatures qui tamponnent une spermatogenèse pathologiquePour ce faire, les transcriptomes des spermatozoïdes de 60 sujets infertiles atteints soit d’oligozoospermie, d’asthénozoospermie ou de tératozoospermie ont été comparés à ceux de 20 patients fertiles. Ces analyses supervisées nous ont conduit à identifier: (i) les gènes clés spécifiques aux différentes anomalies des spermatozoïdes (ii) les voies de signalisation associées, (ii) les différents longs ARNs non codants dérégulés dans ces anomalies. Au niveau de l’oligozoospermie, les transcrits de spermatozoïdes dérégulés étaient associées à divers stades de la spermatogenèse, y compris le cycle cellulaire méiotique, l’assemblage du complexe synaptonémal, la cohésion des chromatides sœurs, les processus métaboliques de piRNA, le processus catabolique protéique dépendant de la voie de l’ubiquitine, à la réponse aux dommages de l'ADN et particulièrement le processus de fécondation. Quant à l’asthenozoospermia, la spermatogenèse, l’assemblage du cil, des voies métaboliques reliées à la spermatogenèse, la chimiotaxie et la physiologie des cellules immunitaires ont été significativement dérégulés. De plus, ce qui nous a intéressé au plus était l’analyse des transcrits sous-exprimés qui a permis l’identification de nombreux transcrits associées aux modifications des histones. Nous avons aussi mis en évidence une sous expression des gènes différentiellement exprimés qui définit la tératozoospermie. Cette sous expression est associée au système ubiquitine-protéasome, à l’organisation du cytosquelette, au cycle cellulaire, à la SUMOylation en réponse aux dommages de l'ADN et aux protéines de réparation ainsi qu’à de nombreux modulateurs épigénétiques. Les gènes signature de l'oligozoospermie ont été liés au processus de fécondation et les composants de la matrice extracellulaire, tandis que ceux de la tératozoospermie sont liés à la spermatogenèse et la morphogenèse cellulaire, alors que les gènes signature de l'asthénozoospermie sont impliqués dans l'assemblage du ribosome et du flagelle. En complément de cette étude, nous avons réalisé une étude très globale du paysage épigénétique du sperme des hommes infertiles. Nous avons, ainsi comparé les niveaux des espèces réactives de l’oxygène (ERO), de méthylation de l’ADN, ainsi que l’intégrité de la chromatine dans les spermatozoïdes de 30 individus infertiles avec ceux de 33 individus fertiles. Nos analyses montrent des niveaux élevés d’ERO chez les individus infertiles. Ces niveaux sont d’une part négativement corrélés avec les niveaux de méthylation globale de l’ADN et d’autre part négativement corrélés avec ceux de la 5-hydroxyméthylcytosine et de la 5-formylcytosine (intermédiaire dans le processus de déméthylation active). Ces derniers suggèrent qu’une infertilité associée au stress oxydatif conditionne l’épigénome du sperme. En conclusion, l’ensemble de notre travail apporte des ressources précieuses et originales dans la compréhension des pathologies de sperme. / Male infertility is actually considered as a public alarming health problem. The sperm pathologies spectrum ranges between different phenotypes including oligozoospermia, asthenozoospermia and teratozoospermia depending on the sperm conventional parameters abnormalities. Abnormal sperm is characterized by genetic alterations and epigenetic alterations which can affect the transcriptome extensively. These alterations in RNA profiles are retrospectively indicative of aberrant spermatogenic events. RNA-seq is a powerful tool for comprehensive characterization of whole transcriptome. To date, RNA-seq analysis of sperm from infertile men has not been reported. Our objectives are: (i) recognize key clusters, key pathways and specific gene transcripts for different sperm abnormalities; (ii) catalog the spermatozoal lncRNAs in different sperm pathologies; (iii) identify signature genes which are mechanistically important in the cascade of events driving a pathological spermatogenesis; (iii) portray the global epigenetic landscape in sperm from infertile men. Expression data from 60 sperm samples from 3 groups of infertile men (oligozoospermia, asthenozoospermia, and teratozoospermia) were generated on Illumina HiSeq platform, compared to 20 fertiles, and the resulting gene expression patterns were analyzed for functional enrichment. Our supervised analyses identified numerous differentially expressed genes between fertile and infertile men. In oligozoospermia, the deregulated spermatozoal transcripts were associated with various stages of spermatogenesis including meiotic cell cycle, synaptonemal complex assembly, sister chromatid cohesion, piRNA metabolic process, ubiquitin-dependent protein catabolic process, cellular response to DNA damage stimulus and interestingly fertilization. As for asthenozoospermia, spermatogenesis, cilium assembly, metabolic-related pathways, chemotaxis and immune cell physiology were most significantly differentially expressed. Interestingly, numerous transcripts associated with histone modifications were highly down-regulated. With regards to teratozoospermia, we evidenced sperm-specific differentially expressed genes which are involved in the ubiquitin-proteasome, cytoskeleton organization, the cell cycle pathway, SUMOylation of DNA damage response and repair proteins, as well as many putative epigenetic modulators of gene expression.. We also attempted to identify distinct patterns of gene expression changes that were definite to the different abnormal sperm phenotypes in infertile men relative to controls. Signature genes of oligozoospermia were over-enriched by genes involved in fertilization and extracellular matrix components, while signature genes of teratozoospermia were enriched by genes involved in spermatogenesis and cellular components involved in morphogenesis, whilst signature genes of asthenozoospermia were enriched by genes implicated in ribosome and cilium assembly.We complemented this work by a parallel epigenetic analysis of the global epigenetic landscape in infertile men. We compared the levels of reactive oxygen species (ROS), DNA integrity and global epigenetic parameters in sperm from 33 infertile subjects with abnormal semen parameters compared to fertile individuals. We pointed out that infertile men are characterized by strikingly high levels of reactive oxygen species (ROS) which were in part negatively correlated with the global DNA methylation, and positively correlated with the levels of 5-hydroxymethylcytosine and 5-formylcytosine (active demethylation intermediates). These findings suggest that male infertility associated with oxidative stress shapes the sperm epigenetic landscape. In summary, this original work yielded a transcriptional portrait of sperm abnormalities and provided valuable resources that would further elucidate sperm pathologies.

<div>Reproductive efficiency in sows and boars affects the profitability of swine production systems. However, breeding stock selection is primarily based on progeny performance traits such as feed efficiency, growth rate, carcass characteristics, physical appearance, and structure, especially for terminal sire lines, with less emphasis on reproduction. While maternal sire lines are co-selected for reproductive traits including birth litter size, number weaned, weaning weight, and wean to estrus interval, currently, there is no single test predictive of fertility, and thus subfertile males and sub-fertile or even infertile females enter the swine breeding herds (Oh et al., 2006b; Safranski, 2008). Thus, to maximize economic returns and swine production efficiency there is a need for a biomarker to identify boars and gilts with the greatest reproductive potential before admittance into the breeding herd. The overall aim of the described studies was to determine if biomarkers of fertility of boars and gilts could be identified in biological samples taken prior to or just after animals entering the breeding herds using high throughput omic screening tools resulting from recent advancements in mass spectrometry.</div><div>Current semen evaluation techniques only identify boars with fertility issues associated with sperm motility, morphology, and concentration. We know that seminal plasma proteins are essential for proper sperm function and play an important role in fertilization. Therefore, we hypothesized that fertility differences could be reflected in the seminal plasma proteome profiles. A fertility index was created from 110 boars with data on total born and farrowing rate following 50 single-sired matings. Thirty-two of the 110 boars were identified as having extreme phenotypes for total born and farrowing rate and were categorized into one of the following: high farrowing rate and high total born (HFHB; n=9), high farrowing rate with low total born (HFLB; n=10), low farrowing rate and low total born (LFLB; n=9), and low farrowing rate with high total born (LFHB; n=4). The seminal plasma proteins were isolated and measured using label-free liquid chromatography-tandem mass spectrometry (LC-MS/MS). There were 436 proteins measured in at least one sample across all animals, with 245 proteins considered for analysis (detected in samples of at least n=3 animals/phenotype). Of the 245 proteins, 56 were differentially abundant (P < 0.05) between the high fertility phenotype (HFHB) and at least one of the three subfertile groups. Proteins previously associated with fertility such as Porcine seminal protein I (PSP-I) and epididymis-specific alpha-mannosidase (MAN2B2) and free radical detoxification such as superoxide dismutase 1 (SOD1), peroxiredoxin 4 (PRDX4), and glutathione peroxidase 6 (GPX6) were more abundant in HFHB. Subfertile phenotypes had a greater abundance of blood microparticle proteins, biomarkers of inflammation, and lower inositol-1-monophosphatase (IMPA1), which regulates inositol production. Findings supported that seminal plasma protein profiles were distinct between boars with different fertility phenotypes and have the potential to predict boar reproductive performance.</div><div>The selection of replacement females for the sow herd is one of the most important facets in sow system management. However, selection of gilts for sow herd replacements is primarily based on how the animal appears such as feet and leg confirmation, the gilt’s underline, and parent past performance. This practice resulted in a high degree of variation in sow reproductive performance traits such as pigs per sow per year (PSY) and increased culling rates due to reproductive failure. In female swine, perinatal nutritional environment has been associated with their long-term fertility. The vaginal lipidome of 2 day and 14 day old gilts was found reflective of nutrition source, which suggests that perinatal nutrition affects the composition of reproductive tissues. Thus, it was hypothesized that the vaginal lipidome profiles of gilts at weaning would be reflective of fertility later in life. The first study aimed to find potential on-farm biomarkers that technicians could use to make selection decisions. Variables chosen as potential biomarkers have potential to influence or predict long-term fertility. Data were prospectively collected from 2146 gilts born on a commercial sow production facility and included birth and weaning weights, vulva length and width at 21 d postnatal (PN), birth and nursing litter size, days nursed, average daily gain from birth to weaning, and age at first estrus. Of the initial animals, 400 (17%) were selected for the sow herd, 353 remained after removing animals culled for non-reproductive reasons. Animals were assigned to 1 of 5 reproductive performance categories based on observation of estrus or pigs per sow per year (PSY) across two farrowings: High Fertility (HF; 23%; n=82; ≥26 PSY), Middle Fertility (MF2; 12%; n=43; 20-25 PSY), Low Fertility (MF3; 15%; n=54; <20 PSY), Infertile-Estrus (IFe; 10%; n= 36; estrus, no pregnancy), and Infertile-No Estrus (IFno; 39%; n=138; no estrus, no pregnancy). Generalized linear model analysis indicated vulva width (P=0.03) was related to PSY, however, it only explained 1.5% of the total variation in PSY. To determine if preweaning variables were predictive of gilt fertility outcome, animals were grouped as those that became pregnant (n=179) or not (n=174). Vulva width tended to be greater in fertile animals versus infertile (P=0.07). Binomial regression analysis revealed a positive relationship between vulva width and gilt fertility; however, this relationship is not strong enough to make sow herd selection decisions.</div><div>Because gilts are so phenotypically similar at weaning, we hypothesized that the biomarker predictive of fertility at this stage of selection might need a more sensitive means of detection. Therefore, we evaluated the vaginal lipid profiles from a subset of animals enrolled in the previous study that were the extremes of fertility phenotype: High Fertility (HF; n=28; ≥26 PSY) and Infertile (IF; n=34; no estrus, no pregnancy). Vaginal swabs of the anterior vagina were taken at 21 ± 4 d PN. Lipids were extracted from cellular material collected with swabs and analyzed using multiple reaction monitoring (MRM) profiling for lipidome analysis. Relative abundance of arachidonic acid (ARA, C20:4) and docosahexaenoic acid (DHA, C22:6) were lower (P<0.05) in IF gilts than HF gilts, whereas abundance of the free fatty acids cerotic (C26:0), ximenic (C26:1), and nonadecanoic (C19:0) acids were greater (P<0.05) in IF gilts. Additionally, eicosapentaenoic acid (C20:5), a precursor of prostaglandins, was also higher (P<0.05) in IF gilts.</div><div> Previous studies support that higher levels of arachidonic acid in vaginal lipidomes maybe a biomarker of colostrum intake, and thus provides further evidence for a relationship between fertility and the perinatal nutritional environment. The perspective of having a panel of lipids captured with vaginal swabs at weaning that can predict the reproductive efficiency of gilts shows promise and warrants future research in this area. Taken together, the experiments described above demonstrate that detection of infertile and subfertile animals before entering the breeding herd is possible and warrants further development and validation of diagnostic panels capable of doing so. </div><div><br></div>

Bakgrund: Polycystiskt ovariesyndrom (PCOS) är en endokrin rubbning och reproduktionsstörning med ärftliga komponenter som drabbar omkring 10 procent av alla kvinnor. Syftet med denna uppsats var att få en forskningsöverblick över vilken betydelse AMH (Anti- Müllerskt hormon) har som klinisk markör vid in vitro-behandling hos kvinnor med PCOS. AMH är en viktig regulator i follikelbildning i ovarierna och det finns en välkänd korrelation mellan nivån av AMH och antal antrala folliklar. Metod: Metoden som använts i denna uppsats är en forskningsöversikt. Relevanta artiklar söktes genom att använda Pub Med. Sökningen begränsades till kliniska studier relevanta för studiens syfte och frågeställning och som publicerats under de senaste 5 åren. Resultatet blev 29 artiklar. Av dessa valdes 5 kliniska studier ut baserat på relevansen till syftet med studien samt frågeställningen. Studierna var av olika studiemetodik. Studiernas fokus låg på forskning kring AMH som klinisk markör samt dess inverkan vid fertiliteten hos kvinnor med och utan PCOS. Resultat: Studierna visade enhetligt att koncentrationen av AMH i follikelvätskan samt serum är betydligt högre i kvinnor med PCOS jämfört med kvinnor med normala endokrina parametrar. Resultatet av studierna visade också att AMH har betydelse vid valet av dominerande follikel samt att AMH-serum och antalet befruktade oocyter i IVM (in vitro-mognad) var oberoende prediktiva faktorer för levande födslar. Resultatet visade också att AMH kunde användas för att förutsäga klinisk graviditet men att den inte var en stark indikator för det. Slutsats: Intrafollikulär produktion av AMH har en betydande roll i de parametrar som styr den follikulära miljön när det gäller follikeldifferentiering, utveckling samt urval vid in vitro-behandlingar. Höga nivåer av AMH i follikelvätskan och även i serum hos kvinnor med PCOS kan visa på en positiv follikelmognad samt vara en markör för stimulansrespons. Slutsatsen är att studierna visar att AMH är en betydande klinisk markör som kan användas vid in vitro-behandlingar hos kvinnor med PCOS. / Background: Polycystic ovary syndrome (PCOS) is a genetic predisposition that is the leading cause of infertility and affects about 10 % of all women. The purpose of this essay was to get a research overview of the importance of AMH (Anti-Müllerian hormone) as a clinical marker in in-vitro treatments in women with PCOS. AMH is an important regulator of folliculogenesis in the ovaries and there is a well-known correlation between the level of AMH and number of antral follicles Method: The method used in this study was a research overview. Relevant articles were searched using PubMed. The search was limited to clinical studies with a focus related to the aim of the present study and published within the past five years. The result was 29 articles. Of these 5 clinical studies were selected based on the relevance to the aims of this study. The studies were of different study methodology. The focus of the studies was on research on AMH as a clinical marker and its effect on fertility in women with and without PCOS. Results: The studies showed a consistent result in that the AMH concentration in the follicle fluid and serum is significantly higher in women with PCOS compared to women with normal endocrine parameters. The results of the studies also showed that AMH is important in the choice of dominant follicles and that AMH serum and the number of fertilized oocytes in IVM (in vitro-maturation) are independent predictive factors for live births. The results also showed that AMH could be used to predict clinical pregnancy but was not a strong indicator of it. Conclusion: Intra follicular production of AMH has a significant role in the parameters that control the follicular environment in terms of follicle differentiation, development, and selection in in vitro treatments. High levels of AMH in the follicle fluid and in serum of women with PCOS may indicate a positive follicle maturation, The conclusion is that the studies showed that AMH is a significant clinical marker that can be applied to in vitro treatments in women with PCOS.

No description available.

This thesis describes relatively new method of assisted reproduction. Uterus transplantation is viewed from feminist perspective, and its potential benefits and risks in wider ethical and social contexts on theoretical level are being considered. It reveals how womanhood and motherhood are constructed in different discourses in context of uterine transplantation through critical reading and thinking. By using of critical discourse analysis I focus on texts produced on this subject in the popular and professional discourse and reveal what kind of gender stereotypes and constructs they are using to support their arguments. These areas of our everyday lives have great power in society and influence the way we perceive and construct reality and thus participate in its creation. Key words: Uterus transplantation, infertility, motherhood, reproductive technology, gender roles

Bakgrund: Ofrivillig barnlöshet drabbar omkring 15% av kvinnorna som försöker skaffa barn, i Sverige. Ungefär en tredjedel av de 15% är helt infertila. Utredningar visar att problemet i cirka var tredje fall ligger hos kvinnan, i var tredje fall hos mannen. I den återstående tredjedel av fallen går det inte att fastställa vad infertiliteten beror på. Att leva med ofrivillig barnlöshet kan ge psykiska och fysiska hälsokonsekvenser. Syfte: Syftet var att beskriva kvinnans upplevelser av att leva med ofrivillig barnlöshet. Metod: Metoden som användes var en litteraturöversikt där tio vetenskapliga artiklar av kvalitativ metod analyserades enligt Fribergs metod. Sökningar genomfördes i databaserna CINAHL Complete och Pubmed. Resultat: I resultatet presenteras tre huvudkategorier: Sociala och samhällsmässigaupplevelser av ofrivillig barnlöshet, känsla av lidande och kulturell skillnad i upplevelser av ofrivillig barnlöshet med sex underkategorier: Stigmatisering, samhällets förväntningar och social press, social status och isolering, otillräcklighet och förnedring, psykisk påverkan, religiös och kulturell påverkan på upplevelsen. Det framkommer i resultatet att ofrivillig barnlöshet kan bidra till psykiskt lidande. Slutsats: Kvinnans upplevelser av infertilitet speglas främst genom en brist i livslust med följder som social, emotionell och psykisk påverkan. I arbetet har författarna fångat upp den bristande vården kring att behandla och hjälpa dessa kvinnor med stöd. / Background: Involuntary childlessness affects about 15 % of women that are trying toget pregnant in Sweden. About a third of the 15% are completely infertile. Investigations show that in about every third case the problem lies with the woman, in every third case with the man. In the remaining third of the cases, it is not possible to determine what the infertility is due to. Living with involuntary childlessness can have psychological and physical health consequences. Aim: The aim of this study was to describe the women’s experiences of living with involuntary childlessness. Method: The method is a literature review where ten scientific articles of qualitative method were analyzed by Friberg’s method. The searchings were made in CINAHL Complete and Pubmed. Results: The result is presented in three main categories: Social and societal experiences of involuntary childlessness, feeling of suffering and culturaldifference in experiences of involuntary childlessness with six subcategories: Stigmatization, society's expectations and social pressure, social status and isolation, inadequacy and humiliation, psychological influence, religious and cultural influence on the experience. It appears in the results that involuntary childlessness can contribute to mental suffering. Conclusion: The women's experiences of infertility are mainly reflected in a lack of zest for life with consequences such as social, emotional and psychological impact. In their work, the authors have captured the lack of care around treating and helping these women with support.

Bakgrund: Infertilitet är ett globalt hälsoproblem som uppstår när paret inte blivit gravida efter 12 månader eller mer efter regelbundet oskyddat samlag. Hos män kan det bero på olika saker som till exempel nedsatt spermieproduktion, hormonella störningar och medicinska behandlingar. Det har mest fokuserats på kvinnor gällande den reproduktiva hälsan. Syfte: Syftet med studien var att belysa mäns upplevelser av infertilitet. Metod: En systematisk litteraturstudie med kvalitativ ansats där 11 vetenskapliga artiklar användes till resultatet och kodades ner till huvudkategorier och underkategorier. Resultat: Resultatet visade att infertilitet var livsomfattande och hade en stor påverkan på livet. Psykiska problem som depression, suicidtankar och att känna sig odugliga var några av problemen. För att vara stöttande till sin partner under IVF behandlingen gömde männen sina känslor och präglades av skam och skuldkänslor. Även brist på kunskap, låg självkänsla och stress bland männen påvisades i resultatet. Konklusion: Män lider av infertilitet och behöver stöttning. Mer kunskap behövs för att kunna erbjuda männen stöd och hjälp. / Background: Infertility is a global health issue and can be seen when the couple does not become pregnant after 12 months or more after having regular unprotected intercourse. It can depend on different things for example reduced sperm production, hormonal disordes and medical treatments. It has been more focused on the women and their reproductive health. Aim: The purpose of the study was to shed light on men's experiences of infertility. Method: A systematic literature study that was based on 11 articles. The articles were used for the result and coded down to main categoryand subcategories. Results: The result showed that infertility had a great impact on life. Problem with mental health like depression, suicidal thoughts and the feeling of being incompetent was some of the problems. To be supportive of their partner during IVF treatment, the men hid their feelings and felt shame and guilt. Lack of knowledge, low self-esteem and stress among men were also demonstrated in the results. Conclusion: Men suffer from infertility and need support. More knowledge is needed to be able to offer men help and support.